Episode 145 Nausea and Vomiting in Pregnancy
[0:00] Welcome to the Great Birth Rebellion podcast. I'm your host, Dr. Melanie Jackson. I'm a clinical and research midwife with my PhD, and each episode, I cast a critical eye over current maternity care practice by grappling with research and historical knowledge to help you get the best out of your pregnancy, birth, and postpartum journey.
[0:24] Welcome to today's episode of the Great Birth Rebellion podcast. Today, I am bringing my personal experience of nausea and vomiting through pregnancy. It was probably the hardest part of both my pregnancies. And I'm also going to bring the strategies that have helped me and now also my clients through this, of course. And it will be backed up by what evidence I can find on the topic. But I have 10 strategies to help you reduce, maybe prevent nausea and vomiting in pregnancy. At the very least, you've got to be better than what you're feeling right now. Hopefully, right? As usual, all the evidence that I use to create this podcast is available for anyone who's on the mailing list for this podcast. You can get on the podcast mailing list at melanethemidwife.com and you'll get all the resources that I use to make every single episode so you can have a look for yourself.
[1:22] All the details are in the show notes. So let's look into nausea and vomiting in pregnancy and the practical strategies on how to reduce it.
[1:32] Before we get started I want to say that some of these strategies will be helpful for you out there if you're experiencing hyperemesis gravitarum what we call HG for short I'm not going to say that the whole time we will discuss it in part because I know some of you are coming and you've got hyperemesis or you think you might have hyperemesis or HG we will discuss it a little bit in part because it's a complex circumstance we can't give you all of the details a lot you know we would need a really comprehensive HG episode but also hyperemesis is really something that should be managed with a care provider that you know and who's familiar with your circumstance, but I am going to touch on it. There will be something in here for you. So if you've come looking for a comprehensive episode, this isn't it. I will touch on it, but no details about medication combinations or treatment protocols for HG will be offered here. This will just be a metric for trying to understand if you have hyperemesis or not. And some of the strategies that I'm going to offer, some of the 10 strategies, might help with some of your symptoms in conjunction with whatever you can navigate with your care provider. It's complex and it's just best managed on an individual level because you need a tailored health plan that suits your particular circumstances.
[2:58] And in the interest of keeping this podcast free, to you, the listener, we would like to thank our sponsor for today's episode, Hydramama by Mini and Me. Kira created Mini and Me to help women thrive, not just survive. She's a mum herself and she has firsthand experience with excessive vomiting during pregnancy. As a result, she created something that serves women who are just like her during that time. Hydramama is an electrolyte drink that's designed with pregnant and postpartum mamas in mind. But to be honest, its uses go beyond that. Me personally, I take movement and care of my body really seriously. I like to go and do saunas. I sweat a lot in my workouts. And so I use Hydramama after my training sessions three times a week and after my sauna sessions.
[3:52] The Hydromama electrolyte sachets are easily transportable. They can go in your birth bag, your handbag, your sports bag, and it can be added to water and used when needed. The thing I love about this product over other electrolyte products is the flavors. There are eight different ones and they are so mild and easy to drink and it doesn't taste overly sweet and strong, sort of overpowering like the other electrolyte drinks on the market. It my favorite is the watermelon and lime but my daughter loves the passion fruit and orange flavor it's honestly the best tasting electrolyte option I've come across it has no sugar and only natural flavors and I'm constantly testing products that I would want to recommend to my clients and this is the electrolyte that is the clear winner for me electrolytes are really important for hydration not only if you're vomiting during your pregnancy but during labor and birth and postpartum when you're making all that breast milk and particularly for women who are having trouble keeping fluids down it's not enough to just drink water you've got to balance out the electrolytes and hydromama is perfect for that it's full of electrolytes magnesium methylated folate vitamins b6 and c and it's endorsed by the Australian College of Midwives.
[5:16] And just for Great Birth Rebellion listeners, Kira is giving 20% off when you purchase Hydramama. You can use the code GBR20 when you purchase at miniandme.co. All the details are in the show notes. You can just click the link and go ahead and put in your order for a 20% off discount.
