With Mayo Clinic certified nurse-midwife Mary Murry, R.N., C.N.M.

Before I ever got pregnant, I worried I would have pregnancies like my dear sister. I think she vomited from the time the sperm united with the egg until her placenta delivered. She never had relief, it just became more predictable. She got the vomiting and fast labor genes and I got the no nausea or vomiting and the slow labor gene.

According to the UpToDate database, some degree of nausea with or without vomiting occurs in 50 to 90 percent of all pregnancies. It begins at five to six weeks gestation, peaking at nine weeks, and usually getting better by 16 to 18 weeks. My sister was one of the 5 percent who continue with it until delivery.

Why do we get nauseated and vomit in pregnancy? Good question — with no definitive answer. There are no studies that can say what causes it. There are theories about hormonal changes and abnormal gastric motility as well as psychological factors.

What can we do about it? If you know that there is a trigger for the nausea, such as the smell of fried food, avoid that. No trips through a drive-through window. Other triggers can be stuffy rooms, perfume and heat. Brushing your teeth can bring it on. Sometimes the iron in your supplements can cause gastric irritation. You could stop your prenatal and take a standard multivitamin or just take your folic acid supplements until after you are feeling better. Eat before or as soon as you feel hungry. An empty stomach can aggravate nausea. Eat frequent high-carbohydrate, low-fat meals. Powdered ginger (1 to 1.5 grams in divided doses over 24 hours) has a positive effect. Some women find lemon-drop candies help.

If your nausea and vomiting are unstoppable, let your health provider know. There is a condition called hyperemesis gravidarum (too much vomiting while pregnant — have to love the fancy name) that can be serious. If you have persistent vomiting and have weight loss exceeding 5 percent of your pre-pregnancy weight, you could fall in this group. Seek help immediately.

I am sure many of you ladies have experienced this. Share with us the things you did to help get through this stage of pregnancy.

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