hi everyone welcome back it's week seven in our 40 week pregnancy journey
and this week we're talking all about the dreaded nausea and vomiting of
pregnancy and hopefully some tips to help you make
it through in addition to that we'll be covering updates from our own
pregnancy as part of our in real life discussions and giving you updates on
what's happening with your baby's development to this point
so just in case you haven't met us before i'm kurt i'm a pediatrician
i'm sarah and i'm an ob gyn and we are the doctors bjorkman
welcome back everyone in case you missed last week's episode we talked all about
choosing where to give birth and also how to choose your ob
provider so hopefully this helped as you're making some of these decisions
for yourself and maybe you've even had your own very
first confirmation or pregnancy visit since we talked last week
if you missed any of those details of that conversation go back and check it
out so as we said this is week seven and
we're talking all about the nausea and vomiting of pregnancy
and all of the pro tips that we have to hopefully
keep this common side effect of pregnancy to a minimum
but before we get into that here are some updates on your baby's development
it's week seven and baby is the size of a blueberry
the arm buds and leg buds continue to grow the heart keeps on beating
and baby is now even developing eyes and ears
so while amazing things are happening with your baby
you might not be feeling so amazing yourself 70 to 85 percent of women
experience some kind of nausea vomiting in
pregnancy and it can really make your life pretty miserable most
women experience start to experiences symptoms between week four
and nine of pregnancy and the good news is that for
almost all women they have resolved by week 16
or so it is important to remember that if you're experiencing these
symptoms early treatment can help prevent the progression to a more severe
form of nausea and vomiting of pregnancy called hyperemesis gravidarum
and there are things you can do from lifestyle modifications as well as
medications that can help make this more manageable
and so almost all women who experience nausea and vomiting in pregnancy
start to feel these symptoms before week 9 of pregnancy
so if you start to feel nausea and vomiting for the very first time
after week 9 this would be abnormal and a reason to look into other things that
could be causing these symptoms important things that would go along
with non-normal nausea and vomiting and pregnancy would be things like fever
chills severe abdominal pains or headache if you're experiencing any of
these with nausea and vomiting for the first time after week nine
please go talk to your ob provider so let's start a discussion about nausea
and vomiting and pregnancy with a little bit about what causes it
so the exact causes of the nausea and vomiting in the first trimester of
pregnancy are not exactly understood there is a thought
that those rising hormone levels are contributing
to your symptoms and that theory is kind of supported by studies
that show women with really elevated levels of estrogen are
more likely to have symptoms and decreased levels of estrogen have less
symptoms it's also consistent with women who in
the past have taken birth control pills with estrogen
and have some nausea when they take those those women are also
more likely to have nausea and vomiting of pregnancy it's really interesting
um there's also some thought that this nausea and vomiting that you experience
during pregnancy is protected for you and baby yeah so if
you think about it this way the time in which you're most likely to
have this nausea and vomiting is in the first trimester
this is also the time when baby is developing organs and
is most vulnerable to insult so the fact that you're having nausea and vomiting
is going to make you a little bit more selective over the foods and what you
put into your body that's protecting you and baby at this
time this may also explain some of your increased sense of smell and your
specific food aversions that is your body's way of protecting
you and baby something important for us to
mention here is hyperemesis gravidarum so hyperemesis
is severe nausea that leads to persistent vomiting
that isn't caused by some other medical condition
with hyperemesis there are signs of starvation like ketones in your urine
and a minimum of a five percent of pre-pregnancy weight loss
you may have signs of thyroid liver or electrolyte
abnormalities and this is really representing the severe
end of the spectrum of nausea and vomiting in pregnancy and
only affects up to about two percent of pregnancies
interestingly nausea and vomiting of pregnancy is the
most common thing women are hospitalized for in the first trimester
and the second most common thing women are hospitalized for
in their whole pregnancy so if your nausea and vomiting is so severe
these are reasons to call your doctor if you haven't been able to keep anything
down for 24 hours if you notice that your lips your tongue
or your skin is dry if you aren't peeing as much as normal
or you've lost more than five pounds in one to two weeks
definitely get in touch with your ob provider when a woman cannot tolerate
liquids without vomiting and is not responding to outpatient management
it is going to be recommended that you go in for evaluation and possible
treatment of dehydration and electrolyte imbalances some specific
risk factors for nausea and vomiting include things like increased placental
mass so this would be like multiple pregnancies
like twins triplets etc or a molar pregnancy
also if you have a history of migraine headaches history of motion sickness
if you have a family history of hyperemesis in mom or sister
or if you have a personal history of hyperemesis another interesting fact is
that you're at an increased risk for hyperemesis
if you're carrying a female fetus so one of the questions i get from moms all the
time is does all of this nausea and vomiting
harm my baby and the short answer is usually no mild
to moderate amount of vomiting has little effect on pregnancy outcome
in fact there are some studies to suggest that pregnancies that have
nausea and vomiting or even hyperemesis have lower rates of miscarriage this
potentially suggests a robust and healthy response of the placental