[5:35] Having said that, let's get into it. I'm keen to bring you some strategies that might help you feel less nauseous and less vomity, these pregnancies.
[5:47] First up, let's differentiate between usual vomiting in pregnancy and hyperemesis, which we, again, we're just going to call HG going forward. Now, this is important because if you are vomiting in early pregnancy, you may not yet have a full-time care provider or have gotten access to the type of care that you particularly want for this pregnancy. There seems to be a gap between when you find out you're pregnant and when you can actually access care that you need and want. So in the early days, women are relying possibly on your GP to give you the early pregnancy care and they might not be aware of the difference between usual vomiting in pregnancy and when it's getting excessive, when it's tipping over into hyperemesis. So you might need to do some advocating for yourself on this one and I'm here to help you with that because the truth is is that hyperemesis is underdiagnosed and women don't get the help that they deserve. They're often told by their care provider that it's normal.
[6:52] Some level of vomiting can be normal but HG is different and I'll explain how to tell if your vomiting is normal and when to get extra help when it becomes abnormal. But firstly on that issue of early pregnancy care and the gap between finding out you're pregnant and actually being able to see the care provider that you choose. Sometimes it might not be until after 16 weeks that you actually get to settle into your chosen care option.
[7:21] Can I suggest for this time, even if you aren't planning home birth or to have a private midwife for your whole pregnancy, but here in Australia there has been a change to how private midwives are allowed to deliver care. We used to be restricted we had women had to get a referral from their GP to come to us but now there are no political barriers to hiring an endorsed midwife for your care because they've taken away that requirement to have a GP referral and that means that the minute you find out you're pregnant you can just contact a private midwife and start care with them as early as you need particularly if you have some special and unique needs during your first trimester where you actually need and deserve maternity care. Often maternity care services just don't have room to care for women in those early stages and so an endorsed private midwife is a great option for this. You're going to get top quality care while you wait for the type of care that you've.
[8:27] Specifically had your eye on but certainly if you have any early pregnancy needs and you can't get into a GP or you don't want to see a GP then a private midwife is a great option in the interim, so that's just a top tip from me to begin with and endorse midwives if you are out there listening remember that with the change in the collaborative rules here in Australia there's nothing stopping you from offering a first trimester care package for women. You can be their first point of contact for their pregnancy. They don't have to see a GP for that anymore. So let's start offering this, working to our full scope and giving women the quality care that they deserve in their first trimester. All right, now let's really get into this. Let's have a look first. What is HG or hyperemesis? And then we'll understand what pathological vomiting looks like before we explore what a normal amount of vomiting and nausea might look like for you in your pregnancy. So hyperemesis, hyper, which means a lot or excessive, emesis.
[9:31] Vomiting, it's a lot of vomiting. It's a pathological amount of vomiting in a sense that the woman's health and well-being suffers because of the amount of vomiting that she's doing. Women with HG often need to use medication, have IV hydration. They need close monitoring due to their condition. Some of them even need to get hospitalized repeatedly because of the severity of the vomiting and the consequence of the dehydration.
[10:03] And if the quality of your life and your health is being affected because of the amount of vomiting that you're doing, consider that you might have hyperemesis. If you can't keep functioning in life because of the vomiting, that's pathological. If you can keep functioning, even though you are doing some vomiting, that's more likely to be a normal or non-pathological amount of vomiting.
[10:30] The medical or diagnostic criteria for HG includes the finding of weight loss. The woman is vomiting so much that she can't keep food down, but is now malnourished to the point of losing weight. As a result, you're also dehydrated, which can be diagnosed by a lack of urine output, so you're not doing a lot of wheeze. Your urine is probably concentrated, and we can diagnose ketosis. But also your blood results will show they're deranged. So there's an electrolyte imbalance and low plasma fluid volume in the blood. So this is called a low hematocrit.
