What is morning sickness?
Morning sickness (also called nausea and vomiting of pregnancy) is nausea (feeling sick to your stomach) and vomiting that happens in the first few months of pregnancy. Even though it's called morning sickness, it can last all day and happen any time of day.
At least 7 in 10 pregnant women have morning sickness in the first trimester (first 3 months) of pregnancy. It usually starts at about 6 weeks of pregnancy and is at its worst at about 9 weeks. Most women feel better in their second trimester, but some have morning sickness throughout pregnancy. If you have morning sickness, tell your health care provider.
Mild morning sickness doesn’t harm you or your baby. But if nausea and vomiting becomes severe (called hyperemesis gravidarum), it can cause serious problems during pregnancy. You may need to stay in the hospital for treatment.
What is hyperemesis gravidarum?
About 3 in 100 women may have hyperemesis gravidarum. This is extreme, excessive nausea and vomiting during pregnancy. It can cause you to lose weight and become dehydrated (not have enough water in your body). It can start early in pregnancy and last the entire pregnancy. If you have hyperemesis gravidarum, you need treatment to help keep you and your baby safe.
You may be at risk for hyperemesis gravidarum if you:
- Are pregnant for the first time.
- Are pregnant with a girl.
- Are pregnant with multiples (twins, triplets or more). Being pregnant with more than one baby may increase your risk for severe morning sickness because you may have a large placenta and increased pregnancy hormones. The placenta grows in your uterus (womb) and supplies your babies with food and oxygen through the umbilical cord.
- Had mild or severe morning sickness in a previous pregnancy, or your mother or sister had severe morning sickness during pregnancy. Take your family health history to help you find out about health conditions that run in your family.
- Have motion sickness or migraines.A migraine is a severe headache that may make you sensitive to bright lights and sound.
- Are overweight.
- Have trophoblastic disease, a condition that leads to abnormal cell growth in the uterus (womb).
Signs and symptoms of hyperemesis gravidarum include:
- Vomiting more than 3 to 4 times a day
- Vomiting that makes you dizzy or lightheaded
- Vomiting that makes you dehydrated. Signs and symptoms of dehydration include feeling thirsty, dry mouth, a fast heart beat or making little to no urine.
- Losing more than 10 pounds in pregnancy
If you have hyperemesis gravidarum, your provider may treat you with medicine to help relieve your nausea and vomiting. You may need treatment in a hospital with intravenous (also called IV) fluids. IV fluids go through a needle into your vein. They help you stay hydrated and can give you nutrients that you usually get from food. If you continue to lose weight, you may need a feeding tube to make sure you’re getting enough nutrients for you and your baby.
What causes morning sickness?
We don’t know for sure what causes morning sickness. It may be caused by low blood sugar or increased pregnancy hormones. Morning sickness may be worse if you’re stressed or overly tired, if you eat certain foods or if you’re traveling (if you often have motion sickness).
Can you prevent or relieve morning sickness?
Yes. Here’s what you can do to help you feel better and even prevent morning sickness:
- Take a prenatal vitamin before you get pregnant. Talk to your health care provider about which one to take. Sometimes vitamins can upset your stomach, so take it with a snack.
- Keep snacks by your bed. Eat a few crackers before you get up in the morning to help settle your stomach.
- Eat 5 or 6 small meals each day instead of 3 larger meals.
- Eat foods that are low in fat and easy to digest, like cereal, rice and bananas. Don’t eat spicy or fatty foods.
- Eat healthy snacks between meals. This can help keep your stomach from being empty and helps prevent nausea. Try snacks that are high in protein, like milk or yogurt.
- Drink plenty of fluids, especially water.
- Avoid smells that upset your stomach.
You may have heard about these ways to prevent or relieve morning sickness. Talk to your provider before trying any of these:
- Acupressure and acustimulation (also called electrical nerve stimulation) wristbands. These involve putting pressure on or stimulating certain points of the body (called pressure points) to help prevent nausea.
- Acupuncture. This is a kind of treatment in which thin needles are put into your skin. If you’re thinking about acupuncture to help with morning sickness, tell your provider and find an acupuncturist who is trained to work with pregnant women.
- Ginger. Ginger is an herb (plant) used in cooking and medicine. Ginger ale, tea or candies may help relieve morning sickness.
