Forget about the *pregnancy glow*, the first months of growing a new life can be completely miserable and debilitating if you’re one of the unlucky women who experiences nausea and/or vomiting in pregnancy.

It’s no secret that I’ve just survived my own storm of nausea & vomiting in my second pregnancy (which lingered for much longer than the typical first trimester period and hit me much harder than my first pregnancy), which was a completely debilitating experience that impacted virtually every aspect of life, from my business and work, to my mental health and cognitive capacity, to my relationships, to taking care of my daughter, and so much more.

Anyone who has navigated NVP knows that it comes with so much guilt – due to things like the difficulty eating a healthy diet or following your usual healthy habits from pre-pregnancy, the concern about the impact this will be having on your growing baby and your own body as you move through pregnancy, and your changed capacity to perform normal daily tasks like working or looking after your other children.

Although it’s easier said than done to simply say ‘don’t feel guilty,’ the reality is that so much of this is outside your control in these early months that beating yourself up about it is a waste of whatever precious energy you have left.

Try to be compassionate to yourself and know that you’re doing the best you can, even if that ‘best’ is very far from where you normally are, or where you’d rather be, or from where you think you should be.

These symptoms are not your fault, you did nothing to cause them to happen, and this is a unique time of life where it’s normal to need to reach out for support, ask for help, and lean on others more than usual.

Some tricks for staying hydrated during NVP:

Some other tips for food intake during NVP:

Ginger is a herbal medicine that has been found to be helpful in alleviating mild pregnancy nausea. It has a long traditional use for nausea and has been studied with positive outcomes for use in pregnancy nausea. It is classified by the Therapeutic Goods Administration (TGA) as a category A drug – meaning that it has been taken by a large number of pregnant women and women of childbearing age without any proven increased risk for the baby.

Vitamin B6, also known as pyridoxine, is an essential vitamin that has been found in studies to help alleviate mild pregnancy nausea and is widely recommended by several medical bodies, including the Society of Obstetric Medicine in Australia and New Zealand (SOMANZ), as a first line treatment option for 

My clinical experience supporting women with NVP is that the combination of ginger and vitamin B6 can be effective for women experiencing mild-moderate symptoms. Those with more severe symptoms usually find this combination alone isn’t enough to reduce symptoms.

The important thing is to take an adequate therapeutic dose for this combination to be effective. Understandably, in an attempt to find relief, lots of women self-prescribe with whatever products they can get their hands on, but these products don’t always have the doses needed.

I strongly recommend getting professional advice to make sure that taking ginger and vitamin B6 is safe for you and your pregnancy, but generally speaking these are the doses to aim for:

• Ginger: the upper recommended intake level during pregnancy is 1000mg/d, ideally taken in divided doses, for example taking 300mg three times or 500mg twice.
• Vitamin B6: the upper recommended intake level is 100mg, ideally taken in divided doses, for example 25mg taken 3-4 times daily. The best form to look for is active B6 or pyridoxal-5-phosphate
• Products:
  • You could consider a prenatal vitamin that contains ginger + B6 within the formula, such as the Naturobest Trimester 1 Prenatal, although the limitation here is that you can’t increase the doses of ginger or B6 because you would then be increasing your dose of all other nutrients within the capsule
  • Elevit Morning Sickness Relief is a product that contains adequate doses of both ingredients
  • Blackmores Travel Calm ginger tablets are another good option – you would then need to pair this with a vitamin B6 supplement providing doses of ~25mg per capsule or tablet
• Always take your supplements after eating to avoided exacerbating your nausea

You can also consider trying some of these at-home ginger remedies:

• Ginger tea: ½ teaspoon of grated fresh ginger root, steeped in one cup of hot water for 10 minutes, then drink.
• Crystalised ginger: chew on crystalised ginger, as your appetite allows
• Drink ginger ale: if you go for this option, it must be ‘real’ ginger ale made with actual ginger root to have any therapeutic action. Many common ginger ales are made with artificial ginger flavour. Two options to look out for are Remedy Kombucha Ginger Lemon flavour or LoBros Real Ginger Ale.
• Try ‘Gin Gins’: chewable ginger lollies, available at most health food stores and some gourmet grocers

if you’re finding your prenatal vitamin is making your symptoms worse, or you’re vomiting so much that you can’t keep it down, here are some things to consider:

Supplements containing iron and/or zinc can both be triggers for nausea. This is especially true for larger doses of either mineral. Consider trying a supplement without iron, in particular. Prenatal vitamins without zinc are difficult to find, so see if an iron-free option works for you first.

