Everything You Need to Know About Morning Sickness

The first thing to know about morning sickness is that it’s by no means just a morning-related condition.

If you’re going through it right now, you’re probably well aware that it can strike at any time.

Sure, it’s most common in the morning.

After a long stretch of sleep with nothing to settle your stomach, the AM is often when the nausea hits.

But the reality is that it can creep up at any point of the day or night.

And in fact, for some people, it’s worse at night.

That’s why we prefer the term nausea and vomiting of pregnancy (NVP).

While it may be no consolation when the toilet bowl beckons, this pregnancy ailment is remarkably common ‒ it happens in as many as eight out of ten pregnancies.

And although it may not feel like it, it actually may be beneficial.

In fact, recent research has linked pregnancy nausea and vomiting to lower rates of pregnancy loss.

But there are cases when severe NVP can become dangerous.

Extreme pregnancy nausea is called hyperemesis gravidarum (HG), and it can lead to dehydration, weight loss, and nutritional deficiencies.

Luckily, it’s far less common, occurring only in 0.5 to 2% of pregnant people.

If you are really struggling right now, check in with a healthcare practitioner ‒ there is no need to muscle through this.

Treatment is available in the form of medication, alternative therapies, and lifestyle interventions.

With all this in mind, we’re going to take you through possible causes of “morning” sickness, what it feels like ‒ and when you should see a doctor for it.

In this article: 📝

When does morning sickness start?

There’s no one-size-fits-all when it comes to NVP ‒ but there are some useful patterns to be aware of.

For lots of women, it strikes throughout the morning, afternoon, and evening.

It should be called “any-time-of-the-day sickness” because let’s get real… it has no mercy.

Pregnancy nausea and vomiting often kicks off in the first trimester.
(Usually before 9 weeks, according to the American College of Obstetricians and Gynecologists.)

So can morning sickness start at 3 weeks?

At 2?

Yep, it’s possible.

In fact, some people experience nausea and vomiting as a pregnancy symptom before even missing a period.

(Curious about other early pregnancy signs? Head here.)

When does morning sickness end?

If NVP has started for you already, you’re probably dying to know when it ends.

Brace yourself for a frustrating answer ‒ it’s different for everyone.

But there are some common threads here.

For most pregnant people, NVP is done by 18 weeks of pregnancy (so, during the second trimester).

Sadly, this is not the case for everyone.

For some people, NVP could last weeks or even months after this, and in some cases, through the duration of your pregnancy.

(Sorry!)

What causes morning sickness?

Well, we don’t know for sure.

We’ll take you through the most likely causes.

Pregnancy hormones

It may not surprise you that much of the research on the causes of NVP points to hormones. (Yep, they’re at the heart of many a pregnancy symptom.)

In the case of pregnancy nausea, hCG (or, if you’re feeling fancy, human chorionic gonadotropin) is likely a big player here.

This hormone is always present in our bodies in small amounts, but when we’re pregnant, the placenta produces more and more, typically reaching peak levels towards the end of the first trimester and then leveling off after that.

Interestingly, hCG is the hormone that is tested in pregnancy tests to see if you are pregnant.

The production of hCG in large amounts stimulates the body to produce more progesterone which helps maintain and stabilize the pregnancy.

Researchers have found higher levels of hCG in those with more severe NVP.

But it’s important to note that other studies have not been able to back up these results, so we’re really not 100% sure about this.

Most likely, hCG is a contributing factor but not the only cause.

Higher levels of estrogen and progesterone could also be to blame.

These hormones both help kickstart and maintain pregnancy, and as their levels rise, they could affect your digestive system.

NVP is most common in the first trimester of pregnancy because this is when all these pregnancy hormones are on a rapid rise.

But it’s not only pregnancy hormones that are to blame here.

Blood sugar imbalances

Troubles with your blood sugar could also be a culprit.

In fact, according to the American Academy of Family Physicians, nausea can be one of the early signs of gestational diabetes (when your body struggles to make insulin when you’re pregnant).

While that might sound quite scary, it can be managed.

As part of your routine prenatal visits, you’ll have a glucose test between weeks 24 and 28 of your pregnancy.

It is important to do these tests around this time because gestational diabetes has a massive effect on your unborn child, and so needs to be managed and controlled.

Genes

Genetics appear to have a role here, too ‒ it may very well run in the family.

Recent research has linked severe NVP with a specific genetic protein.

(This research is still quite young ‒ but it’s looking promising. The more we know, the more treatment options we’ll have available.)

Other possible causes

Then there are some things that just seem to put you more at risk of developing NVP.

This study found that you’re more likely to have it if you’re younger and/or pregnant for the first time.

And this one showed a link between NVP and carrying multiples.

