Throughout September, the Health section is focusing on the topic of pregnancy.
Morning sickness is one of the more visceral experiences a woman can have. The giddiness of a new pregnancy, for many, is mixed with nausea and, at times, vomiting so strong that years later some women get sick at the smell of a certain food or perfume.
Three professionals, an obstetrician, a homeopath and a birth doula, offer ways to cope.
Dr. Ann Marie Raffo
Obstetrician/gynecologist, Saddleback Women's Hospital,Laguna Hills
"As many as 85% of women in early pregnancy will experience the symptoms of nausea and vomiting," says Dr. Ann Marie Raffo, nixing anyone's notion that this is an imagined disease. Most of the time the symptoms pass after the first trimester, but about 20% of these women continue to feel sick into late pregnancy.
The cause, she says, is generally believed to be from the great surge of hormones, progesterone in particular, that are pumping through the body during pregnancy.
The symptoms are more frequent during the morning but sometimes continue throughout the day.
And the symptoms seem to intensify on an empty stomach. "What we generally tell our patients is eat small, frequent meals. Try to always keep something in the stomach," she says.
Patients should keep dry crackers by their bed and eat a few even before they get out of bed. "Stay away from things that make you sick," especially rich, spicy foods.
Also avoid strong smells. "The sense of smell becomes very intensified during pregnancy," she says.
Most women manage to continue normal lives, even gaining the necessary weight for the first trimester, she says. But about 20% of them need prescriptions to stop severe nausea and vomiting.
These include Phenergan in suppositories or tablets to get vomiting under control, in combination with Reglan for nausea. Suppositories are prescribed because women with morning sickness sometimes can't keep down vitamin tablets.
A small percentage of women end up being hospitalized for dehydration or electrolyte loss, she says. "There are good treatment strategies for treating women who end up having to be hospitalized."
But for what she calls "good old-fashioned morning sickness," there's no magic pill.
Doctors are generally reluctant to medicate pregnant women, she says, both in fear of harming the baby and because of lawsuits. In the 1980s, she says, the prescription drug Bendectin was taken off the market after parents of children with birth defects sued the manufacturer. The drug is still considered safe to prescribe in other countries.
Bendectin's active ingredients are found in antihistamines and Vitamin B-6, and some women have found relief from just Vitamin B-6 or a combination of the vitamin and Benadryl, she says. But women should talk to their doctors before trying this combination.
Because of the fear of medication and the fact that morning sickness, no matter how severe, is transient, not a lot of research has been put into it, Raffo says.
Homeopathic physician, Los Angeles Center for Healing
Australian Jan Head says there are as many as 15 homeopathic remedies for morning sickness, each specific for the type of woman and her pregnancy. "Is this a good thing? Is she happy being pregnant? Is this woman dark, Middle Eastern? Is she European? Is she overweight? Is she skinny? . . . Is this a wanted pregnancy or not?
"You have to try and match the remedy to that person as best you can," Head says.
In Australia, England and India, homeopathy is one of the first places a pregnant woman might turn.
Head also incorporates diet counseling, herbs and reflexology in her treatments.
She advises not to get pregnant too soon after coming off contraceptive pills. "Allow your body four to six months to get rid of the synthetic hormones."
And try to be as healthy as possible before getting pregnant. Start preparing with a healthy diet and good multivitamins.
Head stresses a good diet. Avoid nonessential fats and fried foods, such as fried chicken. Drink lots of vegetable juices. And start using ginger, a anti-nausea root, both as a seasoning and in tablets. Most cooking herbs, such as mint and rosemary, are also safe.
Avoid such herbs as goldenseal and pennyroyal.
Reflexology treatment--massaging or applying pressure on the foot to heal other parts of the body--can improve the blood supply to the stomach. Acupuncture can help, "as long as the acupuncturist is aware of the pregnancy."
She also recommends trying tai chi. "Anything that's disciplined and relaxing is going to be good."
Birth doula, Orange
In ancient Greece, a doula was an older woman who lived with a new mother, imparting wisdom and serving her every need until the younger woman was able to step into this new role. Sue Coffman is one of a growing number of women in this country who have taken on this tradition.
As a birth doula, Coffman usually doesn't meet women until they are about to give birth. As the mother of two, she can testify to morning sickness.
Her only relief, she says, came from watermelon, which hydrated and soothed her.
In her readings, Coffman gathered all sorts of non-medical approaches to treating morning sickness: soda crackers in the morning and 7-Up at night; biting down on a wedge of lemon at the beginning of nausea ("It's supposed to shock your system"); chewing on ginger crystals; sipping ginger or raspberry tea; eating papaya first thing in the morning; consuming lots of proteins like white cheeses, yogurt and hard-boiled eggs; and avoiding fats.
Some women, Coffman says, have found relief through aromatherapy, using soothing oils such as lavender or mixtures of sweet orange and sandalwood. Massage oils with spearmint and ginger can also be helpful. But be careful with the essential oils, she says, because they'll burn the skin if placed directly on it.
And, she says, "Some of the essential oils should not be taken in the first trimester. Rose, for one."