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

What is Hemoglobin?
Hemoglobin is found in your red blood cells.  It is a protein your body makes from iron, and is what holds oxygen to transport it around your body to cells and organs.

How do I get the iron my body needs to make hemoglobin?
Food is the best source of the iron your body needs to make hemoglobin.  Remember being told as a kid you should eat liver?  Well, pregnancy is the time to take that advice.  For those who just can't handle liver (including me), red meat such as beef, buffalo, venison etc are the next best source.  Dark chocolate is a good source too.  The darker the chocolate, the higher the iron content.  Lots of foods have iron, so read labels and do some research online.  Be mindful that calcium will block iron absorption, so if you are needing to increase your hemoglobin, think twice about adding cheese to your hamburger.  On the other hand, Vitamin C will increase iron absorption so you can feel good about enjoying some dark chocolate covered strawberries.  Make sure you have are getting folate since iron needs this as well as Vitamin C to do its job.  If your iron has dropped at around 30 weeks gestation, good job expanding your blood volume!  You have time to get your hemoblogin back up to a healthy level before birth. 

What should my hemoglobin level be?
In the first prat of pregnancy, hemoglobin levels should be 12-15 g/dL.  As your blood volume expands, this number drops, usually by 2 g/dL.  This drop is due to your iron being diluted by the increased amount of blood in your body.  I prefer my clients have a hemoglobin level of at least 11 g/dL before the baby is born.  This will help Mom handle blood loss from birth well and lets baby build iron stores.  Iron transport accross the placenta to your baby is highest in the last 4 weeks of pregnancy.

How will I know if my hemoglobin levels are low? 
You may notice fatigue, brittle nails, pale skin, dizziness, shortness of breath and heart palpitaiton or rapid pulse.  I like to check hemoblogin at around 30 weeks gestation so we can see how much of a change there is, and so there is time to get it back into a healthy range.  

What should I do if my hemoglobin levels are low?
I recommend my clients focus on iron rich food while being mindful that sources of calcium will block absorption and vitamin C will increase absorption.  Depending on what lab work indicates, I sometimes recommend supplemental forms of iron and sometimes Folate to help raise levels.  It takes about 2 weeks before any increases will shop up in labwork, although often clients will notice an increase in energy, or a lower heartbeat after just a few days  of working to raise iron levels.  Depending on how much the level has dropped and how a client is feeling after working to raise levels,  I may check it again around 36-37 weeks gestation.

​Hemoglobin is critical for your baby, and for your body.  I expect hemoglobin to drop in pregnancy, and I actually find it more concerning when the level doesn't drop. Monitored through your pregnancy,  hemoglobin levels are very easy to address with simple changes in diet.
 
               



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Chiropractic care can be very beneficial during pregnancy, and a low risk way to keep feeling great throughout. During pregnancy, the hormone relaxin is at work relaxing muscles, ligaments and joints. With things more relaxed or looser, it can be very easy for the pelvis to shift out of alignment.  The Webster technique was developed specifically for pregnancy in the 1980's by Dr. Larry Webster to address this issue.

Babies will go the route of least resistance when entering the pelvis so if the muscles on one side are tight, but are looser on the other side, the baby will go to the looser side since there is less resistance.  This may cause baby to enter the pelvis with the head tilted off to the side instead of centered, or baby may enter in a posterior position with the back of baby's head against the spine. Both of these can cause a longer, more intense labor.  If baby settles into a breech position, Webster Technique is one tool that may help a breech baby into a head down position.   

Having muscles, ligaments, pelvis and spine aligned can reduce common complaints such as low back pain, or hip pain.  Regular adjustments may help with swelling, espeically swelling that is more on one side than the other.  If your baby enters the pelvis with the head off to one side, that can put pressure on the blood and lymph vessels on that side which may cause you to swell more on that side.  If things are aligned, then baby may be able to center their head, more evenly distributing that pressure.

I encourage my clients to get regular chiropractic care, especially when experiencing issues with lower back pain, swelling, hip pain and pelvic pain.  Having everything balanced and in alignment can lead to an easier labor, and birth.  

For clients in Manhattan, Junction City, St Marys, Chapman and the surrounding areas, Nichols Chiropractic, Flint Hills Family Chiropractic,  Alternative Health Care, and Premier Chiropractic and Wellness in Manhattan have chiropractors certified in Webster Technique.  
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