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The early weeks of pregnancy can be a confusing time full of many physical and emotional changes. For some women, morning sickness may be the first sign they notice during pregnancy. Some fortunate women (about 20%) may not develop any nausea during pregnancy, but the vast majority of women will experience nausea for at least part of their pregnancy.
What is morning sickness?
Morning sickness is the general term used to describe nausea and vomiting that most women experience during pregnancy. Up to 80% of women experience these symptoms at some point during pregnancy (Bustos, 2017).
Despite what its name suggests, the symptoms of morning sickness can hit at any time of the day. Many women may experience the worst of their symptoms first thing in the morning. Still, it’s sometimes called “anytime sickness” since nausea may come and go throughout the day. For some people, they may experience their worst symptoms in the evening.
When does nausea start in pregnancy?
When and how long you experience morning sickness is different for everyone. It usually starts during the first trimester, as early as 2–4 weeks (Bustos, 2017).
The most common week for women to notice nausea during pregnancy is the sixth week or two weeks after their first missed period. That same week is also when most women will test positive on a pregnancy test.
The symptoms may appear gradually for some people, while for others, the symptoms may suddenly appear.
Morning sickness symptoms
The most common symptoms of morning sickness are nausea and vomiting. The symptoms may start out of the blue or be triggered by smells, food, heat, and other causes. Some women experience other symptoms like (Foxcroft, 2013):
- Sensitivity to smell
- Fatigue or increased tiredness
What causes morning sickness?
Unfortunately, no one knows exactly what causes morning sickness. It’s believed to be related to several hormonal changes. Changes in estrogen and progesterone levels likely play a role in when morning sickness develops.
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Another pregnancy hormone, human chorionic gonadotropin (hCG), likely affects nausea symptoms. Research suggests a relationship between when hCG levels peak and when pregnancy symptoms are at their highest (Bustos, 2017).
When does morning sickness end?
If you’re experiencing morning sickness, you’re not alone in wondering when it will end. For most women, their nausea symptoms will peak between weeks 8–11 and often go away by the end of the first trimester.
Some women may experience their symptoms in their second trimester. An even smaller number may experience the symptoms during their third trimester. Up to 10% of women may experience morning sickness throughout their entire pregnancy (Bustos, 2017).
When to see a healthcare provider
Most of the time, morning sickness isn’t harmful to you or your baby. While the symptoms can be disruptive and uncomfortable, they’re just a normal part of pregnancy for most people. However, sometimes morning sickness may turn into more severe symptoms.
Hyperemesis gravidarum (HG) is a more severe type of morning sickness that affects about 3% of pregnant women. Risk factors for developing hyperemesis gravidarum include a history of migraines, family history of HG, HG during a previous pregnancy, and a history of nausea when taking hormonal birth control (Jennings, 2021).
HG can become dangerous for both the mother and baby because severe nausea and vomiting may lead to dehydration and malnutrition. Contact your healthcare provider if you experience severe morning sickness symptoms like:
- Weight loss during pregnancy
- Inability to keep food or liquids down
- Dark-colored urine
- Feeling weak, dizzy, or lightheaded
Remedies for nausea during pregnancy
While morning sickness is a normal part of pregnancy, it’s still uncomfortable and unpleasant to feel sick regularly. While you may not be able to stop the symptoms of morning sickness entirely, some tricks may help ease your symptoms.
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Here are a few tips to help with nausea during pregnancy:
- Eat small, frequent meals: Nausea may be worse on an empty stomach or one that’s overly full. Try to eat small meals more often to help with symptoms.
- Track symptoms and possible triggers: Keeping notes of foods, smells, time of day, and other possible triggers for symptoms. Tracking symptoms and triggers may help you avoid problem foods and reduce symptoms.
- Try ginger or peppermint herbal tea: Some herbal teas, like ginger and peppermint, may help ease nausea symptoms. Just be careful if the tea is mixed with green or black tea since those varieties contain caffeine which should be limited while pregnant.
- Drink fluids in smaller sips: Too much liquid in your stomach may trigger nausea symptoms. Try to drink smaller amounts throughout the day instead of drinking full glasses at once.
- Keep light snacks nearby: Keeping some snacks nearby that you know you tolerate may help. If you feel your stomach getting too empty or symptoms starting, a few bites of a light food like toast may help.
- Avoid heavy, greasy meals: Foods high in fat may feel heavy in the stomach and leave you overly full. Try to limit fatty meals that may trigger symptoms.
- Eat crackers before getting out of bed: Sometimes, eating a little before getting out of bed may help prevent morning sickness. If you usually feel sick first thing in the morning, try keeping crackers next to your bed so you can eat a few before getting up.
- Wear acupressure wrist bands: The evidence is mixed for whether this method works. Still, some women find nausea relief from wearing acupressure bands, similar to those used for sea-sickness or motion sickness symptoms. The bands put pressure on a pressure point in the wrist that may help ease symptoms (Van den Heuvel, 2016).
- Do light exercise like walking: Continuing to exercise while pregnant may help you feel better. Try a light walk, prenatal yoga, or swimming to stay active.
- Get extra sleep: Morning sickness and pregnancy can be hard on your body. Making some extra time for rest may help you feel better.
If your symptoms make it difficult to continue through your normal daily activities, talk to your obstetrician (OB-GYN). They may recommend different prenatal vitamins, nutrition supplements, or anti-nausea medications to help ease your symptoms.
- Bustos, M., Venkataramanan R, & Caritis, S. (2017). Nausea and vomiting of pregnancy – what’s new?. Autonomic Neuroscience: Basic & Clinical, 202, 62–72. doi: 10.1016/j.autneu.2016.05.002. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5107351/
- Foxcroft, K. F., Callaway, L. K., Byrne, N. M., & Webster, J. (2013). Development and validation of a pregnancy symptoms inventory. BMC Pregnancy and Childbirth, 13, 3. doi: 10.1186/1471-2393-13-3. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599678/
- Jennings, L. K. & Mahdy, H. (2021). Hyperemesis gravidarum. [Updated Jul 29, 2021]. In: StatPearls [Internet]. Retrieved on Sep. 3, 2021 from https://www.ncbi.nlm.nih.gov/books/NBK532917/
- Van den Heuvel, E., Goossens, M., Vanderhaegen, H., Sun, H. X., & Buntinx, F. (2016). Effect of acustimulation on nausea and vomiting and on hyperemesis in pregnancy: a systematic review of western and Chinese literature. BMC Complementary And Alternative Medicine, 16, 13. doi: 10.1186/s12906-016-0985-4. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711053/
Dr. Steve Silvestro is a board-certified pediatrician and Senior Manager, Medical Content & Education at Ro.