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The Why's of...'Morning Sickness'

50%-90% of pregnant women experience symptoms of ‘morning sickness’ in the early months of pregnancy.  These symptoms can range from mild intolerance to certain odors or food, to more significant, daily nausea and vomiting (N/V).  Studies suggest that up to 25% of pregnant women experience nausea, 50% experience both nausea and vomiting, leaving only 25% of pregnant women unaffected.  In those affected, the symptoms usually manifest by the 9th week of pregnancy.

 

Much is written and discussed about home/medical remedies for morning sickness, but much less is written/discussed about the (possible) causes for nausea and vomiting in pregnancy (NVP).  Though the cause of NVP has not been proven, it has been postulated that NVP is an innate mechanism, presenting as a ‘protection’ for the developing fetus (an inherent ‘aversion’ to substances that could be harmful to the fetus.)  Leading medical theories consider the adverse reaction of the ‘hormones of pregnancy’ as potentially causative (in the absence of other intestinal or medical problems that could present with N/V.)

The pregnancy hormones HCG and estradiol have been found to have an association with NVP.  Estrogen, in the combined oral contraceptive pills, has been known to have the potential for causing N/V, especially in higher doses.  Women having experienced N/V after estrogen exposure, may be more likely to experience NVP.  The symptoms of NVP generally peak around the 8-12th week of pregnancy, resolving for most women by the 20th week.  This pattern of ‘symptom peak’ also follows the pattern of pregnancy hormones, peaking around the 10-12th week, and declining in the subsequent weeks of pregnancy.

 

These hormones of pregnancy may cause a slowing of intestinal motility, allowing for a build-up of ‘stomach acids’, decreased intestinal digestion, and subsequent constipation, nausea and vomiting.  One of the initial measures in treating NVP is a dietary change, involving taking in small, but frequent meals (possibly improving intestinal motility.)

 

Speak with your healthcare provider if you’re experiencing NVP.  Here’s a link with ACOG recommended treatment options:

http://www.medscape.org/viewarticle/730520

 

 

Suzanne Hall, MD (@drsuzyyhall)

Eastside Gynecology Obstetrics, PC (Grosse Pointe, Roseville, Macomb, Rochester, MI)

http://facebook.com/find.drsuzyyhall

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