What's Good About Morning Sickness?
(continued)

1. Drug Therapy:

Most medicines-including those commonly used to treat morning sickness-have not been thoroughly studied in pregnancy.   Remember thalidomide?  While this drug was never on the market in the United States, it was widely prescribed in Europe in the late 1950's-early 1960's to treat morning sickness, with devastating birth defects as a result.  Since then, physicians have tried to avoid using any medications in pregnancy unless the benefits greatly outweigh any potential risks.  Before taking ANY prescription medicines, be sure to alert the physician that you are or may be pregnant.  Review any chronic medications you have been taking prior to pregnancy with your physician to discuss whether you should continue and whether you need the same or a different dose.  If you have nausea or vomiting in pregnancy, be sure to ask whether any of these medicines may be contributing factors before assuming this is due to morning sickness alone.  If you have daily vomiting, ask your physician if you need your other medicines monitored for therapeutic blood levels as a result. 

Over-the-counter (OTC) medicines will usually say on their label whether or not they are safe for pregnant women.  Before taking any OTC medicine, read the label carefully and follow any precautions.  Most OTC medicines will give the warning to discuss any medicine you plan to take with your doctor before self-medicating.  Many obstetricians will have a list of OTC medications they consider safe to self-administer; other doctors will advise you to call if you're considering taking anything other than Tylenol (acetaminophen) or Tums.  Ask your doctor what her policy is about OTC medicine use in your pregnancy.

When using any medicine, check with your doctor if your nausea and vomiting continue or worsen.  Call your doctor immediately if you develop other abdominal symptoms such as pain, cramping, bloating, soreness, spotting, or continuing or severe nausea or vomiting.

2. Alternative &  Adjunctive Therapies:

The difference between alternative and adjunctive therapies is that alternatives are techniques and modalities which have yet to be proven to work in people in general by scientifically controlled clinical research trials, but which many people have testified work for them.  Adjunctive therapies are approaches which have been shown by clinical research to improve prevention and treatment outcomes, but which are often recommended in addition to mainstream therapy.  Remember that any substance that you ingest can have risks as well as benefits.  These may be synergistic with or counterproductive to your other medical treatments, so consult your physician. 

A 1994 federal law allowed dietary supplements to forego extensive scientific study to ensure they are safe and effective for various condition before they are sold.  While that law prohibits dietary supplements from claiming to treat or cure diseases, it did permit advertising for non-disease health conditions.  Since morning sickness is not a disease but a normal symptom of pregnancy, dietary supplements were able to claim to treat them without having done extensive safety testing in pregnancy.  The Food and Drug Administration (FDA) recently closed this loophole (Feb. 2000), no longer permitting supplements to claim safety or efficacy for treating morning sickness unless they had undergone additional testing. 

Vitamins:



• Prenatal Vitamins:  Prenatal vitamins are generally recommended for all pregnant women-and often for women trying to conceive as well.  Generally women take these in the morning.  However, in women who have morning sickness, this timing may not be ideal.  If vitamins seem to coincide with your morning sickness, try taking your vitamins at bedtime or after a meal.  In some women, it is the iron content of prenatal vitamins which irritates the stomach; ask your doctor if you should try a prenatal supplement without iron.  For women who can't tolerate prenatal vitamins at all, speak with your physician about which elements contained in the vitamins are most important for you and least irritating to the stomach (such as folic acid and calcium) and how you can supplement in another way.  For example, chewing Tums™ or Rolaids™ is a great way to supplement calcium and settle your stomach at the same time.
  
  
• Pyridoxine (Vitamin B6):  Claims that Vitamin B6 supplementation can treat/reduce morning sickness have not been substantiated.  However, pregnant women in general have a higher daily requirement for Vitamin B6 than non-pregnant adult women.  The amount required is generally obtained in the standard prenatal vitamin.
  
  

Ginger:

New research shows that ginger reduces nausea and vomiting during pregnancy. In a study conducted in Thailand, pregnant women who took 1 gram of ginger a day significantly reduced the nausea and vomiting they had experienced. During the day before treatment began, 100% of those in the ginger group and 94.3% in the placebo group had vomited at least once. After 4 days, 37.5% in the treatment group had vomited, compared with 65.7% in the placebo group. The ginger was prepared by baking fresh ginger root and grinding it to a powder. Adverse effects were minor and did not prevent participants from continuing the treatment regimen. No significant differences were observed in spontaneous abortions, term deliveries, or cesarean deliveries when comparing the ginger group to the placebo group. There were no cases of congenital anomalies.

Acupuncture:

There is clear evidence that needle acupuncture is efficacious for adult postoperative and chemotherapy nausea and vomiting; many practitioners use it for nausea of pregnancy as well. A recent randomized study of 33 women with hyperemesis from Sweden in the Journal of Pain and Symptom Management (10/00) showed that pregnant women who experience severe vomiting appear to recover more quickly when they receive acupuncture in addition to standard treatment. The women with hyperemesis received standard medical treatment, plus two days of either active manual acupuncture or placebo acupuncture. Active acupuncture consisted of deep needle insertion about 2 inches above the wrist crease on both arms at the traditional PC6 point; placebo acupuncture involved superficial needle insertion 4 inches above the wrist on both forearms. The severity of nausea and the frequency of vomiting both decreased more quickly with active acupuncture than with placebo administration. After two active acupuncture treatments, only 7 of 17 women were still vomiting compared with 12 of 16 women who received placebo acupuncture. According the study authors, the effects of active acupuncture could be seen "often within minutes of stimulation."

Sea Bands:

These are wrist bands often recommended for the treatment of motion sickness.  They work by putting pressure on specific spots believed to be related to the suppression of nausea.  While this has never been proven to work, many women have reported success anecdotally, and they can do no known harm.