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The Motherisk Nausea and Vomiting of Pregnancy (NVP) Forum

Motherisk receives questions from around the world about morning sickness symptoms, effects, treatments and ways to cope. Those questions and answers are posted here for anyone to read, provided the reader acknowledges and accepts the proviso and disclaimer below.

Forum > NVP Symptoms and Effects: Planning ahead
Preparing for pregnancy and NVP

NVP Counselor
Date: 2005-03-29

Question:
I?m 38 years old. I have two children. I experienced morning sickness from 6 weeks until delivery with both my pregnancies.

During my first pregnancy, I was nauseas all day from 6 weeks and vomited 2-3 times a day from 9 weeks until about 24 weeks. I ate what I could, took prenatal vitamins and was able to drink adequate water each day. I was miserable most days. I was ok as long as I was sleeping at night and had no problem getting up for bathroom breaks. I tried, unsuccessfully, to manage the sickness with Gravol until I learned from a friend about Diclectin at 12 weeks. I also had severe vertigo starting around 6 weeks and lasting until I started 2 Diclectin per day at 12 weeks. Diclectin substantially lessened my nausea and made the pregnancy manageable. I also ate frequent (hourly) snacks to manage the sickness. I gained 35 pounds. I now believe that the morning sickness would have all but disappeared if I had taken 4 Diclectin a day.

I wanted a second child but delayed 3 years because I didn?t know if I could handle a baby and morning sickness again.

During my second pregnancy, nausea and vomiting began at 6 weeks. I immediately began taking 4 Diclectin a day with little result. The sickness became worse. It took a week to start to feel any positive effect. The morning sickness became increasingly severe. I was miserable and caring for a 3 year old. The morning sickness took a large toll on my family and prevented my husband from getting to work on time. I learned from Motherisk that I could increase my dose as high as 8 tablets a day. I increased the dose to 5 tablets per day. I also began taking Gravol before taking each dose of Diclectin to help keep it down. It took a week to feel any positive effect again. I found Diclectin upset my stomach. I was waking in the night feeling violently ill. I was unable to drink water without throwing up. Most foods upset my stomach. I couldn?t tolerate my prenatal vitamins either. I force fed myself hourly day and night (when required) to manage the nausea. I couldn?t tolerate any food smells and couldn?t cook. We lived on fast food. My doctor offered Stemetil but I decided to increase my dosage to 6 tablets a day. It took a week to have a positive effect again. By then I was 13 weeks pregnant. Either the sickness was starting to subside or the Diclectin was starting to help a tiny bit. I was exhausted and sleepy all day long. I decided not to increase my dosage further due to drowsiness since I was finally able to manage a bit. The vomiting stopped around 24 weeks. I was nauseas until delivery. I had terrible heartburn for the remainder of the pregnancy and took Zantac most days. I gained 60 pounds because I forced myself to eat so frequently to manage the nausea. The morning sickness was far worse the second pregnancy. When I spoke to Motherisk, I got the impression that without quick intervention and medication, it could have progressed to HG. From the moment I started to vomit in the second pregnancy I begged my husband to have a vasectomy so I would never have to experience this again. He suggested that we should wait since I was in an emotional state and may change my mind. I was so miserable. Should I have taken Stemetil??? Would it have helped???

My second baby is now 18 months old. We had endless difficulties with colic and breastfeeding. I have given away infant clothes, breast pumps and maternity clothes. I didn?t want to go through all of this again.

I suddenly want another baby. I am flabbergasted by the intensity of these feelings. I?m actually being treated for depression because of this. I always wanted 3 children but I never, ever want to experience morning sickness again. I had a flashback in the grocery store recently when a smell triggered memories of morning sickness ? how horrible. My husband is in a very demanding job and won?t be able to help out this time. Morning sickness would result in his having to take a demotion at work and a severe pay cut. Although my in-laws are retired and live nearby, I don?t think I?d get much sympathy if I choose to become pregnant again and then became severely ill. My mother is a fraternal twin so the chance of a twin pregnancy would seem to be higher as would the chance of more severe morning sickness.

I see there is information now that starting Diclectin before becoming pregnant may help. I also understand that taking B6 ahead of time will help. I understand that starting prenatal vitamins early to build up nutrient stores can be important. Is there anything else that can be done????? During both pregnancies, protein (specifically eggs) seemed to help reduce my nausea. Where can I get more detailed information to help me to understand these interventions and their effectiveness.

I don?t have the time to wait until my baby is older this time to have baby number 3. I resent that morning sickness prevented me from having my children closer together. Please help. Your advice will influence whether I decide to have a third child.

Answer:
First, when considering another pregnancy, you might try to approach it with a positive, yet realistic attitude. You might indeed have NVP again, but the extent of the symptoms is not predictable. Rather than fear based on the past, you might see it as positive learning that will enable you to prepare, and act immediately at the onset of symptoms with optimal treatment.

Some steps to consider:

  • Vitamin B6 could be started ahead of the pregnancy (we usually suggest 25 mg, three times daily)
  • 4 Diclectin immediately at the first sign of queasiness, with a regular schedule of 2 in the late evening, 1 early morning, and 1 early afternoon
  • 50 mg rectal Gravol, 1/2 hour before taking Diclectin if vomiting occurred at the onset of the symptoms.

Both Diclectin and Gravol are antihistamines and Gravol, absorbed fast, would give you an indication quite rapidly whether this type of medication will work. If not, our treatment algorithm in the February 2002 Update on this website lists all further treatment options.

All other health issues, such as heartburn, not relieved by the NVP treatment or maintaining small amounts of food in the stomach all the time, should be discussed with your doctor for possible treatment. Any depression should also be controlled, as all other conditions will only add to the NVP symptoms.

To conclude, be optimistic, realistic and well prearned while making your decision and our counselors will be there if you need to call.

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