A Nod to Nausea

It seems counterintuitive, but researchers keep finding reasons to give morning sickness a high-five. The nausea and vomiting of pregnancy correlate with lower risks for miscarriage and, later in life, breast cancer. And in one recent study, the offspring of moms who had morning sickness scored higher on IQ tests. "Morning sickness indicates that proper hormones are being made by mom and baby, that the baby's growing and developing," says Laura Riley, M.D., a fetal/maternal medicine specialist at Massachusetts General Hospital in Boston. "I see it as a good sign."

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That cheery news probably won't make your nausea easier to bear, but if you feel like hurling, you're in good company. Up to 85 percent of moms-to-be experience nausea; about half report vomiting. Symptoms typically start four to eight weeks after conception and begin to fade as the second trimester approaches, though every case has its own idiosyncrasies. "I was surprised that my 'morning' sickness was worse at night," remembers Wilson Diehl, 34, a Seattle-based writer who says she "felt carsick all the time." A few women are queasy the whole nine months.

Keeping it down. Certain smells or foods can set off symptoms, and sufferers often intuitively avoid those triggers. When that's not enough to manage a mild case, Riley suggests such traditional remedies as soda crackers upon arising, frequent but small meals, ginger (candied ginger and ginger ale are favorites, or 250 milligrams of powdered ginger), ice chips and lemonade. "Cold, slushy drinks like Italian ices are good," she says. Experts also advise pairing vitamin B6 with doxylamine, an over-the-counter antihistamine. Ask your doctor about the recommended proportions.

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Some women cope by restricting their diets to simple carbohydrates, such as mashed potatoes or bread; others find relief from acupuncture or motion sickness wristbands, like the Sea-Band. Diehl says the only time she wasn't nauseated was while eating, so she downed bowl after bowl of cereal and milk. "I tried to focus on the notion that being nauseous probably meant I was having a healthy pregnancy," she says. "That helped, like, 0.002 percent."

Whatever you do, don't try to tough it out. When symptoms intensify, treatment becomes more difficult. Call your doctor if home remedies don't work, you can't keep food or fluids down or symptoms continue past the fourth month. "You don't want to get dehydrated or lose too much weight," Riley warns. While it's not unusual for women with significant morning sickness to drop a few pounds in the first trimester, a severe case, when left untreated, can cause a 10-percent loss in body weight. Many women hesitate to take drugs during pregnancy, but the medications your doctor will prescribe are safe and effective. They can help prevent the condition from progressing to the point that it requires intravenous hydration or even a feeding tube.

Diehl's vomiting responded well to prescription anti-nausea medications, though she still felt queasy until week 20 of her pregnancy. "When the morning sickness stopped, I felt like I'd gotten my life back," she says. "And I immediately went out for Ethiopian food."

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Who gets the sickest? Severe morning sickness, or hyperemesis gravidarum, afflicts 0.5 percent to 2 percent of pregnant women and requires medical treatment. At higher risk are women who are carrying multiples or had hyperemesis in a previous pregnancy. Being pregnant with a female fetus also raises the risk, as does having a mother or sister who suffered from the condition.