[11:09] Now, of course, your practitioner should also rule out any other possible causes for the constant vomiting. Let's not just assume that it's hyperemesis because you happen to be pregnant. So there's a differential diagnosis, obviously, that your care provider can do. But there's some simple blood and urine checks to diagnose if you're dehydrated or malnourished as a result of the vomiting so if your practitioner is not taking you seriously when you go to them to get help be really clear that you feel like your vomiting is more than normal or more than usual and ask them to do a thorough check electrolytes blood test urine checks and if they don't know how to check for hyperemesis or you can go further and ask them do you know how to treat hyperemesis and they are not confident then that is a big huge red flag that you've got an underskilled clinician for your particular needs and it's time to find a new one.
[12:09] So there's no shame in that. I'm not shaming the clinician but the clinician should be comfortable to tell you that they feel out of their scope and refer you to a more experienced clinician. Now I know some of you are living rural or you only have one particular option for GPs or, you know, it's hard to do some hunting for a GP or a care provider. I acknowledge that. I'm just speaking to this because women who have high premises find that this is a constant problem that their care provider is underskilled and underdiagnoses their circumstances.
[12:47] Many of you are sitting there thinking, I hope she puts a number on how many vomiting episodes per day is normal or not normal. But the diagnostic strategy doesn't really ask women to count their vomits. So more importantly, it's how well are you as a woman? Can you manage to get enough fluids in and enough nutrition in? And what's the state of your mental, emotional, social and economic health in light of the situation that you're in. If you're physically well or physically feeling well but you're vomiting too much to go to work or too much to care for your children or you're really struggling with it emotionally and mentally and you're having intrusive thoughts and feelings that are impacting you then the vomiting is too much. It's impacting your well-being and your life too much and so in this scenario it becomes less about how many times are you vomiting do you actually have high premises but if it's too much for you to feel enough comfort to keep going on with your life then consider that you do need some more help with it and this should be attended by your care provider.
[14:01] So it's not about how many times, it's about how it's impacting you and your well-being overall. You know, I've also had clients who have had all the physical symptoms of hyperemesis, losing weight, struggling to keep hydrated, all of the things. But they've been so well cared for and supported by the people around them that although they had hyperemesis, they weren't suffering emotionally, mentally or economically. They were just having a physically really rough time, and they had to give it their full focus. But I've also witnessed women who have been admitted to hospital almost for their whole pregnancies, feeling so distressed at their circumstances that they've considered terminating their pregnancies because of how severe the hyperemesis is. Hyperemesis is no joke. and unfortunately it's often gps and doctors not experienced in caring for pregnant women who see these women and misdiagnose the scenario and then women don't get the help that they need so please know that if you are vomiting too much for it to feel like a normal vomiting in pregnancy and it's impacting on all the elements of your wellness or some
[15:15] of the elements of your wellness Seek help. It's possibly hyperemesis. And pursue a midwife or an obstetrician for these early appointments because they're more likely to recognize what's going on and give you some help.
[15:30] And often women with hyperemesis need to be medicated. I'm not going to go through each individual medication. But the care approach needs to be individualized because each woman responds to different medicines differently and different dosages differently. Okay, now you are feeling nauseous and vomiting through your pregnancy.
[15:56] We aren't calling it morning sickness because it doesn't just happen in the morning. We're letting go of the term morning sickness. I don't know about you, but I felt nauseous 24-7 with random periodic vomits through my pregnancy.
[16:14] I didn't vomit more than once or twice a day on most days, but pretty much felt like I was going to vomit the whole time. So much so that I just wished I would vomit just to get the short amount of relief that you get from actually vomiting the nausea was just so distracting there wasn't a moment in the day where I wasn't wondering if I was about to vomit it was all consuming so if you are out there not vomiting much but feeling nauseous all day long your experience is just as distressing as if you were vomiting. I am with you on that. I used to have conversations with people and I'd be talking and in my head thinking, oh my gosh, I think I might be about to vomit. I don't know, am I? It was just constant.
[17:09] So today I'm going to share some strategies that worked for me, that worked for my clients, some that I suggested work from the research. Today I'm not including pharmaceutical medicine options because prescription medicines are something to discuss with your midwife or doctor and they're not really the scope of this podcast. This is more of a sort of at-home remedies episode.