And, although the jury’s still out on this one, some research suggests that if you’ve experienced nausea and vomiting in previous pregnancies, it’s more likely that you’ll have it in subsequent ones.

There are a few other theories that are being researched as to why.

A popular one is that exposure to harmful chemicals and toxins in our diets could lead us to be oversensitive to certain foods.

In some rare cases, a medical condition like thyroid or gallbladder disease may cause pregnancy-related nausea and vomiting.

Stay in touch with your doctor about your symptoms so that they can get you the help you need, including referring you to other specialists if necessary.

What are the symptoms of morning sickness?

Unsurprisingly, nausea (feeling like you’re going to throw up) and vomiting (actually throwing up) are the top two symptoms here.

These can be brought on by smelling particular smells or eating certain foods.

Very sweet, very spicy, and very fatty foods can all do it.

If you have severe NVP (HG), you’ll experience more serious symptoms that can be really tough to cope with.

If your nausea and vomiting feel really extreme and goes on for a long time, it could be a sign that you are struggling with this more severe form of the condition.

When should you see a doctor for morning sickness?

The bottom line here is if you’re worried, it can’t hurt to check in with your doctor.

In most cases, pregnancy nausea and vomiting won’t harm your baby ‒ it’ll just be pretty uncomfortable for you and can affect your day-to-day activities.

Going to work, attending social engagements, and taking care of other family members can all be affected by it.

Talking to a healthcare professional about treatment options can help you feel a lot better.

But if you have severe nausea and vomiting, as is the case with HG, it can lead to complications.

If you’re vomiting more than three times a day and not able to keep anything down, it’s best to check in with a healthcare professional as soon as you can.

It’s also a good idea to seek medical help if you are experiencing pain or cramping.

Here’s what else to watch out for.

Dehydration

One of the big dangers is dehydration.

And while this can be challenging at any time of life, it’s particularly scary when pregnant.

According to the American Pregnancy Association, dehydration can lead to a bunch of pregnancy complications, including low amniotic fluid, issues that affect the development of your baby’s spine and brain, and premature birth.

So it’s really important to check in with your doctor if you experience the following symptoms:

• Extreme thirst
  
• Extreme fatigue
  
• Dizziness
  
• Dark yellow pee that has a strong smell
  
• Not peeing much (the opposite of what often happens during pregnancy)
  
• Rapid heartbeat
  
• Headaches
  
• Confusion

Dealing with some other fun digestive issues, like diarrhea, can further complicate things.

Remember you know your body, if things seem off, chat with your doctor.

Weight loss

If nausea and vomiting are causing you to lose weight during pregnancy, it’s worth touching base with your doctor.

Most pregnant people gain in the region of 25 to 35 pounds during their pregnancy.

This is healthy and necessary.

That little peanut is adding some pounds to the scale, and you’re also building up supplies to make sure that your baby is well-fed, both while they’re in the womb and when they’re born.

So that usually means adding about 300 calories to your diet a day.

If you are not gaining weight (or losing it), you and your baby may not be getting adequate nutrition for the big task at hand so it’s important to reach out for medical help.

Should you see a doctor if you’re throwing up blood while pregnant?

The short answer is yes.

Throwing up blood can be really scary.

Vomiting frequently, as you might be doing right now, puts a real strain on the lining of the esophagus (the tube that transports food from your mouth to your stomach).

Sometimes you are retching so hard the lining in your esophagus tears (ouch!).

This is called an esophageal rupture and causes you to vomit bright red blood.

As you can imagine, this is pretty painful and means it’s time to speak to your doctor about ways of managing your nausea and vomiting.

It’s important to note that there are other reasons why you might be throwing up blood, including a bacterial infection, bleeding gums, and nosebleeds ‒ all of which you’re more susceptible to when you’re pregnant.

So the best thing to do is check in with your doctor how you can best resolve the situation.

How to relieve morning sickness

Treatment depends on how serious your NVP is.

If your NVP has progressed to HG, hospitalization is necessary to treat your dehydration and weight loss.

In the hospital, they can administer an IV line and manage your fluid and nutritional intake.

When you are continually retching, your body becomes depleted of many essential minerals, like sodium, potassium and magnesium, which are vital for life.

These may be added to your IV to bring your body back into balance and allow your baby to thrive.

In many cases, you’ll be able to manage and treat pregnancy nausea and vomiting at home.

While lifestyle adjustments can really help, you might also require medication.

According to the ACOG, the first-line treatment for NVP should be pyridoxine (vitamin B6) on its own or with a drug called doxylamine.

Doxylamine is actually an antihistamine medication that’s used in the treatment of allergies and insomnia.

It’s sold under the brand name Unisom.

