Morning Sickness and Nausea During Pregnancy

You're sailing along on your early pregnancy adventure — just little breast tenderness and more frequent urination, but nothing you can't handle. Until one day, you wake up feeling queasy.

Does it seem like you've got a bout of seasickness? Or a bad case of butterflies in your tummy? That's how many pregnant women describe pregnancy nausea and vomiting, also known as morning sickness. And chances are you'll be dealing with this early pregnancy symptom for at least the next few weeks.

What is morning sickness?

Morning sickness describes the nausea and vomiting that happens to an estimated 3 in 4 pregnant women during their first trimester. The “morning” part of this pregnancy symptom, however, is quite a misnomer — it can actually hit at any time of the day or night.

Morning sickness typically starts at around week 6 of pregnancy. (No wonder it's one of the first telltale signs you're expecting — that's only a week after your hCG hormone levels have risen enough to produce a positive pregnancy test.)

Some moms find that the nausea kicks in a little later between weeks 7 to 9, but luckily this not-so-fun pregnancy symptom usually disappears around the beginning of the second trimester. For the vast majority of expectant moms, nausea and vomiting typically subside between weeks 12 and 16 of pregnancy, with symptoms at their worst from weeks 10 to 16. 

That said, a few women continue to experience symptoms into the second trimester. And a very few, particularly those expecting multiples, may suffer from some pregnancy nausea and vomiting throughout their pregnancies. 

Morning sickness symptoms

Typical symptoms of morning sickness include:

• A nauseous, queasy feeling in the first trimester of pregnancy that many pregnant women liken to seasickness or car sickness
• Queasiness that often comes in the morning but can surface at any time of the day or night
• Strong aversions to certain smells and foods that are so powerful they can make you sick to your stomach
• A seasick feeling that's often either accompanied or immediately followed by hunger pangs
• A nausea that strikes after eating
• A nausea that's so strong it can lead to vomiting

Morning sickness itself doesn’t harm your baby. However, you should see your doctor if you:

• Can't keep any foods or liquids down
• Are starting to lose weight
• Suspect your prenatal vitamin is making your pregnancy nausea worse
• Feel dizzy or lethargic
• Are experiencing fever or flu-like symptoms

Morning sickness vs. hyperemesis gravidarum

Hyperemesis gravidarum is a severe form of pregnancy nausea and vomiting that impacts about 3 in 100 pregnant women. Hyperemesis gravidarum symptoms are much more persistent and can involve vomiting three or more times a day, leading to dehydration and weight loss. It often begins at around the same time as run-of-the-mill morning sickness (around 6 weeks), but can last for the duration of pregnancy. If you are diagnosed with hyperemesis gravidarum, you will need treatment to keep you and your baby safe. 

Morning sickness causes and risk factors

What causes pregnancy nausea and vomiting? No one knows for sure, though many experts blame pregnancy hormones. The pregnancy hormone hCG peaks around the time morning sickness is worst, and rising levels of estrogen and progesterone relax the muscles of the digestive tract and make digestion less efficient. 

Morning sickness can strike anyone, but you may be at higher risk if:

• You have history of migraines 
• You've always had a sensitive stomach (for example, if you tend to get carsick or seasick)
• You pregnant with multiples (you'll have higher levels of hCG)
• This is your first pregnancy
• You suffered from pregnancy nausea and vomiting during a previous pregnancy
• Your mother or sister had morning sickness

How to prevent or relieve morning sickness

While the only way to get rid of pregnancy nausea is to give it some time, you may find some relieve with these home remedies for morning sickness:

• Avoid smells that trigger nausea.
• Take your prenatal vitamin with a meal.
• Keep a snack by your bed. Nausea is most likely to strike when your stomach is empty, like it is following a night’s sleep. Eat foods that are low in fat and easy to digest, like crackers or cereal.
• Aim for six mini-meals throughout the day (rather than three large ones).
• Brush your teeth after every meal. A fresh-tasting mouth may prevent queasiness, and decreases the risk of damage to teeth from vomiting.

