Are you pregnant and experiencing waves of nausea or wondering when you can expect morning sickness to begin?
Nausea has garnered a reputation as the hallmark symptom of pregnancy, but it presents differently for every mother-to-be. While some of us struggle to keep anything down through the entire pregnancy, others never experience a tinge of discomfort.
Having experienced plenty of morning sickness ourselves, we understand the struggle, and we want to help.
We’ll discuss what you need to know about nausea during pregnancy — what it is, what causes it, how long you can expect it to last, and, perhaps most importantly, how to manage it.
- What is Nausea During Pregnancy?
- The Causes of Nausea During Pregnancy
- What Does Pregnancy Nausea Feel Like?
- When Does Pregnancy Nausea Occur?
- Who Is Likely to Experience Nausea?
- What Are Food Aversions?
- Should I Be Concerned About Pregnancy Nausea?
- What is Hyperemesis Gravidarum?
- How to Treat Nausea During Pregnancy
- What Medications Can Help with Pregnancy Nausea?
- The Bottom Line
What is Nausea During Pregnancy?
Nausea during pregnancy is a feeling of queasiness commonly experienced by expectant mothers, particularly during early pregnancy. We usually refer to it as “morning sickness,” though that is a misnomer, as the feeling can occur during any time of the day or night.
Up to 90 percent of pregnant women will experience this nausea, though the length and severity of the discomfort may vary drastically.
Nausea during pregnancy commonly disappears between weeks 11-14 as you get into your second trimester.
Editor's Note:Katelyn Holt RN, BSN, BC
The Causes of Nausea During Pregnancy
Pregnancy nausea is directly linked to the pregnancy hormone HCG, though the exact relationship is unclear. Early in pregnancy, when morning sickness is typically at its worst, HCG levels rise rapidly to help grow and nourish the fertilized egg.
By the 12th or 13th week, the placenta has developed enough to take over these tasks. At this point, HCG levels tend to drop a bit and then remain stable for the duration of your pregnancy. This is also when most women begin to feel their nausea subside.
Why Does This Happen
Besides the presence of HCG in the body, other things can cause nausea during pregnancy as well, including the following:
- An increase in estrogen.
- Stress hormones — including cortisol.
- Low levels of vitamin B6.
- An aversion to a specific food.
Interestingly, studies show that mother’s who experience nausea have a higher chance of a successful pregnancy (1). However, nausea isn’t a surefire guarantee you won’t miscarry.
What Does Pregnancy Nausea Feel Like?
How pregnancy nausea feels varies among women and can even feel different to the same woman at different times of the day.
Pregnancy nausea or morning sickness can feel like any of the following:
- A general, lingering sense of feeling like you need to vomit but without the urgency to do so.
- A sudden, urgent need to vomit.
- A feeling that you’re hungry but without the ability to stomach anything.
- Dizziness or weakness.
Some women experience nausea during pregnancy and never actually vomit, while others vomit several times a day. The vomiting can sometimes provide a reprieve from nausea until it returns.
Pregnancy nausea is often exacerbated by the intense fatigue experienced during the first trimester.
Exhaustion and tiredness can even cause nausea in a person who isn’t pregnant. So, the fact that women in their first trimester have a double whammy of both exhaustion and nausea can make them compound one another.
When Does Pregnancy Nausea Occur?
Pregnancy nausea is most likely to occur during the first trimester when HCG levels are highest and rising rapidly. It usually starts around the sixth week of pregnancy and subsides by the 16th (2).
You Won The Lottery
Although “morning sickness” can occur at any time of the day, for many women, the nausea is usually the worst during the morning hours because they are waking with an empty stomach.
Nausea tends to be exacerbated by hunger, so after fasting for several hours through the night, it becomes a morning battle to quell the queasiness (3). And during this time, women may be caught in a Catch-22 of not being able to keep things down yet needing to fill their stomach to cure nausea.