[17:33] There are some medications that can help you if you need that but there are also lots of lifestyle strategies and natural therapies that are worth trying before you consider medication. No medicine is risk-free so let's explore some of the other options. All right, so firstly, there are a few lifestyle things that you can change that might help. Top tip number one, avoid triggers.
[18:03] You know what I'm talking about. Those things that immediately set it off. So for me, it was certain smells. I couldn't stand the smell of burning toast. Believe it or not, the smell of falafel being cooked. Or if there were onions or shallots in the fridge and you open it and get the waft of smell and also the smell of my own poo when I was going to the toilet was a massive trigger for me. So same for foods there are certain foods that you just can't eat because of how nauseous they make you feel. So step one is initially to identify and avoid as many triggers as you can. Avoid the things that make you nauseous let all the people around you know what makes you feel nauseous so they can avoid getting triggers in your space I know that's not always possible but it's just step one so identify and reduce exposure to triggers the other thing that triggered my symptoms was if I'd gone too long without eating and I'll explain why later.
[19:17] So next, tip number two for nausea and vomiting in pregnancy, reset your expectations. Oh my gosh, just as I said that, I wanted to stab my own eye with a fork, but reset your expectations. If you feel nauseous and you're vomiting, are you expecting to feel completely well? Do you want the symptoms gone completely like they never happened? And if that's the case or if that's what you're expecting, you may need to reset your expectations.
[19:51] So pharmaceutical and natural therapies can be very effective but it's very unlikely that you're going to take the nausea and vomiting away altogether. So if that's what you're aiming for, nothing is going to feel like it's working for you and so consider that it's time that you reset your expectations and resetting them can be the difference between you suffering from or living with the symptoms so if you expect to be completely symptom-free and they don't go you're going to suffer the whole pregnancy and when I was going through this myself with both my first and my second pregnancies I was really feeling it and I generally have mental toughness and resiliency in my life so my plan was to do my very best to reduce it knowing that I might also just have to tolerate it and I reminded myself that pregnancy was a time to prepare me for parenting and.
[20:54] And to make me the type of parent that my child needed. And maybe coping with this discomfort could be turned into a bit of a training exercise in resilience where I just got better and better at dealing with discomfort. And it allowed me to develop strategies for that. And ultimately that would see me through my parenting years but also through life. Sometimes things are not as easy as you were expecting them to be. And it's an opportunity to build some resilience, some mental toughness, reset some expectations.
[21:30] I was definitely uncomfortable all the time, but I chose not to suffer. And I also held on to hope that maybe when I got to 16 weeks or 20 weeks,
[21:43] that the symptoms would reduce significantly and I would only be kind of soldering on for a short time. And certainly that is that is most women's experience is that you'll get to 16 to 20 weeks or so and the symptoms start to ease might not be for you and I'm sorry if that's you so just check in with yourself what are your expectations because based on those you'll be making your choices about what you do to help remedy this nausea and vomiting okay tip number three is be prepared. Again, this is an early strategy that you can use while you're adjusting and working out what works for you and what doesn't work for you and what your triggers are. I noticed that if I managed my triggers well, that although I felt nauseous, I didn't get to the point of vomiting. However, there are days where this was outside of my control and will be outside of your control. And you know, I'm also a private midwife, so I live my whole life on call and at that time when I was pregnant I was on call all day every day so I had to be super prepared so.
[22:54] I had to deal with random vomits just wherever they happened. And so I made myself these little go bags, like a vomit go bag. So I had a container and it had food in it that I knew would help ease my nausea. It had water, electrolytes, and can I just put in another plug for Hydramama electrolytes here? They come in a sachet, so they're really easy to put in your vomit go bag. You can just put sachets in. You don't have to have it already mixed. I had a banana, a vomit bag. So you can buy actual vomit bags that kind of clip shut once you've vomited in them. And I had some tissues or wet wipes in there as well. So this traveled with me and you can make little individual go bags if you want to have a few dotted around the house or in different bags or in your car. And then if I needed to have a little vomit especially if I was out in public then you don't have to run and try and find a place to vomit you just sort of tuck out to the side find a little private space do your vomit into the vomit bag you can clean your face with the wipes have a big sip of water have a snack pop your electrolytes in your water rehydrate and then keep going on the day. And this was particularly helpful if I was driving, you can pull over, you know, there's been times where I just.
