Like most parents, I feel that near-constant nausea that comes with parenting three kids, but I didn’t experience pregnancy nausea. I am the non-biological mama to the kids my partner carried. Her pregnancy was conceived through donor sperm purchased from a cryobank and with the assistance of intrauterine insemination at our hospital’s fertility clinic.
I was the emotional and physical support, but in no way will I ever pretend to know what it is like to grow babies inside my body. My partner experienced very little morning sickness; the solution was for me to leave to her alone and refrain from cooking certain smelly things. But I have sympathized with many friends who have had to hold their hair back each morning (and night) thanks to the growing lifeform wreaking havoc on their systems. They needed more than a short list of banned foods. They needed something to make the sickness stop.
OB/GYNs have been recommending the combination of B6 and doxylamine (the active ingredient in Unisom) for pregnancy nausea and vomiting for a while now. The combination of the two is safe, easy to get over the counter, and relatively cheap. Depending on the severity of sickness, the doses of B6 and Unison can be adjusted throughout the day. It can feel like a full-time job, but taking Unisom at night, in the morning, and midafternoon in conjunction with B6 three times a day can provide relief.
Pregnancy-related nausea typically starts around week 5, peaks between 11 and 12 weeks, and usually subsides early into the second trimester. According to the Fertility and Midwifery Care Center, 90 percent of pregnancy-related sickness ends by 22 weeks. Some people are sick throughout their pregnancy and the degrees of nausea and vomiting vary.
The trade-off for not tossing your cookies is drowsiness, though, when using the B6 and Unisom combination. To combat the sleepy side effects of Unisom, OB/GYNs often prescribe Zofran as an anti-emetic. It works well, but can cause constipation. Pregnancy is a blast, huh?
Another potential solution is Diclegics, an extended release formula of B6 and doxylamine; it works well but without causing tiredness. Because it is a relatively new drug, Diclegics may cost a patient $400-$500 — a hefty increase from the $10 OTC drugs it is replacing.
Jennie Lowell, MD, FACOG explained to Scary Mommy that a few years ago, the American College of OB/GYN released a statement that Category B drugs like doxylamine (Unisom) should be used first for pregnancy induced nausea and vomiting. However, the anti-drowsy Zofran is a Category C drug. This means there was a shift to move away from the B6/Unisom/Zofran formula and move to prescribing Diclegis, a drug that is the same thing but in a new (pricier) package.
Dr. Lowell told Scary Mommy, “It is very frustrating as a prescriber, as often we have to battle the insurance companies to cover Diclegis, having to provide proof that a patient has failed the over the counter Unisom and B6.”
But it does work.
Expectant mother Erica Sans told Scary Mommy, “After I hit six weeks, nausea became my annoying little friend. Everyone had advice. My OB suggested eating green apples. My doula recommended milk thistle drops. My osteopath told me to try drinking ginger tea. [I tried] acupuncture, Sea-Bands, and Preggie Pop Drops. I ate small, bland, protein filled snacks every 90 minutes. Nothing helped.”
Sans finally found and tried the magical B6 and Unisom combination, but that didn’t work either. Her OB prescribed Diclegis and thankfully it was covered by insurance. “The Diclegis was really that magic pill that I had been hoping for. The nausea decreased and I was able to function. At 22 weeks, I have tried to wean myself off, but every time I decrease the dose or skip a day, the nausea starts coming back.”
First trimester sickness is a pain in the ass, but it can usually be remedied with time-tested anti-nausea tricks. But when a pregnant person can’t function through the nausea and vomiting and they need something else, a B6 and Unison combo can make the world of difference. It may take tweaking doses until the perfect mixture is found, but it is a safe alternative that can be guided by your OB team. And if you can afford to take the leap or need to try something else, Diclegis may be the drug you are looking for to get through your day without ralphing.
Children won’t make you any less woozy, so try to find the relief you need now before the baby is born and pregnancy becomes parenting.