The good news is that, for most women, this pregnancy discomfort usually resolves by the second trimester. However, for about 10 percent of women, nausea persists throughout their entire pregnancy.
Who Is Likely to Experience Nausea?
As many as 90 percent of women experience some level of pregnancy nausea, so your chances of encountering it are quite high. And while there aren’t specific risk factors to notify you that you’ll be one of those women, there is one group who experiences morning sickness more frequently than others — mamas carrying multiples.
This is theorized to occur because of the higher levels of HCG from carrying more than one baby. Since HCG appears to be the leading cause of pregnancy nausea, it makes sense that having more of it coursing through your body could put you at greater risk of morning sickness.
But what about previous bouts of pregnancy nausea? If you’ve had it in one pregnancy, are you guaranteed to have it in subsequent pregnancies?
If You’ve Had It Before, You Might Dodge It Next Time
The only exception to this is for women who experience Hyperemesis Gravidarum (HG), a severe form of pregnancy sickness that occurs in about one percent of pregnancies. Unfortunately, if you’ve had HG during one pregnancy, you’re likely to have it in subsequent ones.
No matter how nauseated you are, nutrients will get to your baby if you can take in any food. Try your best to eat at least a little and stay well hydrated.
What Are Food Aversions?
Food aversions during pregnancy are waves of nausea caused by eating, smelling, being around, or even just thinking about a specific food. While typical pregnancy sickness has no specific trigger, you can avoid nausea due to food aversions once you identify the exact trigger.
We don’t know what causes food aversions, but it’s likely related to the good old HCG that causes regular pregnancy nausea. There may also be a psychological component, where you experience severe nausea or vomiting after eating a particular food and then can’t stomach the idea of being around it again.
Then again, it may have no known cause because it’s also entirely possible to go from hating a food to craving it at another point in your pregnancy.
Some food aversions last throughout pregnancy, while others may come and go.
Some of the most common food aversions are:
- Meat — raw or cooked.
- Foods with strong scents or flavors, like vinegar-based foods or citrus fruits.
Should I Be Concerned About Pregnancy Nausea?
Nausea and vomiting are rarely a cause for concern during pregnancy as they are common — though unfortunate — occurrences. But there are a couple of instances where you may want to seek medical attention.
If you are unable to keep down any food or water, you risk dehydration, the loss of electrolytes, as well as reduced nutrients to nourish both you and your baby. In severe cases, women may need to be hospitalized to rehydrate.
Dehydration has the potential to cause congenital disabilities and premature labor, so it’s essential to keep yourself nourished and hydrated — and if you can’t, contact your doctor for medical treatment to keep you and your baby as healthy as possible. Aim for two extra glasses of water a day.
Sudden Onset Late in Pregnancy
If you experience sudden nausea or vomiting that develops toward the end of your pregnancy, check in with your doctor immediately.
This can be a symptom of severe preeclampsia, which can be life-threatening for both you and your baby. It is diagnosed by screening your urine for protein and taking your blood pressure. An unrelenting headache is another symptom of severe preeclampsia.
If you are concerned about your blood pressure but don’t have a blood pressure monitor at home, most retail pharmacies have staff who will check it for free or machines set up in their waiting area for customers to use. This isn’t a replacement for your regular doctor but can be used in a pinch if you are concerned and want to check your blood pressure on a whim.
While many women worry about pregnancy-related nausea, it can often be considered a good sign. Since rising HCG levels are linked to a healthy pregnancy, having nausea because of high HCG levels can indicate your pregnancy is going as expected.
What is Hyperemesis Gravidarum?
Hyperemesis Gravidarum (HG) is a serious condition that develops in approximately one percent of pregnant women (5).
While commonly described as “severe morning sickness,” that terminology fails to describe the reality of the situation. HG is often debilitating and can threaten the life of both the mother and baby.
HG is different from traditional pregnancy nausea in that:
- The nausea is constant and severe.
- You cannot eat or drink anything without vomiting.
- You feel an excess of saliva in your mouth.
