When Morning Sickness Becomes All Day and All Night Sickness

Have you tried ginger?”

“My friend’s sister’s college roommate was really sick during her first pregnancy, and she swore by sucking on peppermint, you should try it!”

“Keep some saltines by your bed; it’s the trick for beating morning sickness!”

Almost every expectant mom has heard these and many other “methods” to get them through the first trimester of pregnancy which can often be the most difficult thanks to surging hormones, morning sickness, and extreme exhaustion. But for some women, such as myself, who experience more extreme early pregnancy symptoms, these words of wisdom, no matter how well-meaning, can become incredibility frustrating.

When I became pregnant with my first child last summer my “morning sickness” quickly escalated to all day and all night sickness. It didn’t matter how much ginger tea I drank, how many saltines I kept by my bedside, in my purse, at my desk, and even in my coat pocket—the nausea and vomiting wouldn’t subside. These first trimester woes are often made even more challenging because most women are keeping their pregnancies under wraps during those precarious early weeks. This means suffering in silence and thinking of some really creative ways to explain to your colleagues why you are no longer drinking coffee, can’t make it to happy hour, and even more embarrassingly, why you are making those strange coughing, choking noises in the bathroom stall.

Celebrities like Kate Middleton have helped take away some of the secretiveness around early pregnancy symptoms. Middleton has been open about her struggles with Hyperemesis gravidarum (HG) during all three of her pregnancies. HG is different from typical morning sickness—it causes loss of appetite, severe nausea, vomiting, dehydration, and fatigue. Many women with HG need to be hospitalized to ensure they are getting enough fluids and rest. These extreme symptoms can last for the entire pregnancy.

But for me and a surprising number of other women suffering from severe early pregnancy symptoms, HG isn’t actually the problem—it’s something seemingly much more common but no less serious— acid reflux.

I didn’t have any of the common morning sickness or HG symptoms: I was HUNGRY. All. The. Time. I desperately wanted to eat, but would immediately get sick after a meal. Most women experience morning sickness when their stomachs are empty, not full, and usually feel better after eating. And, fortunately, I wasn’t actually losing any weight; I was gaining it, mostly because I could only tolerate toast, ramen noodles, and other complex white carbohydrates.

“Most pregnant women think that they only need to worry about acid reflux during their final months of pregnancy, when the baby is bigger,” said Sindhu Srinivas, MD, an associate professor of Obstetrics and Gynecology. “But in reality, a lot of women suffer from acid reflux very early on in pregnancy due to hormones such as relaxin and progesterone, which literally relax joints and sphincters in the body, including the sphincter between the esophagus and stomach, causing reflux.”

It didn’t matter what I ate (or mostly didn’t eat), it would all come right back up. I couldn’t even look at a cup of coffee let alone fathom drinking one. An apple to soothe your stomach? Nope, see you again way too soon, Mr. Apple! And that ginger ale everyone told me to drink only made the nausea worse.

“Many of the remedies for more common pregnancy-related nausea such as ginger, peppermint, and fizzy drinks can exacerbate acid reflux,” Srinivas said. “Anyone suffering from acid reflux should avoid these and other acidic foods like orange juice, tomato sauce, and chocolate.”

Once I was diagnosed by my doctor, given a prescription for antacids, and adjusted my diet (I incorrectly thought that being pregnant was the one time in my life I could enjoy chocolate guilt-free), I began to feel better almost immediately, but also came to two alarming realizations:

For weeks, by just following the advice of well-meaning loved ones, friends, and even a few unfortunate strangers who happened to be next to me when I suddenly needed to throw up while walking down Market Street, I was actually making myself worse.
There are probably so many other women suffering from acid reflux who also think it’s “normal” morning sickness and/or have it confused with HG. Acid reflux should be better explained as a pregnancy symptom.
“Acid reflux is incredibly common in pregnancy,” Srinivas said. “There are many antacids that are perfectly safe to take throughout pregnancy that can help minimize symptoms and ensure that pregnant women are getting the nutrients they need to keep themselves and their babies healthy.”

Luckily, thanks to antacids (which my doctor and hours of internet research assured me were safe to take during pregnancy) and some diet changes, my severe reflux has subsided. I can even occasionally enjoy a yummy slice of pizza (with tomato sauce!) and I am definitely indulging in chocolate from time to time. But now I know my limit, how to manage my symptoms, and when to ignore advice from other people.

“It’s great to have a network of friends and family who can give you advice and support, especially during early pregnancy,” Srinivas said. “But it’s so important to talk to your doctor. Many women are afraid of being ‘wimps’ or being considered high maintenance when it comes to pregnancy and that’s just not true. Every pregnancy is different and every mom-to-be deserves to have her questions answered and get the treatment she needs to enjoy her pregnancy.”


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