The FDA has approved a medication called Diclegis, which is a combination of doxylamine and pyridoxine.

You can get a prescription for this medication from your doctor, or you can get the two key ingredients separately OTC.

(We still recommend touching base with our doctor, though, so that they can supervise your treatment and make sure the medication doesn’t interfere with anything else.)

What we are finding more and more is that it may be best to treat NVP holistically ‒ and this might include a combination of medication, dietary changes, and alternative therapies, like hypnosis and acupuncture.

(New research on the last two is proving to be really promising!)

Here are some of the tried and trusted methods that mamas-to-be have used to find relief:

Go for ginger.

Probably the first to come up when you ask others for tips to relieve any sort of nausea ‒ and with good reason.

There’s research to back it up.

According to this study, ginger has been shown to seriously reduce nausea and stop vomiting in 1 in 3 pregnant people within six days.

While ginger appears to be safe for most pregnancies, there is a chance that it could lead to complications in high-risk pregnancies if it’s consumed towards the end of your term ‒ so, like any treatment, it’s best to check in with your doctor first.

Try OTC treatments and supplements.

Ask your doctor about what’s on offer.

The American Pregnancy Association highlights various options, including vitamin and mineral supplements, lollipops, and wristbands that use acupressure to alleviate symptoms.

Start your day slowly.

Particularly if your morning sickness is genuinely morning sickness, it can help to get out of bed slowly.

And not until after you’ve had a delicious breakfast-in-bed of dry crackers or cereal.

That’s according to the American Pregnancy Association.

Eat small meals throughout the day.

Although there is no concrete research on eating many smaller meals rather than one or two large meals, most OBGYN’s will recommend this.

That’s because they see positive results when their patients do this.

Keep your fluid intake up.

This can be hard if you’re really struggling with your symptoms, but keep a flask near you and take little sips throughout the day.

It’s recommended to drink eight to twelve cups of water a day.

It can also help to space out your eating and drinking.

Wait half an hour before and after meals to get your fluids in.

This can help prevent your system from being overwhelmed.

Get enough rest.

This is important anyway when you’re pregnant.

Your body is going through some pretty big changes right now, which means you may not be able to sleep for long periods of time, so taking time out when you need to is highly needed.

Steer clear of alcohol and cigarettes.

This is good advice when you’re pregnant, regardless of how you’re feeling ‒ but it’s important to mention here as these are specific triggers for nausea and vomiting.

(The CDC has issued these guidelines on substance use during pregnancy, including all the details to be aware of and who to contact if you need help.)

Avoid your morning sickness triggers

Morning sickness can be triggered by just about anything (sorry, mama-to-be!).

However, a few common culprits include:

• Spicy food
  
• Certain odors
  
• Heat
  
• Excess salivation
  
• The sight, smell, or taste of meat
  
• Strong-tasting vegetables
  
• Alcohol
  
• Cigarette smoke

Unfortunately, you won’t know what triggers your morning sickness until it happens, but as you progress through the first trimester, you’ll quickly learn which triggers you need to avoid.

What should you eat (and avoid) to reduce your symptoms?

Sadly, a lot of the NVP menu is pretty bland ‒ but luckily, you don’t have to stick to it forever.

Spicy, high-fat, and processed foods are all likely to exacerbate your symptoms.

Citrus can also do it for some people.

As can caffeinated drinks.

Both are really acidic and could be enough to set you off.

Also, caffeinated drinks are diuretics which means you pee more, and then need to drink more water to replace those fluids.

As for very sweet foods like cakes and pastries, these may not be the best idea either.

Listen to your body.

What triggers nausea in one person may not do the same for another.

(A food diary can really help here.)

As for foods that can help?

Carbs for the win.

You may get very well acquainted with crackers at this time.

Potatoes, rice, white bread, oatmeal ‒ yum, yum, yum.

Some people find that sipping, sucking, or munching cold foods can help.

This can be anything from frozen yogurt to cold gingerbeer to plain ol’ ice cubes.

Sports drinks and nutrient-added waters have additional electrolytes, which can be really beneficial right now.

Taking a prenatal vitamin is also a must to ensure that you keep your nutrients up.

Unfortunately, some pregnant people find that their vitamin actually triggers nausea.

Zinc is a big one for causing nausea, so make sure you eat something before you take the vitamins.

If you are still battling to get your prenatal vitamins in, ask your doctor for their advice on a nausea-friendly brand.

Morning sickness: the bottom line

Morning sickness is common, feels pretty awful, and is not restricted to the AM hours.

In some cases, it can be severe and requires treatment to keep you and your peanut safe.

Know that you don’t have to go through any of this alone.

We have a whole Peanut community having this conversation and so many others related to pregnancy and beyond.

Join us. ❤️