- You lose more than 5 percent of your pre-pregnancy body weight.
- You cannot function in your regular life.
This condition is also accompanied by side effects, including:
- Lower birth rate for baby.
Aside from the physical symptoms, HG can make it nearly impossible to do regular activities such as going to work, caring for yourself, or taking care of your family. This can contribute to depression, feelings of failure, and isolation.
For most women experiencing HG, the symptoms subside by the 20th week of pregnancy. However, for some women, it will last until they deliver.
In some cases, women need to be hospitalized to ensure they remain adequately hydrated and nourished since they can’t keep anything down when eating.
HG moms are warriors. Pregnancy is already a sacrifice of yourself, and having to push through an unrelenting sickness like HG is extremely difficult. There are resources to support you, such as hyperemesis.org. Your care provider can assist you with more.
How to Treat Nausea During Pregnancy
There are many ways to treat nausea during pregnancy, but what works for one woman doesn’t necessarily work for all.
Here are some things to try to relieve your nausea:
1. Get Plenty of Rest
Exhaustion, tiredness, and fatigue are all hallmarks of early pregnancy, but they can also worsen your nausea. Rest as much as you can, and take it easy on yourself.
Growing a human is hard work, so try to lay aside your personal expectations of productivity and give in to your need to rest and care for yourself.
2. Eat What You Can
I know you want to eat a healthy diet, but if your nausea and food aversions are making that impossible, just give in to them and eat what you can stomach. Try for small high protein foods, like a cheese-stick or seeds and nuts.
Your baby is receiving nutrients from your pre-pregnancy reserves, and once you feel better, you can re-balance your eating habits. For the immediate time, though, fed is best.
3. Eat Regularly
Nausea is most likely to occur on an empty stomach, so to combat it, try to keep food in your stomach and your blood sugar stable throughout the day. Do this by eating small meals at regular intervals.
Try not to skip meals, and remember to eat before you feel hungry since hunger can trigger nausea.
When choosing foods, choose ones high in protein and fiber to keep you feeling full longer. This should help stave off that empty feeling in your stomach. Have a protein-rich snack before bed, and see if it helps prevent the nausea you experience immediately upon waking. Sometimes, eating a couple of crackers before getting out of bed in the morning can really help morning sickness, so a simple trick is keeping crackers in your nightstand ready for your morning wake-up.
4. Keep a Stash of Emergency Snacks
No matter how meticulously you plan your meals, you may still experience nausea due to an unexpectedly empty stomach or a drop in blood sugar. Keep a stash of snacks with simple carbs that will hit your blood sugar quickly to help manage these waves of nausea.
Good examples include crackers, juice, or a granola bar. These could also be good snacks to keep on your nightstand if you feel nausea in the morning.
5. Eat Cold Foods
For some reason, cold foods tend to be more palatable0 than hot or cooked foods during pregnancy. If you can’t seem to find anything that you can keep down, see if there are foods in your fridge or freezer that might help settle your stomach. Hello, ice cream!
6. Try Ginger
Ginger has been used for centuries to help settle upset stomachs and treat nausea. These days, there are many ways to enjoy it, including sodas, teas, and candies. See which one you can stomach the best and use it to help tame your tummy.
7. Suck on Pregnancy Pops
Pregnancy Pops Drops are candy designed for pregnant women. With flavors like sour lemon or ginger and infused with vitamin B6, they are typically palatable for even the most nauseated women and help raise your blood sugar to relieve your nausea quickly.
8. Eat Mint
Not only can mint help freshen your breath after vomiting, but it can even help with your nausea battle. Mint tends to have a cooling effect, and the freshness often helps with the sick feeling.
So carry around some lozenges or a pack of gum, and pop one in your mouth whenever the nausea hits.
I know exercise is probably the last thing you want to do when you’re feeling ill, but it can actually help you combat morning sickness. The good news is that your workout doesn’t have to be crazy. A 20-minute walk might even do the trick.
