The midwives’ tips for first trimester nausea
Nausea is a classic early symptom of pregnancy, generally starting for most people between 6 and 8 weeks and subsiding between 12 and 16 weeks. Though it is often referred to as “morning sickness” due to low blood sugar exacerbating nausea (your blood sugar might be low in the morning after going 12 hours or so without food), it is often an all-day occurrence. It is not only disruptive to daily life, but can lead to dehydration, excessive weight loss, and contribute to depression or anxiety.
Know that you are not alone if you’re having a rough go, and it is temporary. There are absolutely things you can do to limit the nausea and vomiting and improve your quality of life in these early weeks of pregnancy. Here are our top safe and effective methods for managing and lessening pregnancy nausea:
1. Eat every 2 hours, prioritizing protein and complex carbohydrates.
When we go too long between meals or snacks, the nausea will almost always be worse. This is a horrible cycle in early pregnancy and it is likely the last thing you want to be told, but you have to eat. It can be small amounts. If you can eat a little protein each time, this will help to regulate your blood sugar, preventing big dips and therefore intensified nausea.
2. Choose plain, cold, sour, and carbonated.
You likely are not able to stomach all the seasoning and complex flavors you normally do outside of pregnancy, and that’s okay. This first part of the journey is sometimes about just doing what you have to do to get through it. Plain foods are less likely to cause nausea or aversions. Cold foods and fluids are also shown to reduce nausea over warm meals and beverages. Sour foods and drinks are helpful for limiting nausea and vomiting: think lemon water, frozen raspberries or blackberries, cold greek yogurt. Some people find relief with carbonated drinks. We recommend avoiding soda, but carbonated water with lemon or a small dash of apple cider vinegar, kombucha, or ginger can be a game changer when sipped on frequently between snacks.
3. Get good rest.
Exhaustion and stress intensify nausea and vomiting in the first trimester. If you are able to nap, please do it. Get fresh air and gentle movement.
4. Utilize safe herbal supports.
Ginger can be taken as tea, added to a carbonated drink, or as hard candy. Peach leaves have been traditionally brewed for tea in Appalachia for hundreds of years for stomach discomfort and nausea, and the tea can be put in the refrigerator for cold consumption in early pregnancy. Mint can also be taken in small amounts in tea, or simply used as aromatherapy. Mint can increase symptoms of heartburn or GERD, so we don’t recommend consuming mint if you have this condition.
5. Prioritize B6, and consider switching to a gummy prenatal vitamin.
Vitamin B6 (10-25mg every 6-8 hours) has been shown to improve nausea symptoms. If B6 alone isn’t improving the situation, taking with Unisom is also an option, as well as 1.5mg Thiamine (B1) a day. If you are currently taking an iron supplement, this may be adding to your nausea and vomiting and can be paused for now (unless your unique health picture calls for more aggressive iron supplementation). Taking prenatal vitamins is also a common nausea trigger. Always take prenatal vitamins with food, and take at night if nausea is worse in the morning. You also may need to switch to a gummy instead of a hard pill or capsule for now. Once the nausea has subsided, we recommend switching back to a pill or capsule if possible, as they generally have more nutrients than the gummy prenatals.
6. Acupressure points or acupuncture therapy.
Neiguan (P6) is an acupressure point on the wrist that you can press with your fingers, or activate with an appropriate TENS unit. There are bracelets called “seabands” that can be worn to stimulate P6. You can also visit an acupuncturist for this point and more that can support stress relief and better rest.
When to call your midwife or doctor:
If you are unable to keep down foods or fluids for more than 12-24 hours
If you have signs and symptoms of dehydration
If you have abdominal pain
If you experience weakness, confusion, or lethargy
If your mental health is suffering and/or you are unable to complete needed daily activities