Avoid taking your prenatal on an empty stomach, as this can worsen nausea. If you are able to get any food down, or liquified food like a smoothie or glass of juice, try having your prenatal immediately after this. 

Try breaking your prenatal up into separate doses, for example, breaking the tablet in half and having ½ in the morning and ½ in the evening to reduce the overall dose

Try a different prenatal supplement. Don’t slog it out with a supplement that is exacerbating your nausea. Each supplement has a different taste profile, capsule/tablet size, and chemical make-up. If it’s within your budget to try an alternative, experiment to see if there is another better tolerated option. Smaller, less odourous capsules are usually the best choice.

Try taking just take the basics: depending on your stage of pregnancy and personal needs, you can try taking just the most important nutrients, for example folate and iodine. Try supplements in different forms, like liquid drops or sprays or powders, which you may be able to tolerate more than swallowing capsules or tablets. Avoid products that are flavoured.

Consult a practitioner trained in prenatal nutrition for personalised support, like a women’s health naturopath, nutritionist, or dietician.  

When nothing is working with your prenatal

If none of the above works for you, try not to worry and return back to practising self-compassion and reminding yourself that your body is resilient (as discussed above). When the nausea passes (if it does!) you can refocus on your nutrition goals and replenish your body with the nutrients that may have been lost after this difficult phase is over.

In the worst of the sickness in this current second pregnancy, I was unable to do much more than lay horizontal on the couch or bed for hours at a time. Cooking, cleaning, working and many of my other normal daily responsibilities were all out of the question – including, at times, taking care of my young daughter which was heartbreaking.

I was forced to either offload, outsource, or let go of many of these responsibilities, which comes with lots of mixed emotions (guilt, frustration, anxiety, letting people down) and some pretty tricky logistical challenges (changing work schedules, rescheduling clients, finding childcare options at short notice, and more)

Saying things like ‘just ask for help’ is so much easier said than done and we all have different home and family circumstances when it comes to the level of support we have around us, so it’s hard to generalise. But my experience not only with NVP this pregnancy but also with having supported hundreds of mothers over the last few years with their health in motherhood has taught me that being able to ask for and accept help has many layers to it.

This is a time when you might be forced to confront those layers, which might include things like your desire to be perfect and always capable, the urge to be independent and self-sufficient, not wanting to burden others with your problems or needs, or beliefs about what a ‘good’ mother or pregnant woman ‘should’ be doing.

Often this is deep inner work and trying to go deep while in the thick of bad NVP isn’t ideal or possible, but at the very least try to sit with any resistance or discomfort that comes up when you think about asking for help and get curious about where the discomfort is coming from.

Some practical tips for managing your responsibilities during this time:

• Talk openly with your partner or any other close support people in your life (such as your parents or in laws) about reshuffling the responsibilities you have for the time being and outlining what capacity they have for taking on your responsibilities while you’re sick and need to rest. Although you might think it’s obvious and goes without saying that your partner might need to step up in certain areas, having a direct and specific conversation about it is always the better option
• Use a meal delivery service to cover cooking for the family or feeding yourself when you are unable to cook (I used Dinner Ladies and Dineamic for several months, but there are lots of options out there)
• If you have the budget, consider domestic support like a cleaner or housekeeper to do laundry or cooking, even if only or twice or sporadically, to allow you to relax and know that the basic responsibilities are covered for a time
• Better yet, let go of the need to have a clean and tidy house – of course there are some bare minimum task that will still need to be completed, but beyond this let the rest go until you have your energy back
• Call on family, friends, neighbours, or anyone else in your village to help out however they can, especially with your other children, if you have them – drop offs, pick ups, trips to the park, etc.
• If you’re not already utilising grocery deliver or online ordering options, consider these to reduce your need to leave the house
• Guilt free screen time – I used the TV and iPad like a babysitting on the days where I was parenting alone and too sick to get off the couch. Is it ideal? No. Did I feel guilty? Yeah, sometimes. But in the absence of any other option, it was a good solution that kept my daughter happy and allowed me space to rest.
• If you’re unable to work, you may be eligible for support payments through Centrelink. Although applying can be a tedious process, if loss of income is impacting you, it’s worth considering – find out more about eligibility here 

If you’re currently navigating this awful and miserable phase of pregnancy, my heart is with you. Be kind and compassionate to yourself as you endure what might be one of the toughest times in your life, and give yourself permission to take the path of least resistance in any way needed. Remind yourself that it will eventually end and that you’re doing such an important job growing new life.