There are a lot of videos available for simple pregnancy exercise, including this yoga video specifically for morning sickness and fatigue:
10. Take Vitamin B6
A vitamin B6 deficiency may be the cause of some women’s nausea, so it makes sense that a supplement could help ease it. The typical treatment dose is 10-25 milligrams three times a day (6).
But before you start a regimen on your own, talk with your doctor to get their exact dosage recommendation. While vitamin B6 is widely considered safe to take during pregnancy, it’s always a good idea to check with your doctor before taking any new supplements.
Prenatal multivitamins are necessary but can upset your stomach. Always take them with a little food to prevent nausea.
Editor's Note:Katelyn Holt RN, BSN, BC
11. Take Medication
I understand many women are hesitant to take medications during pregnancy, especially when they’re concerned about the effects of the meds on their baby. However, for many women, this becomes necessary to perform the basic functions of everyday life.
The good news is there are lots of options — both over-the-counter and prescription. Talk with your doctor about the options available to you, and together, you can work to find one to get your life back.
What Medications Can Help with Pregnancy Nausea?
If you’re considering taking medication for your pregnancy nausea, always talk to your doctor first to discuss the risks and benefits of each option. Here are some of the medications you may discuss:
This prescription medication was previously marketed under the name Bendectin but then was pulled from the market. Its formula was re-worked to ensure the safety of both mother and baby and is currently the only FDA-approved prescription medication available to treat pregnancy-related nausea (7).
One of the significant drawbacks of this medication is it can be costly if you don’t have good drug coverage on your insurance, and there is currently no generic version.
Zofran is a drug that was developed to treat severe nausea in patients undergoing cancer treatment. Because of its effectiveness, many doctors have prescribed it for pregnancy nausea as well.
It went out of vogue for a while due to fears about birth defects but has recently made a comeback following a study that indicated there was no cause for concern. The brand-name drug can be pricey, but the active ingredient (ondansetron) is available in generic form at considerable cost savings.
Though it seems silly, antihistamines can be used to treat nausea because they affect the vestibular system and, therefore, the vomiting reflex (8). For this reason, doctors sometimes prescribe Vistaril to help ease morning sickness even though it was initially developed to treat anxiety.
There is also a generic form called Hydroxyzine, which can help make this option affordable.
Because antihistamines can help with nausea, your doctor may recommend you try over-the-counter versions like Benadryl or Unisom. However, they can also cause drowsiness, particularly Unisom, as it’s specifically marketed as a sleep aid.
Before opting to take any over-the-counter option, speak with your doctor about its use over the long haul. These options may be better for intermittent nausea.
Unisom was originally developed to help women with morning sickness, but because of the drowsy effect, it was remarketed as a sleep drug. Pairing Unisom with B6 supplements is one way to combat morning sickness. Ask your provider if this is an option for you.
Acid Reflux Medications
Frequent vomiting can cause damage to your esophagus and teeth and make you feel horrible all around. Acid reflux medications can reduce the acidity in your stomach, helping to keep you from vomiting but also helping to prevent damage if you do.
There are many acid reflux medications, both over-the-counter and prescription medications. Most over-the-counter antacids like TUMS, Rolaids, and Maalox are safe to take in pregnancy, but avoid Alka Seltzer, which contains aspirin. Your doctor may prescribe one of two types of medications, such as Histamine-2 blockers and proton pump inhibitors, which have been found to be safe in pregnancy as well.
Motion Sickness Remedies
There are lots of over-the-counter medications to help with motion sickness, including pills like Dramamine or medicated patches that you place on your skin. These are generally considered safe for pregnancy and may help with your nausea, but you should still check with your doctor before taking them.
Non-medicated motion sickness treatments include wearable wristbands that may help relieve your feelings of sickness.
The Bottom Line
Few people would disagree that nausea is one of the worst parts of pregnancy, as it can keep you from enjoying this special time and severely limit your ability to participate in everyday life. Thankfully, it’s short-lived for most women and eases by the second trimester.