[24:21] Went to the side in public, hid away somewhere. You do not want to be putting your head into a public toilet bowl when you are nauseous and vomiting. It almost feels like it's going to induce more nausea and vomiting.
[24:35] So these bags came really in handy. Just being prepared improved the quality of my life while I was pregnant, knowing that I had the capacity to vomit anywhere, clean up after it have a snack and rehydrate all in one little go bag these little go bags they're just a really good tip for women if you are commuting to work or you can have them at work with you or if you're at home looking after kids and taking them out to activities you don't have to adjust your day around potential vomit locations you have a traveling go pack designated for vomits and I've made a list of the things that were in my vomit go bag and they're in the resource folder. So for those of you who are on the mailing list for this podcast, that will get sent to you when you sign up for the mailing list if you all aren't already on it. And I've got my full vomit go bag list. The link is in the show notes below. Sign up to the mailing list. It'll get sent out to you. All right, now for some more tips to try not to vomit and reduce feelings of nausea. Number four is plan to get enough sleep. Resist the urge to stay up late, binging shows. So pregnancy is tiring enough as it is and it's worse if you don't have healthy sleep habits that at least give you the opportunity, enough hours to get enough sleep.
[26:00] And not getting enough sleep not only does it make you feel a bit more rubbish but it actually makes nausea and vomiting worse. So for sure the times in my pregnancy when I was called out to night births for example or I was parenting young children while also pregnant the next 24 hours of nausea and pregnancy were way worse. So the combination of nausea and vomiting and tiredness are enough to seriously affect your mood and feelings of well-being and then make it more difficult to work through how you're already feeling and mentally cope with the vomiting. So being tired takes a more emotional toll. So planning to get enough sleep is important. And if you have little people that keep you awake at night, perhaps consider a nap roster that you consciously attend to through the day or tag teaming at night can help. You'll have to come up with your own strategies depending on the support that you have. But this tip of prioritizing sleep is going to take discipline. You definitely have to be strong to commit to this.
[27:09] All right, number five, this is a big one, is keep your blood sugar balanced. So full disclosure, I haven't been able to find a specific study that says exactly this, that keeping your blood sugar balanced reduces symptoms of nausea and vomiting. There's some data around it, but something that I can specifically send you to that explains it really thoroughly and clearly I didn't really find but I know for myself and for my clients when you avoid hunger and eat to manage your blood sugar levels to keep them stable rather than fluctuating then you can prevent the feeling of getting hungry and this alone can reduce the nausea and stop you from vomiting and also stop your blood sugar from peaking really high and then dropping really low and then you have to eat to peak it high again it's those fluctuations in blood sugar that can really kick off a vomiting episode so i could do a whole episode on how exactly to balance your blood sugar but a great resource on this that i highly recommend is a book called the glucose revolution and i'll put a link in the resource folder for those who are on the mailing list it is life-changing advice and tips on how to balance your blood sugar easily and healthfully.
[28:35] All the tips are fine to use during pregnancy too, but I'll share a few tips here that I used personally and that I talked to my clients about. And also when I worked as a naturopath, we focused really heavily on blood sugar management. So it's an area that I feel comfortable in and that I've transferred also over into my work as a midwife. But the Glucose Revolution book has further information on the things I'm about to talk about anyway.
[29:01] So in order to balance your blood sugar, you can eat before rising out of bed. So you usually wake with a lower blood sugar than you operate with over the day. So before you get moving, before lifting your head or going to the toilet, hydrate well.