There are also several pregnancy nausea treatments you can discuss with your doctor:

• Switching your prenatal vitamin. A pill with more B6 and less (or no) iron may be right for you.
• Taking vitamin B6 or the antihistamine doxylamine (found in Unisom SleepTabs).
• Diclegis and Bonjesta are FDA-approved prescription drugs proven safe and effective for treating pregnancy nausea and vomiting. Doctors sometimes also prescribe an anti-nausea medication (like scopolamine, Phenergan or Reglan).
• Complementary medical approches such as acupuncture, acupressure, biofeedback and hypnosis. They’re worth a try if nothing else works.

One remedy you definitely should not use for morning sickness is marijuana or THC-containing products, which have not been shown to be safe during pregnancy. Both the Food & Drug Administration (FDA), and the American College of Obstetricians and Gynecologists (ACOG) warn that cannabis can be dangerous for a developing fetus.

Best foods for morning sickness

A pregnancy diet that's high in protein and complex carbohydrates is not only good for baby, it can also help keep nausea at bay. Think whole grain toast and peanut butter, or hard cheese and crackers. Steer clear of greasy and processed fast foods, which are hard to digest and can make morning sickness worse. 

Wondering what to eat for morning sickness? A few of the best foods when you’re nauseous and vomiting during pregnancy include:

• Bland, easy-to-digest solids. Bananas, toast, rice, pretzels and applesauce are relatively palatable foods that may help you fit in some calories.
• Almond milk. A glass of cold almond milk has been touted to help settle an upset stomach and quell heartburn. 
• Soups, smoothies and shakes. It’s often easier to drink your vitamins and nutrients, especially if the liquid’s icy-cold. If you can’t stand water, try sucking on a Popsicle for hydration. 
• Carbonated drinks and some herbal teas. Getting enough fluids is more important than eating early on in pregnancy. You might find a carbonated drink or some types of pregnancy-safe herbal tea (especially with lemon or ginger) helpful when it comes to easing nausea. If drinking and eating at the same time strains your digestive tract, sip on fluids between meals. 
• Water-packed fruits and veggies. If fluids make you queasier, try eating solids with a high water content. Melons are often a good choice. 
• Ginger. Numerous studies have shown that ginger really does reduce nausea and vomiting in pregnancy. You may find even the smell of fresh ginger calms an upset stomach. Stock up on staples made with real ginger (check the label; many prepared foods don’t contain the real deal), such as ginger snaps, ginger ale, ginger tea, ginger candies, ginger biscuits or crystallized ginger. Use fresh ginger when you’re cooking (in soup or stir fry, for example), or add it to your tea. 
• Citrus fruit. Many people find the smell and taste of lemons and oranges comforting during pregnancy. Sour sucking candies or a sniff of freshly-cut lemon may be your ticket to relief.
• Peppermint candies. Sucking on peppermint-flavored candies sometimes helps relieve nausea.

Can morning sickness hurt my baby?

Although you might be feeling sick, your baby almost definitely isn't. In the short term, not eating very much isn't a problem. Even women who have such a hard time keeping food down that they actually lose weight during the first trimester aren’t hurting their babies, as long as they make up for the lost weight, as needed, in later months. 

However, contact your practitioner if you experience any of these symptoms:

• Dark urine or no urine at all, which is a sign of dehydration.
• Vomiting several times a day.
• Unable to keep any food or liquids down.
• Confusion or lethargy.

Is it bad if I have no morning sickness?

While pregnancy nausea and vomiting can, in a way, be an uncomfortable yet reassuring reminder that you’re pregnant, it’s also perfectly fine if you rarely or never have a bout of queasiness while you're expecting. While 75 percent of all pregnant women experience morning sickness, that means 25 do not. If you're among those who have little or no morning sickness, consider yourself not just pregnant, but lucky! Remember, too, that having no morning sickness at 6 weeks pregnant may only be temporary: Nausea and vomiting can kick in at any time during the second or third month of pregnancy.