Are you pregnant? Are you experiencing waves of nausea, or are 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 women struggle to keep anything down through the day they deliver, others never experience a tinge of discomfort.
If you have questions about morning sickness or pregnancy nausea, you’ve come to the right place. Here’s everything 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 survive 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. It is widely referred to as “morning sickness,” though that is a misnomer as the feeling can occur during any time of the day.
This nausea is experienced by up to 90 percent of pregnant women, though the length and severity of the discomfort may vary drastically (source).
The Causes of Nausea During Pregnancy
Pregnancy nausea is directly linked to the pregnancy hormone hCG, though the exact relationship is unclear (source). Early in pregnancy, when morning sickness is typically at its worst, hCG levels rise rapidly to help grow and nourish the fertilized egg.
Around the 12th or 13th week, the placenta is 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 the time 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:
- An increase in estrogen.
- Stress hormones including cortisol.
- Low levels of vitamin B6.
- An aversion to a specific food.
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:
- 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 that is also 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 (source).
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While the term “morning sickness” is commonly thrown around to describe nausea during pregnancy, it can occur at any time of day. However, 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 queasies (source). 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 the majority of 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 in advance whether 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 main 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), which is 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 — Kate Middleton, the Duchess of Cambridge, has suffered from the condition in all three of her pregnancies (source).
What Are Food Aversions?
Food aversions during pregnancy are waves of nausea that are caused by eating, smelling, being around, or even just thinking about a specific food. While typical pregnancy sickness has no specific trigger, nausea due to food aversions can be avoided once you identify exactly what the trigger is.
It’s unclear exactly what causes food aversions, but it’s likely related to the good ol’ hCG that causes regular pregnancy nausea. There may also be a psychological component, where you experienced severe nausea or vomiting after eating a certain 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 crave the exact food you hated later in your pregnancy.
Some food aversions last throughout the entire 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’re considered common — though unfortunate — occurrences, but there are a couple of instances in which 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 need to be hospitalized to rehydrate.
Dehydration has the potential to cause birth defects and premature labor, so it’s important 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.
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 the presence of protein, and by taking your blood pressure.
If you are concerned about your blood pressure but don’t have a blood pressure monitor at home, most retail pharmacies have staff that 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, I tell my patients to consider it 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.
Editor's Note:Christine Traxler, MD, BS
What is Hyperemesis Gravidarum?
Hyperemesis Gravidarum (HG) is a serious condition that develops in approximately one percent of pregnant women (source).
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 properly hydrated and nourished since they can’t keep anything down when eating.
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 make your nausea worse. 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 of 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.
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 hunger since hunger can trigger nausea.
When choosing foods, choose ones high in protein and fiber to keep you feeling full longer and to 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.
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 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. You may even want to keep these things by your bed to eat as soon as you wake up if you tend to be nauseated first thing in the morning.
5. Eat Cold Foods
For some reason, cold foods tend to be more palatable 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 lots of different 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 are lollipops designed specifically for the pregnant woman. With flavors like sour lemon or ginger and infused with vitamin B6, they are typically palatable for even the most nauseated woman and help raise your blood sugar in order 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. Just a 20-minute walk might even do the trick.
10. Try Acupuncture or Acupressure
Acupuncture and acupressure involve placing needles or pressure along certain parts of the body. This ancient form of medicine is based on the theory that parts of the body are connected, and that well-placed external treatment can facilitate internal healing.
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11. Try Hypnosis
Severe pregnancy nausea can result in high levels of anxiety around food and lots of food aversions, which can compound your difficulty with eating.
Hypnosis has been used to help free the mind of these aversions and address eating anxiety, allowing you to relax and eat the foods you need to nourish your body. If you do this, you’ll be in good company — Kate Middleton used hypnotherapy to help treat her Hyperemesis Gravidarum.
12. Take Vitamin B6
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.
13. Take Medication
I understand many women are hesitant to take medications during pregnancy, especially when they’re concerned about the effects the meds may have on the baby. However, for many women, this becomes necessary in order to just 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 currently is the only prescription medication available that is FDA-approved to treat pregnancy nausea (source).
One of the major drawbacks of this medication is it can be very expensive 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 (source). Because of its effectiveness, many doctors have prescribed it for pregnancy nausea as well.
It went out of vogue for awhile 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 (source). For this reason, Vistaril is sometimes prescribed to help ease morning sickness even though it was initially developed to treat anxiety.
There is also a generic form called Hydroxizine, 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 — Unisom in particular, 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.
Acid Reflux Medications
Frequent vomiting can cause damage to your esophagus and teeth, and also just 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.
Editor's Note:Christine Traxler, MD, BS
Motion Sickness Remedies
There are lots of over-the-counter medications to help with motion sickness, including pills like Dramamine along with medicated patches that are placed on the 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 to relieve your feelings of sickness.
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, for most women it’s short-lived and eases by the second trimester.
In order to deal with nausea during pregnancy, you can:
- Get plenty of rest.
- Avoid food triggers.
- Eat foods that are pleasing to you.
- Eat small, regular meals.
- Have simple carbs on hand for emergencies.
- Eat cold foods.
- Sip drinks with ginger.
- Suck on pregnancy pops.
- Chew things with mint.
- Try acupuncture or acupressure.
- Get hypnosis to deal with food triggers and anxiety.
- Take a Vitamin B6 supplement.
- Take an antacid.
- Try motion sickness pills, patches, or wristbands.
- Ask your doctor about over-the-counter antihistamines.
- Ask for a prescription for an anti-nausea medication like Diclegis, Zofran, or Vistaril.
Nausea during pregnancy is certainly no fun and can easily suck the joy out of even the most elated mama-to-be.
Are you struggling with pregnancy nausea right now? What are your best tips to treat it? Let us know down in the comments below.