[29:18] Get some wholesome food into you, not high sugar foods. Foods, firstly, that make you feel better. So choose a food that when you eat it, you go, oh, that feels a bit better. But something that will also help keep your tummy full between when you get up and when you actually make yourself a proper breakfast that would be the next tip is make yourself a proper breakfast don't skip breakfast because skipping breakfast or having a really highly processed breakfast high in carbs and sugar is a surefire way to trigger off blood sugar fluctuations through the day. Your best chance at a stable blood sugar is a wholesome, high-protein breakfast in the morning. So in order to remedy this early morning low blood sugar, I would have snacks next to my bed and my husband would also wake up 30 minutes before me to prep my breakfast and bring it to me in bed and I would eat it laying down and I would wake up so hungry. He'd bring me a lot of Food, bless him. So on the days that I could do this, that I could lie in bed and where he had the time to make me a full breakfast, this made me feel heaps better.
[30:34] While I had that meal, I would also take ginger and B6 supplements. And at that time, Blackmore's had a product that had them both in there. So that's something you could look for as well, either ginger and B6 separately or in a combined supplement. But doing those two things together in the morning and properly hydrating made my symptoms way better for the whole day.
[30:59] Not 100%, just better than they are if I didn't do that. So commit to that make a plan for that we used to plan that before we went to bed now with the ginger supplements the dosage is around one gram a day and you can spread that through the day and with the b6 some.
[31:19] Sources say that up to 200 milligrams a day is okay but you probably need less than that and i'm reluctant to offer a clear dose here because too much B6 certainly over 200 milligrams is linked to side effects but about 100 milligrams per day spread over the day seems to be a sufficient amount to help with symptoms when we look at the research around the use of ginger for remedy nausea and vomiting in pregnancy they're using around the 100 milligram dosage so you shouldn't overdose with that and again we're only going to use that while you're feeling nauseous it's not something to just have daily now to go with your very hearty wholesome fully nourishing high protein breakfast in the morning consider eating protein with each meal to keep you full for longer and prevent sudden spikes and peaks and troughs in your blood sugar and you'll find heaps more protein hacks in the glucose revolution book but essentially you want to avoid just eating carbohydrates by themselves particularly refined carbohydrates so.
[32:30] When I say refined carbohydrates anything that tastes sweet or is really white rice pasta.
[32:37] Cakes anything that's processed grains is considered sort of a processed carbohydrate so you want to dress those up with some protein and good fats to slow down how fast that sugar moves into your bloodstream you want a steady release into your bloodstream so you don't get a massive peak and then a massive trough as your body freaks out trying to remedy the high glucose levels in your bloodstream. And consuming protein in each meal and dressing up your food like that can help reduce those peaks and troughs. In line with this, some small regular meals can help maintain your blood sugar level too. So don't go too long without eating. Have a plan, meal plan, so that you know you're going to be able to get enough food to prevent a drop and an exacerbation in your symptoms.
[33:32] That was point five, avoiding blood sugar drops. Number six, eat what makes you feel better. Let's just trust maybe that sometimes your body makes you feel nauseous with certain foods because your body just doesn't want it or need it. So eat what makes you feel better. Don't feel guilty about that. So I ate a whole pineapple and a whole pawpaw one day during my pregnancy because it just made me feel better. I also ate a lot of hash browns I'm not proud of that but that's what happened the hash browns, honestly eat what makes you feel better obviously the caveat with that is that it's important to focus on whole foods and limit the highly processed foods that have heaps of additives in them you want to minimal additives food that's actually food hopefully your body craves real food and that's what makes you feel better. Number seven, keep hydrated.
[34:35] Remembering you can't just have water if you're vomiting and feeling nauseous. Just having water can actually exacerbate dehydration. If your electrolytes are out of balance, then you're not going to be able to adequately hydrate. Here's where the electrolytes come in if you're vomiting a lot. Number eight, Thank you. Take pregnancy supplements after your food or with it. So don't take them on an empty stomach. And if you feel rubbish, if you're just burping up B vitamins all day long and that's triggering your nausea and vomiting, consider maybe another supplement or a food-based way to get those supplements, get those nutrients in because maybe, or maybe consider taking a break from them until you feel a little bit better. If they're not absolutely essential, if you're just kind of taking them because someone told you you should. That's another thing, burning up your pregnancy supplements can make you feel horrendous so consider if that's triggering you, would it be okay to stop them? Are they essential at this point? Why are you taking them? Are they absolutely necessary?
