What is pregnancy sickness?
No-one knows why the first sign of pregnancy for many mums-to-be is an early morning dash to the bathroom. With about eight out of 10 pregnant women feeling sick, and half of them actually vomiting, many women spend the early weeks of pregnancy feeling awful rather than "blooming".

Pregnancy sickness is the most common medical condition of early pregnancy, but how bad it is varies widely from woman to woman. You may get the odd bout of mild queasiness when you first wake up, or find that certain smells trigger waves of nausea throughout the day. You may have to endure weeks or even months of feeling or being sick morning, noon and night.

"Morning sickness" is misnamed. It may be worse in the morning, but most sufferers get it throughout the day and into the evening. Pregnancy sickness can take over your life for a time. If you get it badly you may find yourself unable to work, to care for your toddler or other children, to cook, shop or run your home. When you should be feeling happy and excited about your pregnancy you may feel miserable and ill, and your relationships with your partner, family and friends may become strained.

Women with unrelenting pregnancy sickness often feel that nobody really understands what they are going through. Not suprisingly, this can lead to depression. Talking to a fellow sufferer can help you feel less alone. Get in touch via our community.

The most severe form of pregnancy sickness is called hyperemesis gravidarum (literally "excessive vomiting in pregnancy"). If you are vomiting many times a day, are unable to eat and drink without vomiting, and if you are losing weight then you probably have hyperemesis. Unlike normal pregnancy sickness, hyperemesis can affect your health and that of your baby, so talk to your doctor or midwife as soon as you can.
Why am I feeling sick?
Although it won't help your nausea, feeling sick is actually a good sign that your pregnancy hormone levels are high. The cause of pregnancy sickness is unknown, but it is thought to be connected to the hormone human chorionic gonadotrophin (HCG). This is produced in large quantities until your placenta takes over the job of maintaining and nourishing your baby at around 12 to 14 weeks. Other hormones such as oestrogen and the thyroid hormone thyroxine are also thought to be responsible.

If you also suffer from travel sickness, your symptoms may be linked to a disorder in the balancing mechanism in your inner ear. Other, rare, causes of pregnancy sickness include a disturbance to one of the brain's "feel good" chemicals, serotonin, or a digestive infection called helicobacter pylori.

If you are tired, hungry, or stressed the nausea may be worse, and if you are expecting twins or triplets you will have higher levels of pregnancy hormones, and may get more severe sickness.

An evolutionary theory is that a pregnant woman's increased sense of smell and nausea is a protective measure, making her less likely to be harmed by poisons or toxins in the environment.

Whatever the cause, it can be a shock for a previously healthy woman to find herself overwhelmed by pregnancy sickness. No-one understands why some women get it and others escape, but seeing your pregnant friends "blooming" can feel horribly unfair. It may help to remember that nothing you have done is causing your symptoms.

Some doctors still believe that pregnancy sickness is a psychological condition, but a recent review of studies found no evidence for this.
How long will it last?
Pregnancy sickness usually starts at around five or six weeks of pregnancy and improves for most women by 14 weeks. Some women find it persists until 16 weeks, whereas others experience varying degrees of nausea or vomiting for the whole nine months until the birth. Fortunately, this is unusual, especially if you get help early on.

If you have pain, a fever or a headache, or if you get nausea and vomiting for the first time after nine weeks of pregnancy, see your doctor as you may be suffering from another condition.
Will it affect my baby?
Pregnancy sickness won't threaten your baby's well-being as long as you're able to keep some food down, and drink plenty of fluids.

Eat a balanced diet if you can, but if you are feeling very sick, eat whatever you can cope with. Your baby can catch up on his nutrients later on in your pregnancy when you're feeling better.

Your food choices may be odd for a while - you might only be able to manage potatoes and Lucozade for a month - but try not to worry about it, and catch up on the healthy eating later. Your liver stores many of the nutrients your baby will need to develop normally, so it won't matter too much if you are not eating. It's important that you take a folic acid supplement though, as this will help your baby's spine and nervous system develop. Take it at the time of day when you're most likely to keep it down.

If you are vomiting many times a day, are unable to eat and drink without vomiting, and are losing weight, see your doctor early on or you may become dehydrated. There are treatments that can help you at home, or you may need to be admitted to hospital.
Getting help and support
You may find that a combination of dietary changes, self help and natural remedies mean you can tolerate your sickness until it eases off. If nothing works, and you are still suffering, see your doctor or midwife as early as possible. Treatment becomes more difficult the longer you leave it. They can discuss other ways of coping, including medication.

Tell your partner, your family and your friends how you're feeling, and what you need, as they may not know how to help you. There's no need to feel guilty about asking for help with practical things like shopping, cooking and chores – you're ill! You may have to tell the people you work with about your pregnancy (and your sickness) earlier than you wanted, to get the support you need.

If you had pregnancy sickness with your first baby, there are things you can do to prevent or lessen it second time around. Again it's important to start early.

It can sometimes be hard to get help for pregnancy sickness. Pregnancy books and magazines often skim over the issue, as do medical textbooks, and you may find that your doctor or midwife doesn't have all the information you need. The internet can be invaluable. There are many useful websites with information for women and health professionals on this subject.
Useful websites

www.pregnancysicknesssupport.co.uk - information and telephone helpline.

www.hyperemesis.org.uk - "Blooming Awful". Information and support on extreme pregnancy sickness.

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