What Is Morning Sickness?

Nausea and Vomiting Common in First Trimester of Pregnancy

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Morning sickness (also called nausea and vomiting of pregnancy) describes stomach upset during pregnancy. Morning sickness affects many people who are pregnant, particularly in the first trimester. Knowing what to expect and what treatment options are available can help you manage bothersome symptoms and get on with your day.

How to Ease Morning Sickness Symptoms

Brianna Gilmartin / Verywell

When Does Morning Sickness Start?

Morning sickness symptoms usually begin between five and six weeks of pregnancy and almost always before nine weeks. Relief typically comes by the end of the first trimester, while 87% of pregnant people will have their symptoms resolved by the 20-week mark.

A small percentage of people who are pregnant experience nausea and vomiting for the entire duration of their pregnancy.

Morning Sickness Symptoms

Morning sickness is a widespread condition associated with normal pregnancies. Between 50% to 80% report some degree of nausea, and 50% experience vomiting.

Despite its name, morning sickness can occur at any time throughout the day, with 80% of people who are pregnant reporting symptoms that last all day, and less than 2% having symptoms only in the morning.

Hyperemesis gravidarum describes severe nausea and vomiting, affecting between 0.3% to 3% of all pregnancies. Individuals with hyperemesis gravidarum may vomit multiple times throughout the day and end up losing more than 5% of their prepregnancy weight.

Causes

The specific cause of morning sickness is unknown, but there are several theories. A rise in pregnancy hormones, including human chorionic gonadotropin (hCG) and estrogen, is thought to contribute to nausea and vomiting symptoms. Slowed gastric emptying, a genetic predisposition, and psychological changes may also play a role.

While the reasons for morning sickness aren’t quite clear, various risk factors can increase your likelihood of developing an issue, such as:

  • Female fetus
  • History of migraine headaches or nausea while taking estrogen (commonly found in birth control pills)
  • Mother or sister who experienced nausea and vomiting of pregnancy
  • Personal history of motion sickness or morning sickness with a previous pregnancy
  • Pregnancy with multiples (i.e., twins, triplets, etc.)

Treatment

For most, morning sickness is a nuisance but does not end up requiring medical intervention. Luckily, dietary and lifestyle changes may offer some relief.

Here are some ideas to alleviate some of your symptoms:

  • After eating: Brush your teeth after eating and avoid lying down (to prevent reflux).
  • Avoid triggers: These may include strong odors, heat, humidity, noise, spicy/high-fat foods, and flickering lights.
  • Eat early: Dry, bland crackers or a high-protein snack can be helpful before starting your day.
  • Eat often: Frequent, small meals (every one to two hours) can prevent stomach overfilling or excessive hunger between meals.
  • Hydrate: Sip cold, clear, carbonated, or sour drinks between meals, such as flavored water, ginger ale, or lemonade.
  • Sleep: Get enough rest and avoid becoming overtired.

Speak with your doctor if you are taking a prenatal vitamin that contains iron. Switching the prenatal vitamin to one without iron may be an option that can reduce nausea. Taking your prenatal vitamin at night may also help.

Your doctor may advise treatment for morning sickness if symptoms begin to impact your quality of life negatively. You may need additional help if you find it challenging to consume enough fluids or food or if you start to lose weight.

Supplements

Ginger capsules taken several times per day have been shown to improve nausea symptoms. Other options include grated fresh ginger in hot water (like a tea) or crystallized ginger. Speak with your doctor before trying this supplement to determine if it’s a good option for you.

Vitamin B6 (pyridoxine) alone or in combination with doxylamine (an antihistamine found in many sleep aids, such as Unisom) are often the first medications that will be tried. Vitamin B6 and doxylamine are available as separate, over-the-counter products.

A combination prescription product (Diclegis) is also available. Vitamin B6 with doxylamine has been proven to treat both nausea and vomiting symptoms effectively and is well tolerated. The most common side effect is drowsiness. It has also been shown to be safe for your baby.

Wrist Bands

P6 acupressure with wrist bands (pressure applied to the P6 location on the inside of the wrist) has shown conflicting clinical study results. However, since some people experience symptom relief and there are no risks, you may consider this a safe, medication-free alternative.

Medication

If your symptoms persist, your doctor may recommend another anti-nausea or antihistamine medication. Some products are available over the counter such as Benadryl (diphenhydramine) and Dramamine (dimenhydrinate).

Others require a prescription and include Reglan (metoclopramide), Zofran (ondansetron), Compazine (prochlorperazine), and Phenergan (promethazine).

Hyperemesis Gravidarum Treatment

A small percentage of people with severe symptoms of hyperemesis gravidarum may require hospitalization for dehydration, electrolyte abnormalities, and nutrient deficiencies. Intravenous fluids can be administered, along with injectable anti-nausea medications.

Patients may also require enteral nutrition (nutrients administered via a tube that goes through the nose and into the stomach/small intestine). In very extreme cases, a patient may need to receive nutrition through their veins (total parenteral nutrition).

When to Contact Your Doctor

Morning sickness usually resolves without any complications. However, if you experience severe symptoms, you should contact your doctor for further evaluation. Watch out for the following signs:

  • Abdominal pain or cramping
  • Fever or diarrhea
  • Nausea or vomiting that occurs for the first time after nine weeks of pregnancy, as this could be a sign of an undiagnosed condition unrelated to morning sickness
  • Signs of dehydration, including infrequent urination or inability to urinate, dark-colored urine, dizziness upon standing, or a racing or pounding heartbeat
  • Vomit that contains blood
  • Vomiting throughout the day
  • Weight loss of five pounds or more

It’s important to keep your doctor informed of morning sickness issues, especially if it’s affecting your ability to keep food down or stay hydrated.

A Word From Verywell

Pregnancy can be an exciting and hopeful time in your life. However, it may not be easy to concentrate on much else if you are experiencing morning sickness.

Fortunately, the majority of symptoms go away on their own by the end of the first trimester. Following these tips can help you enjoy the early stages of pregnancy as you await the arrival of your little one.

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Article Sources
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