Nausea and vomiting are common experiences for many people during labor, often adding a layer of physical distress to an already intense process. This physiological response is reported by an estimated 50% to 80% of laboring individuals, particularly as contractions intensify into the active phase. While the symptoms are usually temporary and not harmful to the baby, they can be highly disruptive, making it difficult to maintain focus and energy for the work of labor.
Why Nausea and Vomiting Occur During Labor
The onset of nausea and vomiting during labor is triggered by a combination of physiological shifts and external factors. One significant cause is the body’s hormonal response to the intensity of contractions. As labor progresses, the body releases elevated levels of catecholamines and endorphins, which affect the digestive system and activate the brain’s vomiting center. Intense uterine contractions activate the central nervous system, leading to a reflexive response that includes nausea.
The body prioritizes energy toward the uterus, causing the gastrointestinal tract to slow down significantly, a condition known as delayed gastric emptying. This slowdown means food and fluids remain in the stomach longer, increasing the feeling of queasiness. Medical interventions for pain management also contribute to gastrointestinal distress, as narcotic pain medications like opioids are known to cause nausea and vomiting. Regional anesthesia, such as an epidural, can cause a temporary drop in blood pressure (hypotension), which is a frequent trigger for nausea.
Proactive Strategies for Non-Medical Prevention
Preparation taken before and during the early stages of labor can significantly reduce the severity of later symptoms. Maintaining proper hydration in the days leading up to and during early labor is an impactful strategy, as dehydration can exacerbate nausea. Consuming water or electrolyte-rich drinks is helpful, and the choice of food during early labor is also relevant since digestion becomes sluggish once active labor begins. Focusing on small, easily digestible, and bland snacks provides necessary energy without overtaxing the digestive system. Examples include crackers, toast, fruit, or clear broths.
Practicing specific coping mechanisms can help minimize the pain-related triggers for nausea. Utilizing focused breathing techniques helps to calm the nervous system and manage the pain perception associated with contractions. Reducing anxiety through relaxation can lessen the overall intensity of the body’s physiological stress response.
Immediate Relief and Positional Management
When nausea begins during established labor, several non-medical strategies can provide immediate relief. Positional changes are effective, as lying flat on the back can increase pressure on the abdomen and slow digestion further. Shifting to an upright position, leaning forward, or lying on the left side can help optimize blood flow and gastric emptying. Sensory management involves controlling the environment to reduce triggers that worsen nausea, such as strong smells, bright lights, or a warm room.
Requesting dim lighting, using a cool compress on the forehead or neck, or having a fan for airflow can offer comfort. Inhaling certain scents can quickly interrupt the sensation of nausea. Peppermint, ginger, and lemon essential oils are often used for their antiemetic properties, typically by placing a few drops on a cotton ball or cloth to sniff during contractions. Ginger itself, in the form of candied ginger or a tincture, is effective when consumed in small amounts. When a contraction starts, focusing on slow, deliberate breaths can help prevent the gag reflex that often accompanies intense pain.
Pharmacological and Clinical Interventions
If non-medical approaches are not enough to control the symptoms, the clinical care team has several options. Intravenous (IV) fluids are frequently administered, particularly if vomiting has led to dehydration or if hypotension is suspected following regional anesthesia. IV fluids help restore the body’s fluid balance and address the blood pressure drop that often causes nausea after an epidural. The primary medical treatment involves antiemetic medications, which are drugs specifically designed to prevent or treat nausea and vomiting. These are commonly given through an IV line for rapid effect.
Medications like ondansetron, which works by blocking serotonin receptors in the brain and gut, are often considered a first-line treatment. If the nausea is believed to be a side effect of pain medication, the healthcare team can adjust the dosage or switch to a different class of pain reliever. If hypotension is the root cause after an epidural, medications to raise blood pressure, such as vasopressors, can be administered.