When should I take my pregnant wife to the hospital for nausea?

Question

My wife is 12 weeks along with our first child and we are very excited to be parents next year. However, since about week 6, she has had quite a few bouts with nausea. We were quite aware that this is normal in pregnancy and informed that it most often slackens in intensity during the second trimester (here's to hoping that's the case), but yesterday was probably the worst day yet. She ate early in the morning and then was unable to hold down liquids or food for the remainder of the day. This culminated in an evening of about 5-6 trips to the bathroom to vomit which made a rough total of about 9 or so episodes of vomiting.

Long story short, I was quite concerned and tried repeatedly to convince her that it was time to go into the hospital (Sunday night so urgent cares and/or doctor's offices were closed) so that she could get hydrated and possibly some nourishment. My question is was I over-reacting? If not, what are some ways that I could convince her that the hospital is the best bet? (The situation was complicated by the fact that she was very tired, both from the dehydration and a poor night of sleep, so going into the hospital sounded like a terrible idea to her). If it helps with severity of her symptoms she did mention this morning that she probably should have gone in last night. I just want my wife and my growing child to be safe and healthy.

Answer 1

No, you're not over-reacting.

The health care system exists for everyone. People go to the Emergency Room for far less serious problems than your wife has, and that's fine (I work in an Emergency Room.) Please know that doctors are sympathetic to this situation. I can think of almost nothing worse than to be nauseated 24/7.

Normal nausea of pregnancy usually improves with rest and bland carbohydrates (women are advised to keep crackers by the bedside and eat one or two if they wake at night, and as soon as they wake up in the morning - before getting out of bed.) Keep nibbling at carbs throughout the day, and take frequent sips of fluids (flat ginger ale is a natural - though very mild - anti-emetic.) Fats often aren't well tolerated. Cold or cool foods are usually tolerated better than hot, and bland is better than spicy. Here's to hoping this is what she has.

However, your wife may have something called hyperemesis gravidarum. The risk is dehydration and ketosis (because her body is relying on fat breakdown for energy.) The treatment is IV fluids, a short hospitalization, and when necessary, anti-emetic medications. While most nausea of pregnancy goes away (usually between 16-20 weeks), HG does not.

Please encourage your wife to seek treatment if her nausea causes her that much distress. It's better for her and her baby to keep hydrated and to eat food every day.

Nausea and morning sickness
Severe vomiting in pregnancy

Answer 2

Dehydration is a condition which is potentially very serious, especially for pregnant women (http://americanpregnancy.org/pregnancy-complications/dehydration-pregnancy/). I'm assuming she's tried a number of remedies for nausea (dry crackers is the one I've heard most often) and nothing is working. In case it helps any, I've heard from most of my friends that severe nausea early in a pregnancy often means the later pregnancy will be easier.

Many years ago I was pretty sick (not pregnant, just vomiting, etc). The vomiting started at about noon, and by eight o-clock my husband was concerned enough to call an ambulance (over my strenuous protests). The ambulance guy looked at my tongue (yes, apparently they can tell how dehydrated you are just from that) and into the ambulance I went. They poured two bags of water into each arm and told me that it was a good thing my hubby called them because I was maybe a couple hours away from kidney shutdown. That was after only eight hours (not normal, I grant you, I dehydrate easily).

Your wife was probably embarrassed at the thought of going to the hospital for something that normally people are just expected to "be tough" about. I can totally empathize. But when your life isn't just yours any more, you need to think of your family and get past the embarrassment. Is it always going to be a totally warranted life-or-death situation when you run off to the hospital in the middle of the night because your husband is worried to death about you...no. Not always. But if nothing else works just tell her that you need to take her to the hospital for your own sake, because you need to know that she is okay, and for the sake of your child, who is unable to tell his/her parents what (s)he is experiencing. And even though dehydration is not as dangerous for the baby early in a pregnancy, it is still one of the warning signs that may mean she needs to go to the hospital (http://www.webmd.com/baby/features/pregnancy-first-trimester-warning-signs)

Here are some things to pay attention to when you are trying to decide whether she needs to see a doctor: http://www.livestrong.com/article/507675-how-to-know-if-you-are-dehydrated-when-pregnant/. I'd recommend going to a clinic and seeing what they have to say about her level of dehydration when she is feeling bad. At the very least it may give you peace of mind if they tell you she's okay. And if they immediately start up the IV, then you both know to take her condition seriously.