Morning Sickness And Nausea During Pregnancy - What To Expect

You're sailing along on your early pregnancy adventure — just a 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 bad case of butterflies in your tummy? Or maybe a full-on bout of motion sickness? That's how many pregnant women describe pregnancy nausea and vomiting, also known as morning sickness. Chances are you'll be dealing with this early pregnancy symptom for at least the next few weeks.

Key Takeaways

• Morning sickness is common and temporary. About 75% of pregnant women experience nausea and vomiting, usually starting around week 6 and peaking between weeks 10 and 16. For most, symptoms ease by the start of the second trimester.
• Hormones play a key role in causing nausea. While we don't know an exact cause of morning sickness, rising levels of pregnancy hormones like hCG and GDF15 are probable culprits.
• Simple remedies may help. Eating small, frequent meals, avoiding strong odors, and trying vitamin B6 or doctor-approved medications often help. Seek medical attention if you can't keep food or fluids down, as this may signal hyperemesis gravidarum, a more severe condition.

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 a misnomer — it can hit at any time of the day or night.

"My morning sickness gets worse as the day goes on and is really bad at night and overnight," says What to Expect Community mom Nauseas713. Community mom SL7908 agrees: "I have only been sick starting at 2ish every day and it gets way worse by supper and night!"

One of the first telltale signs you're expecting, morning sickness typically starts at around week 6 of pregnancy, just a week after your hCG hormone levels have risen enough to produce a positive pregnancy test. Some moms find that it kicks in a little later, though, between week 7 and week 9.

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.

"I was having severe nausea and was VERY tired — sleeping allll day," says What to Expect Community mom natyat1. "I'm currently 12 weeks and 3 days. I've noticed the past few days my symptoms have gone away." Track your symptoms with the My Journal tool in our free app

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.

Track your symptoms with the My Journal tool in the What to Expect app, where you'll find expert pregnancy advice and tips from other parents.

Morning sickness symptoms

Women experience morning sickness in different ways and to different degrees. Typical symptoms of morning sickness include:

• A nauseous, queasy feeling similar 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. "Smells are killing me!" says What to Expect Community mom QuesoMomma. "It hurts to go to the grocery store now."
• A nauseated 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

While morning sickness is common, do talk with your doctor or midwife about it, to make sure you're staying as healthy as possible and to get some help minimizing your symptoms.

Morning sickness causes and risk factors

No one knows for sure what causes pregnancy nausea and vomiting, and there are probably many factors involved. But a variety of pregnancy hormones traditionally take the blame, says Shannon Smith, M.D., a board-certified OB/GYN and partner at Brigham Faulkner Ob/Gyn Associates in Boston, Massachusetts, and a member of the What to Expect Medical Review Board.

For example, the pregnancy hormone hCG peaks around the time morning sickness is worst and trends downward as symptoms lessen. "Observational studies demonstrate that patients with worse symptoms of nausea and vomiting generally have higher levels of HCG," says Dr. Smith. "This is often seen in patients pregnant with multiples, as their HCG levels consistently are much higher compared to singleton pregnancies."

A promising 2023 study has identified another hormone, GDF15, as a primary cause of morning sickness. The hormone is released by the fetus and various tissues in the body in response to infections and other forms of stress.

Researchers learned that the amount of GDF15 detected in a woman's bloodstream is linked to how severe her morning sickness is. Women with bad morning sickness had abnormally high levels of GDF15 in their systems. Those who were exposed to GDF15 before pregnancy, however, didn't have a strong reaction to it when they were expecting.

"This new and very exciting research is the first step in leading researchers toward innovative and novel therapies for treatment and even prevention of nausea and vomiting during pregnancy," notes Dr. Smith.

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

• Have history of migraines
• Have a sensitive stomach (for example, you tend to get carsick or seasick)
• Are pregnant with multiples
• Are carrying your first baby
• Suffered from pregnancy nausea and vomiting during a previous pregnancy
• Have a mother or sister who had morning sickness

Morning sickness vs. hyperemesis gravidarum

Hyperemesis gravidarum (HG) is a severe form of pregnancy nausea and vomiting. It's a condition that impacts about 3 in 100 pregnant women.

Hyperemesis gravidarum symptoms are much more persistent than morning sickness and can involve vomiting three or more times a day, leading to dehydration, feeling constantly dizzy and lightheaded, and weight loss, according to the Cleveland Clinic.

HG 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're diagnosed with hyperemesis gravidarum, you'll need treatment to keep you and your baby safe.

"Unfortunately, pregnancies with multiples, while exciting, come with increased risks," says Dr. Smith. "One very common early symptom is hyperemesis. This is thought to be due to the higher and rapidly rising HCG levels associated with multiples."

How to prevent or relieve morning sickness

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

• Avoid smells that trigger nausea.
• Take your prenatal vitamin with a meal. If your prenatal still seems to make you nauseated, ask your doctor about switching your prenatal to one that contains more vitamin B6 and possibly less (or no) iron. What to Expect Community member Prov2611 says, "I stopped taking a multivitamin with iron, and my nausea is so much better."
• 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 decrease the risk of tooth damage from vomiting.
• Try complementary medical approaches, such as acupuncture, acupressure, biofeedback, and hypnosis. These options may be worth a try if nothing else works, but get your doctor's go-ahead first.

Also ask your doctor about over-the-counter or prescription medication, such as vitamin B6 or the antihistamine doxylamine (found in Unisom Sleep Tabs). Diclegis and Bonjesta (which contain both B6 and doxylamine) are FDA-approved prescription drugs proven safe and effective for treating pregnancy nausea and vomiting. If none of these helps, your doctor may prescribe other anti-nausea medication after weighing the risks and benefits.

"Morning sickness is giving me HELL this time around," says What to Expect Community mom natchekn19. She says doxylamine and vitamin B6 are doing the trick for her, but — because doxylamine is a sleep aid — she needs to figure out the best time to take it.

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.

"Children who've been exposed to cannabis in utero have been shown to have cognitive deficits, high rates of impulsivity, and possibly autism," notes Dr. Smith.

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.

"I started eating a bite of breakfast sandwich, turkey sandwich, or pbj sandwich every hour — just a bite or two — and that helps with the nausea a lot," says What to Expect Community mom mommyfaith. "I wake up twice throughout the night to eat two crackers with some lemon water to wash it down ... this helps keep the first wake-up nausea at bay as well."

Wondering what to eat for morning sickness? A few of the best foods 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 matters worse, try eating solids with a high-water content. Melons are a good choice.
• Ginger. Numerous studies have shown that ginger reduces nausea and vomiting in pregnancy. You may find even the smell of fresh ginger calms your 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?

Typical morning sickness won't hurt your baby, though you'll want to make sure you don't become dehydrated, which can be harmful for both of you. And you'll need to consume adequate nutrients over the course of your pregnancy.

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, you should see your doctor if you:

• Can't keep any foods or liquids down
• Are vomiting several times a day
• Have dark urine or no urine, which is a sign of dehydration
• Are starting to lose weight
• Suspect your prenatal vitamin is making your pregnancy nausea worse
• Feel dizzy, lethargic, or confused
• Are experiencing fever or flu-like symptoms

Is it bad if I have no morning sickness?

However uncomfortable, pregnancy nausea and vomiting can be a reassuring reminder that you're pregnant. But it's also perfectly fine if you rarely or never have a bout of queasiness while you're expecting. While 75% 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.

Hang in there — morning sickness can be tough, but it's temporary. Take it one day (and one small meal) at a time, lean on your support system, and remember that every wave of nausea means your body is busy growing your little one.