[35:42] Number nine, now with this one another caveat, although I had a look a very, I tried very hard to have a look at this, there was no research papers to back this up but I'm putting that down to the fact that research rarely focuses on women firstly and then much less focuses on pregnant women. So there's no surprise that no one has studied the impact of orgasm on nausea and vomiting in pregnancy but I have had clients say that they were using orgasms to remedy nausea in pregnancy.
[36:27] Orgasms as a tool to reduce the feeling of nausea. And maybe not just on its own. It might not be the thing that takes away your nausea completely. But we combined with the other strategies that I've offered in this episode, you know there are some real life experiences that I can draw from from my clients who've suggested that you might be able to have orgasms to reduce nausea. What I did discover in my research is that orgasm releases dopamine and oxytocin which are both hormones that are responsible for feelings of happiness and joy and bliss and there's no side effects to an orgasm so I'm putting it out there as an option for those who are having just unbearable days where you are scraping together anything that will offer you some relief. Why not try an orgasm and then pay attention to how your nausea feels afterwards. One of my clients reported that she had four hours of nausea relief after an orgasm. So there you go. Strategic orgasms for relief of nausea in pregnancy. Okay, tip number 10.
[37:45] Acupuncture or acupressure and there is a stack of research on this and I put the papers in the resource folder and certainly if you can afford regular acupuncture to help relieve the symptoms there is good evidence behind this so yes it's an option I did this for my second pregnancy for me I had to go twice a week to get the relief that I needed to function and if that's not something that's within your means you can look up some acupressure points for nausea or potentially have a few appointments with the acupuncturist and maybe they can show you some at-home acupressure strategies that you could use to help reduce your symptoms between appointments but there's also those motion sickness wristbands and there is a bit of research on those that suggests that these can help in conjunction with some other management strategies that these can help reduce the feeling of nausea and the number of times that you vomit when they compared it to women who weren't wearing them. So I don't think by themselves they would work you know to make huge change but in conjunction with all the other strategies that I've suggested today you could certainly add that to the package.
[39:01] So to sum that all up my top 10 tips for top 10 tips for pregnancy and nausea management so firstly identify and avoid the triggers check and reset your expectations be prepared for vomits with your vomit go bag so it's easier for you to live your life and a full list of what's in my vomit go bag is in the resource folder number four be disciplined in planning enough sleep number five keep your blood sugar balanced using the strategies that I mentioned in the podcast but also the Glucose Revolution book. Eat what makes you feel better. That's point six.
[39:47] Seven, keep hydrated and remember the necessity of electrolytes in avoiding dehydration. You can't always just hydrate with water. Sometimes you need to rebalance those electrolytes.
[40:00] Eight, take your pregnancy supplements strategically. So with food, after food, do you need to have a break from them? Is there another time of day you could take them where they wouldn't trigger
[40:11] your nausea and vomiting? Number nine consider some orgasms as a management strategy and number 10 explore some acupressure and acupuncture for some symptomatic relief now remember if none of these things work and you are absolutely suffering there are other pharmaceutical things that can help you see your care provider for a more individualized care strategy for you that has been today's episode of the great birth rebellion podcast and don't forget that Hydramama from mini and me have given us 20 off of their electrolyte products. Just for Great Birth rebellion listeners, when you purchase Hydramama, you can use the code GBR20. Go to their website miniandme.co to claim your discount this has been the great birth rebellion and i will see you in the next episode to get access to the resources for each podcast episode join the mailing list at MelanieTheMidwife.com and to support the work of this podcast wear The Rebellion in the form of clothing and other merch at TheGreatBirthRebellion.com Follow me, Mel @MelanieTheMidwife on socials and the show @TheGreatBirthRebellion. All the details are in the show notes.
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