Nausea or morning sickness is a common complaint of pregnancy.  Morning sickness typically resolves by the end of the first trimester, although some Moms can have it their entire pregnancy.  

It is unknown exactly what causes nausea in pregnancy.  It may be caused by elevated progesterone and hCG (human chorionic growth hormone), or swings in blood sugar levels or a nutritional deficiency like low magnesium. During pregnancy, the body becomes very sensitive to swings in blood sugar levels.  When blood sugar levels drop, that can cause feelings of nausea and may lead to vomiting. Since you don't eat while you are sleeping, blood sugar levels are low in the morning (hence the name morning sickness).   A sudden increase in blood sugar levels depending on what you eat may bring on more nausea. Sometimes certain smells, foods or food textures can cause nausea. Whatever the cause is doesn't change the fact that having nausea in pregnancy is not pleasant.

What can be done to prevent or minimize nausea?

• keep blood sugar levels stable.  Having protein and healthy fats every time you eat can help, so can having small, frequent meals or adding in snacks throughout the day.
• Have a protein rich snack right before bed.  This helps keep your blood sugar from dropping as much during the night.
• Try taking 50 mg Vitamin B-6 at bedtime.
• Ginger: tea, candy, ginger ale etc can help calm nausea symptoms.
• Peppermint: smelling peppermint oil, or having peppermint candies may help.
• using an acupressure wristband  or magnetic bracelet specifically for nausea.
• anise or fennel leaf tea first thing in the morning, and chewing on the seeds through the day.
• Probiotics, either a supplement or in fermented foods and yogurt may help.

Nausea in pregnancy can escalate into a problem known as hyperemesis gravidarum.   If you experience any symptoms of hyperemesis gravidarium, contact your midwife or doctor.  The signs of this include

• ceaseless, uncontrollable vomiting
• decreased urine output
• fainting
• weight loss that exceeds 5% of body weight 
• dehydration

Nausea typically peaks around 11 weeks gestation and ends at 14 weeks for the majority of pregnant Moms. My perspective as a midwife is that my clients should not expect morning sickness to be their normal. As part of my midwifery care, I share all these suggestions and more to help reduce or eliminate morning sickness.  I want my clients to feel amazing during their entire pregnancy.


Sources not linked in blog post:
Davis, E (2012). Heart & Hands: A Midwife’s guide to Pregnancy and Birth (5th ed.)  Ten Speed Press
Frye, A. (2007). Understanding Diagnostic Tests in the Childbearing Year (7th ed.). Portland, OR: Labry’s Press
Frye, A. (2008). Holistic Midwifery, Vol 1. Portland, OR: Labry’s Press
Sinclair, C (2004). A Midwife’s Handbook. Elsevier Ltd

I am a firm believer that there is no such thing as "one size fits all". I can assure you "one size fits all" does not apply to gloves or pajamas and it certainly doesn't apply to midwives.  

We are all individuals with unique personalities, needs and desires. We all have unique backgrounds, upbringing, family history, and so on.  This is part of what makes life interesting.  Being unique means that what works for one person may or may not work for someone else.  Being unique also means we may connect more with one person, and not connect as well with someone else.  I feel this is normal, and perfectly ok.  

As a midwife, I want to connect with my clients and I want them to connect with me.  A huge factor in the safety of home birth is trust.  Trust in the birth process, and trust in mom's body is important.  Even more important, in my opinion, is trust in your birth team, especially your midwife.  As I attend more births, that need for trust in the birth team has become more and more evident to me.  The births where there is a lack of trust just don't seem to work as well as births where trust is overflowing.  

Before I agree to serve a client, I need to meet them in person.  This is the chance for the client to interview me and for me to interview them as well.  During the interview I am looking for a connection, understanding and respect.  With those things in place, trust can be nurtured. If they are not there, I am not the midwife for that client. I want the very best outcomes for my clients and families, so there are times I have to turn down someone who wants to hire me. Likewise, I have interviewed with prospective clients who decided to hire a different midwife. I'm thankful those Moms recognized they connected better with a different midwife. I want potential clients to know if they have any doubts, or do not feel a connection, they should continue looking for a midwife to find the one they connect well with.  Knowing I am not the midwife for everyone who is pregnant makes me a better midwife for everyone.