Nausea Medicine and Morning Sickness: What's Safe During Pregnancy?
Experts weigh in on the pros and cons of treating morning sickness with prescription drugs.
Anyone who's ever dealt with morning sickness will tell ya: It's no joke. And now, medical experts are shedding a bit more light on how important it is to adequately treat the issue.
According to Britain's Royal College of Obstetricians and Gynecologists, four out of five pregnant women experience morning sickness through pregnancy and, despite its name, this affliction can strike all day, every day. Because of this, the group has rolled out new guidelines stressing the importance of proper treatment for morning sickness.
"Women with persistent nausea can often feel that there is a lack of understanding of their condition," Dr. Manjeet Shehmar, the lead author of the guidelines, said, according to the BBC. "They may be unable to eat healthily, have to take time off work and feel a sense of grief or loss for what they perceive to be a normal pregnancy. It is therefore vital that women with this condition are given the right information and support and are made aware of the therapeutic and alternative therapies available to help them cope."
According to the guidelines, there's a lack of understanding about morning sickness. While drug-free therapies like ginger and acupuncture can provide relief, experts believe severe cases of morning sickness may require anti-sickness drugs or even hospital treatment.
Jonathan Schaffir, MD, an associate professor in the department of Obstetrics and Gynecology at The Ohio State University College of Medicine, explained that the issue of whether or not to treat morning sickness with medication is complicated.
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"Nausea and vomiting in pregnancy is extremely common and ranges from the occasional discomfort to a miserable experience with weight loss, dehydration and inability to tolerate any food at all," he says. "While the low end of this spectrum may be amenable to non-prescription treatments like bland foods and ginger, the more severe symptoms will usually require some help in the form of medication."
Anti-Nausea Medicine Options
There are several treatment options available, according to Dr. Schaffir: "There are many anti-nausea remedies that are used in pregnancy. The most extensively studied medication that has been proven safe is a combination of vitamin B6 (pyridoxine) and doxylamine, which is available over the counter as a sleep aid."
"Other antihistamines like promethazine are effective as well," Dr. Schaffir continued. "Many women don't like the sedative effects that these medications have because they make them too sleepy to work or take care of other children. A non-sedating medicine that is helpful for nausea in pregnancy is ondansetron. While used widely with no bad effects, the use of this medicine in the very early part of pregnancy has come under increased scrutiny lately because of conflicting reports that it may be associated with a small increase in the rate of certain birth defects. This association has by no means been proven, but because of the uncertainty, many caregivers will avoid this medication until after the first two months of pregnancy. Regardless, if a woman is unable to keep any food or drink down, then the risk of complications of dehydration and insufficient nutrition is greater than the risk of using these medications."
The American Congress of Obstetricians and Gynecologists echoed the idea that dealing with morning sickness can be tricky and that treatments depend on the severity of the case.
"If diet and lifestyle changes do not help your symptoms, or if you have severe nausea and vomiting [during] pregnancy, medical treatment may be needed," the group said in an emailed statement. "If other medical conditions are ruled out, certain medications can be given to treat nausea and vomiting. You and your obstetrician or other members of your health care team can discuss all of these factors to determine the best treatment for your personal situation."