hormones that we believe are related to the nausea and vomiting in the first
place yeah also no studies have shown an
association between hyperemesis and congenital anomalies
and while some studies show a slightly increased risk of a low birth weight
infant some studies do not demonstrate this
effect so with all of this the next obvious
question becomes what can you do to limit these symptoms of nausea and
vomiting in pregnancy and so for this we're going to group
these things that you could do into two categories the first being lifestyle
modifications and the second being medications so
let's start with lifestyle modifications eating small frequent meals seems to be
the key to keeping nausea at bay trying to eat every one to two hours to
avoid a full stomach as well as to avoid an empty stomach
seems to really be the key you're going to want to try to avoid
eating spicy or fatty foods and try eating dry bland foods high
protein snacks or even eating some crackers in the
morning before you get out of bed yeah interestingly enough there's a
small study that showed meals high in protein are better at alleviating
symptoms more so than meals high in carbohydrates
or fats some other things you can do is make
sure you're well rested as much as you can
and then also avoiding things that you think could be your trigger
common things could be noise heat humidity
or even flickering lights other things you can try to reduce symptoms include
ginger or peppermint some studies have shown that
ginger in its variety of forms can help to reduce
nausea but the studies don't really show that it helps at all with vomiting
yeah and so sucking on peppermint or sipping mint tea may be helpful for you
other women have found that smelling these scents can be helpful so
you could try putting mint oil in a diffuser
another non-medical option that has been studied
is acupressure and so some women find helpful to have
wristbands that apply pressure to help with the nausea
the data for that isn't great some find it helpful yeah
interestingly enough there are some studies that have shown that women who
have taken prenatal vitamins are less likely to have significant knowledge in
vomiting pregnancy i know we keep hammering the point about
prenatal vitamins but this is just one more reason why it's great to be taking
them but on that note um sometimes prenatal
vitamins that contain iron can be irritating and cause some
nausea so if you are finding that's happening to you you
may want to try a prenatal vitamin without iron or just take a folic acid
supplement for a little while so overall i'm feeling pretty good i
noticed that sometimes at night actually i get this like almost nausea
feeling and so i eat like a salty snack and it
goes away um my favorite this week was pringles
which i probably haven't had since middle school so that was funny
um i definitely thought the carby snack actually helped more than
the protein snack despite what the studies show
um and i definitely found i'm way more sensitive to heat
like if i get really hot my stomach starts feeling kind of icky
so i've just been sure to avoid that this brings us to medical management of
nausea and vomiting and pregnancy if you made it to this point where your
lifestyle modifications haven't helped you please
please by all means consult your ob provider as we've mentioned before
early treatment of nausea and vomiting of pregnancy is recommended to prevent
progression to hyperemesis randomized control trials have shown
that women who have a history of severe nausea and
vomiting of pregnancy in a prior gestation
actually do better in their next pregnancy when they initiate
anti-nausea therapy before the onset of their symptoms
when you compared it to women who waited to start those anti-nausea meds until
they had symptoms so in other words if you're having
significant nausea and vomiting don't wait to treat
treatment and so that first line of treatment is actually vitamin b6 or
pyridoxine and this can be given with or without doxalamine
this combination has been shown to be safe and effective for moms
and also on multiple epidemiologic studies has been shown to be safe for
baby definitely there are other medications
like zofran reglan compazine and antihistamines and
these can be given iv or dissolve under your tongue or even
can be given as a rectal suppository and they can significantly help your nausea
and vomiting that being said they do have some
different side effects so you're going to want to talk with your ob
provider about your personal medical history to decide which one is best for
you and specifically reglan compazine and
antihistamines have been shown to have no
increased risk for birth defects in baby in zofran itself there's been a couple
studies that have shown a small increased risk of birth defects
having said that other studies have shown no increased risk and that the
absolute risk is quite low correct remember that all of these
medications do have some maternal side effects
so you want to talk with your ob provider about what they those are and
which one is going to be best for you and how to manage those so
i feel like i've been pretty fortunate in that i have been
able to get away with some little lifestyle modifications
um but i have had friends who are also ob gyns who've just been miserable sick
and have had to try some of these other things uh the ginger not so helpful
essential oils not so helpful the zofran is what saved them
and so don't hesitate to talk to your ob about
what options are out there and what is safe because you don't have to be
miserable during your pregnancy so to sum everything up
from this week's episode the keys to success seem to be stay
ahead of your nausea with small frequent meals
definitely rest and avoid anything that makes your stomach feel
icky like heat or strong smells and if your lifestyle modifications aren't
cutting it don't delay talking to your ob provider
about medications or other options that could help absolutely
so that's a wrap on week seven we hope you enjoyed
please click subscribe to our channel leave a comment or a question below
and we'll see you back next week bye guys
we're doctors but not your doctors anything we've said in this video is for
education or entertainment purposes only it is not medical advice
any specific medical questions you have should be directed to your provider