With Mother’s Day celebrated this year in March here’s a quick guide to a health problem that affects up to half of all pregnant women: morning sickness Nausea and vomiting in pregnancy –also known as morning sickness –is very common in early pregnancy. According to the NHS, around half of all pregnant women experience it, while around three in 10 women are affected by nausea without vomiting. The name morning sickness, however, is misleading, since the symptoms don’t just affect you during the early party of the day (they can happen at any time). Experts aren’t sure why some women are affected while others have no symptoms at all. But according to the charity Pregnancy Sickness Support, it’s thought that nausea and vomiting in pregnancy is caused by hormones produced by the placenta. There is some evidence of a link between the pregnancy hormone Human Chorionic Gonadotrophin (hCG) and the symptoms of nausea and vomiting in pregnancy. For instance, experts have discovered that women who are carrying twins have a high blood level of hCG, and twin pregnancies are generally associated with increased nausea and vomiting in pregnancy. The good news is that the symptoms of nausea and vomiting often ease as your pregnancy progresses. And for nine out of 10 women, by the third month of pregnancy the symptoms have all but disappeared. Most importantly, nausea and vomiting in pregnancy won’t cause any harm to your baby. Coping tips Luckily there are ways of keeping morning sickness at bay. Here’s some of the advice offered by the NHS to help reduce pregnancy sickness symptoms: Get plenty of rest because tiredness can make nausea worse If you feel sick first thing in the morning, give yourself time to get up slowly, and if possible, eat something like dry toast or a plain biscuit before you get up Drink plenty of fluids, such as water, and sip them little and often rather than in large amounts as this may help prevent vomiting Eat small, frequent meals that are high in carbohydrate (such as bread, rice and pasta) and low in fat (most women can manage savoury foods, such as toast, crackers and crispbread, better than sweet or spicy foods) Eat small amounts of food often rather than several large meals, but don’t stop eating Eat cold meals rather than hot ones because they don’t give off the smell that hot meals often do, which may make you feel sick Avoid foods or smells that make you feel sick Avoid drinks that are cold, sharp or sweet Ask the people close to you for extra support and help (it helps if someone else can cook but if this isn’t possible, go for bland, non-greasy foods, such as baked potatoes or pasta, which are simple to prepare) Distract yourself as much as you can asoften the nausea gets worse the more you think about it Wear comfortable clothes without tight waistbands Anti-nausea remedies There are some remedies you could try to relieve your symptoms, such as ginger supplements and products. Note, however, that these are unlicensed as remedies for nausea and vomiting in pregnancy here in the UK, but there is some evidence that they may help reduce the symptoms. Ask the pharmacist to recommend a ginger supplement that’s safe to take during pregnancy. You could also try ginger biscuits or ginger ale, as some women find these help. Another product your pharmacist may be able to supply is an acupressure wristband designed to reduce the symptoms of nausea. Some experts believe these wristbands trigger the release of chemicals in the brain that help to reduce nausea and vomiting. To date, there haven’t been any reports of serious adverse effects while using an acupressure wristband during pregnancy, but they may cause numbness, pain or swelling in your hands. Other pregnancy-safe remedies include teas such as peppermint, lemon balm or small amounts of chamomile tea. Aromatherapy oils such as peppermint, spearmint, lemon, lime and ginger may also help relieve your nausea, but in some women the smell of the oils may make their symptoms worse. Always talk to your GP, midwife or pharmacist before taking any supplements, herbal remedies (including teas) or using aromatherapy oils during pregnancy. Extreme NVP While nausea and vomiting in pregnancy may be unpleasant, one percent of women affected experience extreme morning sickness, a condition called Hyperemesis Gravidarum. Often needing hospital treatment, Hyperemesis Gravidarum can make affected women sick many times a day (some up to 50 times). Other symptoms include dehydration – a result of not being able to keep drinks down – plus weight loss, low blood pressure when standing and ketosis, a serious condition caused by the build-up of acidic chemicals in the blood and urine. If you have Hyperemesis Gravidarum you may also have an extremely heightened sense of smell and produce an excessive amount of saliva (known as ptyalism), as well as experiencing headaches and constipation, both of which are caused by dehydration. And unlike the usual form of nausea and vomiting in pregnancy, Hyperemesis Gravidarum may not clear up by the third month of pregnancy. In some women, the symptoms may start to ease at around 20 weeks, but others are affected until their baby is born. If you experience severe nausea and vomiting in pregnancy, see your GP or midwife. There are some medications you can take to help improve your symptoms, including anti-sickness drugs, steroids and vitamin B6 and B12, and the earlier you start taking them, the more effective they may be, but always consult your doctor, midwife or pharmacist before taking these medicines. However, if these medicines don’t control your nausea and vomiting, you may be admitted to hospital where you may receive intravenous fluids via a drip. But as dramatic as it sounds, Hyperemesis Gravidarum is unlikely to harm your baby, if treated effectively. If left untreated it could cause weight loss, which may lead to you having a baby with a low birth weight. Find out more about nausea and vomiting in pregnancy, as well as Hyperemesis Gravidarum, by visitingwww.pregnancysicknesssupport.org.uk Do the streak Striae Gravidarum –or stretch marks during pregnancy – are also very common, with eight out of 10 pregnant women affected. They look like long narrow streaks or lines on the surface on the skin, and are often red or purple to start with, then gradually fade to a silvery-white colour. And as you may imagine, they are caused when the middle layer of the skin – the dermis –stretches during pregnancy. Your pharmacist can recommend creams, gels and lotions designed to moisturise the skin and help reduce the appearance of stretch marks. Camouflage make-up is also available at pharmacies that can help disguise small areas of skin affected by stretch marks. Meanwhile, other options include laser therapy and cosmetic surgery – though these can be expensive and they’re not available on the NHS. Tired and emotional Tiredness can often accompany pregnancy in the very early stages (within the first 12 weeks), thanks to the hormonal changes that are happening in your body. According to the NHS, the only solution is to rest as much as possible, eat a healthy diet and get plenty of sleep. During the later stages of your pregnancy, the extra weight you’re carrying may make you feel tired too. Plus you may not be getting a good night’s sleep because you find it uncomfortable to lie down. Health experts recommend sleeping on your side after 16 weeks, and support your bump with pillows, with another pillow between your knees. Taking exercise is also a way to feel less tired – try to be active during the day by going for a walk or a swim, or by joining an antenatal exercise class such as yoga or Pilates.