Chapter 9 – Nausea during pregnancy

In the first trimester of pregnancy, nausea and vomiting are very common and are considered “psycho-biological adaptations” of the pregnant woman. Among the typical symptoms, nausea is one of the first to appear and is very often associated with altered taste perception and increased sensitivity to smells.

It is commonly referred to as “morning sickness”, but its symptoms can appear throughout the day and even at night (24). The symptoms generally appear between the 4th and 9th week, peak between the 7th and 12th, and tend to disappear between the 12th and 16th.

Vomiting during pregnancy is a symptom that occurs especially in the first trimester and is caused by increased hormonal activity in the woman’s body. This leads to a disruption in the normal functioning of the digestive system, which implements this mechanism in order to protect the fetus’s growth from food contamination.

We speak of “hyperemesis gravidarum” only when these symptoms persist beyond the first trimester or increase in intensity, with continuous vomiting, electrolyte imbalances, weight loss, ketosis, and acetonuria.

Typical cases of nausea during pregnancy usually do not pose any risk to the mother or the fetus. However, it can be harmful when it is so intense that it causes an excessive loss of fluids and nutrients through vomiting, resulting in a decrease in the mother’s weight, creating a state of stress that may also be potentially harmful to the fetus (25).

To alleviate the sensation of nausea, experts have developed a series of recommendations, listed below:

• sleep as many hours as possible: fatigue from pregnancy worsens nausea. Upon waking, it is recommended to get up slowly to avoid sudden drops in blood pressure;
• avoid hot places, because rising temperatures increase the sensation of nausea;
• take a daily walk;
• do not lie down after eating;
• avoid brushing your teeth immediately after meals;
• avoid long car trips.

As for nutrition, here are some very useful tips (26):

• eat small meals and snacks frequently, preferring cold foods over hot ones;
• prefer foods rich in protein and low in fat: for main meals, a classic second course in rotation (meat, fish, eggs, legumes, cheese); for snacks, small quantities of shelled dried fruit (walnuts, hazelnuts, almonds) and seeds (pumpkin, sunflower, sesame) are recommended. In some cases, foods containing ginger may be helpful;
• increase fiber intake (including blended vegetables, fruit, legumes, wholegrain toast, wholegrain pasta and bread) to avoid constipation, which may increase discomfort;
• drink at least 8–10 glasses of water a day;
• avoid foods and smells that seem to worsen nausea;
• chew slowly to aid digestion;