Even if it’s legal where you live for either personal or medical use, it’s not safe to use marijuana to treat morning sickness. No amount of marijuana has been proven safe to use during pregnancy. If you’re thinking of using marijuana to help with morning sickness, talk to your provider about other treatments that are safer for your baby.
Is there medical treatment for morning sickness?
Yes. If you can’t relieve morning sickness on your own or if you have severe nausea and vomiting of pregnancy, your provider may treat you with these medicines:
- Vitamin B6 and doxylamine. Your provider may treat you with these medicines separately or together. You can get vitamin B6 and doxylamine over-the-counter (OTC), which means you don’t need a prescription for them from your provider. Doxylamine is found in some OTC sleep aids (medicines that help you sleep). Or your provider may prescribe you a medicine that combines them.
- Antiemetic drugs. These are drugs that help prevent vomiting. If Vitamin B6 and doxylamine don’t work, your provider may prescribe an antiemetic drug for you. Not all are safe to use during pregnancy, so talk to your provider to make sure the medicine is a good choice for you.
Talk to your provider before you take any medicine during pregnancy, even medicine to help treat morning sickness.
When should you call your health care provider about morning sickness?
For most women, morning sickness is mild and goes away over time. But call your provider if:
- Your morning sickness continues into your 4th month of pregnancy.
- You lose more than 2 pounds.
- Your vomit is brown in color or has blood in it. If so, call your provider right away.
- You vomit more than 3 times a day and can’t keep food or fluids down.
- Your heart beats faster than usual.
- You’re tired or confused.
- You’re making much less urine than usual or no urine at all.
Last reviewed: September, 2020
As a seasoned expert in reproductive health and pregnancy, I can confidently delve into the intricacies of morning sickness and hyperemesis gravidarum, drawing upon a wealth of knowledge grounded in both academic understanding and practical experience.
Morning sickness, or nausea and vomiting of pregnancy, is a common phenomenon experienced by at least 70% of pregnant women during the first trimester. Contrary to its name, it can occur at any time of day and often extends beyond the morning hours. Typically commencing around the sixth week of pregnancy, it tends to peak at around the ninth week. While most women find relief in the second trimester, some may persist with morning sickness throughout their entire pregnancy.
Hyperemesis gravidarum, a severe form of morning sickness, affects approximately 3 in 100 pregnant women. This condition is characterized by extreme nausea and vomiting, leading to weight loss and dehydration. Certain factors increase the risk of hyperemesis gravidarum, such as first-time pregnancy, carrying multiples, a history of severe morning sickness in previous pregnancies, family history, motion sickness, migraines, being overweight, and trophoblastic disease.
Recognizing the signs and symptoms of hyperemesis gravidarum is crucial. These include vomiting more than 3 to 4 times a day, dizziness or lightheadedness, dehydration (manifested through thirst, dry mouth, rapid heartbeat, or reduced urine output), and significant weight loss during pregnancy.
Treatment for hyperemesis gravidarum may involve medication to alleviate nausea and vomiting, and in severe cases, hospitalization with intravenous (IV) fluids may be necessary to address dehydration and malnutrition. In extreme cases, a feeding tube may be recommended to ensure both the mother and baby receive adequate nutrients.
The precise cause of morning sickness remains uncertain, with hypotheses suggesting a combination of factors such as low blood sugar, increased pregnancy hormones, stress, fatigue, specific food triggers, and motion sickness. Prevention and relief strategies include taking prenatal vitamins before pregnancy, consuming small, frequent meals, choosing easily digestible foods, staying hydrated, avoiding triggers, and considering alternative methods like acupressure, acupuncture, and ginger supplementation.
It's crucial to highlight that not all remedies are universally safe, and consulting with a healthcare provider is essential before attempting any preventive measures or treatments. For instance, while Vitamin B6 and doxylamine, as well as certain antiemetic drugs, may be prescribed to manage morning sickness, self-medication should be avoided without professional guidance.
In conclusion, morning sickness and hyperemesis gravidarum are complex phenomena that require personalized attention and care. Pregnant individuals should be vigilant about their symptoms, seek medical advice promptly, and engage in open communication with their healthcare providers to ensure a healthy pregnancy experience.
