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Managing Nausea During Pregnancy

Me & My OBGMay 17, 2015Articles

I’m an Ob/Gyn. I’m pregnant. I am nauseous.

I am now experiencing exactly what I have been telling my patients is normal for years. It’s karma. I am also thinking of this as a kind of blessing because I’m thinking about the advice I’ve been giving in a whole new way. The biggest insight I’ve had is there are so many simple lifestyle changes that help. I have been lucky and have not required much medication to make this tolerable and found that the following things really improved my ability to get through the day without being completely miserable.

    • nauseaAvoiding constipation – Yes, it is not socially graceful to talk about but above all things this is the biggest help for me. Whenever I get behind in my bowel regimen, I feel overly full, my reflux symptoms get much worse, I experience gas cramps and am overall miserable. The regimen that has worked for me was colace 100mg twice a day (aka docusate, available anywhere over the counter for about $4-7 for 1 month supply), metamucil one glass every evening (aka psyllium husk, over the counter $15-20/ 2 months supply), plenty of water and a high fiber diet. When I am really nauseous, a high fiber home-made fruit/vegetable smoothies is perfect because it is easy on my stomach.
    • Eating frequent small meals – This is age-old advice that really makes a world of difference. Even if I start to get nauseous, just putting something in my stomach helps settle my stomach. I have found that having an empty stomach has led to a vicious cycle of increasing nausea which makes me not want to eat which makes me more nauseous and so on and so on. I make sure I always have snacks with me and I recently found out that I can bring food into places where food is usually restricted due to my ‘medical condition’. Haha! I thought I would have to sneak my peanuts into the Capitol on my recent trip to DC but the kind National Guardsman told me I could keep it because I am pregnant. Win.
    • B6 – ACOG recommends taking Vitamin B6 10-25mg three to four times a day which has been shown in multiple well designed studies to improve nausea and vomiting. I can personally attest that taking this prophylactically every day does help a lot and I recommend it to all of my friends and patients.
    • Ginger Candies or Tea – It helps that I loved all things ginger before pregnancy as well, so I am constantly sucking on ginger candies with delight. I think this helped for two reasons: I am constantly eating something and there are some good studies that show that ginger has some inherent properties that specifically help with pregnancy related nausea/vomiting. Plus they’re yummy.

By the time this is going to be posted, I will be (hopefully) be feeling much better and getting into my second trimester. For those of you who are not there yet, I hope these tips help with techniques you can do at home on your own. Remember though, sometimes lifestyle modifications are not enough, and you may need to supplement with medications. I took some medications to get me through the roughest few weeks. Talk to your doctor if you are struggling with nausea and vomiting of pregnancy and I hope together you can come up with a regimen that works for you.

Dr. Marian Steininger is a resident physician at the University of Texas Southwestern Medical Center, Dallas, TX in the Department of Obstetrics and Gynecology. Dr. Steininger currently serves at the District XI Junior Fellow Advisory Council Secretary/Treasurer.

Reference: ACOG Practice Bulletin Number 52, Nausea and Vomiting of Pregnancy, April 2004 (Reaffirmed 2013).

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