Morning sickness is a common pregnancy issue that doesn’t just happen in the morning.
An obstetrician-gynecologist breaks down what morning sickness is, the most common symptoms and causes, and what you can do to get some relief.
Morning sickness is a spectrum of disorders that can range from nausea alone to severe vomiting, said Dr. Sudheer Jayaprabhu, an ob-gyn with Christus St. Michael Hospital in Texarkana, Texas.
The good news is that while mild morning sickness occurs in up to 90% of pregnancies, it does not hurt your fetus in any way. It may even be a good sign:
It may indicate that all is well with you and your fetus
Morning sickness might be related to a lower risk of miscarriage
Your symptoms probably show that the placenta is making all the hormones needed for a healthy pregnancy
While it varies from patient to patient, here are some common morning sickness symptoms:
Nausea and vomiting any time of the day
Dizziness and headaches
Gastric reflux (stomach contents coming up into esophagus)
Heartburn
Morning sickness symptoms usually begin about five to six weeks after your last menstrual period and peak around nine weeks, Jayaprabhu said.
While morning sickness usually subsides by 16 to 20 weeks, this isn’t always the case.
“In about 15% to 20% of patients, it can continue until the third trimester," Jayaprabhu said. "Sometimes, it can continue until delivery.” That's true in about 5% of patients.
Morning sickness is usually caused by hormonal changes that lead to decreased stomach emptying. Factors that make symptoms worse include an increased sense of smell and gastric reflux.
You may be at higher risk for morning sickness if:
You're having multiples (twins or more)
You had severe morning sickness before
You get motion sickness (car sick)
You suffer from migraine headaches
Your mother or sisters have experienced morning sickness
You’ve felt sick when taking contraceptives that contain estrogen
It's your first pregnancy
You are obese (BMI of 30 or more)
You're experiencing increased stress
For nausea with occasional vomiting, Jayaprabhu suggests these steps:
Eat frequent small meals
Avoid trigger foods
Eat low-fat, high fiber foods
Drink liquids at least 30 minutes before or after solid foods
Drink cold, clear and carbonated or sour drinks
Try ginger-ale, ginger tea or a ginger lollipop
Drink small amounts at a time
Use a straw
Brush your teeth after a meal and spit out your saliva
Take your prenatal vitamin with a snack
There are some effective morning sickness medicines. Many experts recommend vitamin B6 and Unisom (doxalamine). A combination of the two (Diclegis) can be taken. Check with your physician before taking any medications.
Although it may be tempting, do not use cannabis, Jayaprabhu emphasized, as it may harm the fetus.
Here are more tips for living with morning sickness:
Keep your morning slow and calm
Avoid triggers such as food odors or other smells
Avoid cigarette smoke
Get enough sleep and decrease stress when you can
Try wearing acupressure wrist bands, which are available at pharmacies
Eat a few soda crackers before you get out of bed in the morning
Sometimes, women suffer from a severe form of morning sickness called hyperemesis gravidarum. It may become impossible for you to keep anything down and other prescriptions might be needed. If those don’t work, you might need to be hospitalized to protect your health and that of your fetus. In the hospital, labs will be done and you may receive intravenous fluids and medications.
Call your ob-gyn if you have any of these signs and symptoms of dehydration:
You don’t have much urine and it is dark in color
You can’t urinate (pee)
You can’t keep liquids down
You feel dizzy or faint when you stand up
Your heart is racing
While morning sickness is normally a mild discomfort during pregnancy, in rare cases it can become a more serious problem requiring medications and even hospitalization. Knowing what is and isn’t normal will help assure that you, and your fetus, remain healthy.
Sources: Sudheer Jayaprabhu, MD, obstetrician-gynecologist, Christus St. Michael Hospital, Texarkana, Texas
American College of Obstetricians and Gynecologists: Morning Sickness: Nausea and Vomiting of Pregnancy
National Library of Medicine – MedlinePlus: Morning Sickness
National Health Service, U.K.: Vomiting and Morning Sickness
For more information on pregnancy, check out these additional resources:
The Most Common Signs of Labor, According to an Ob-Gyn
Second Trimester Prenatal Testing: An Ob-Gyn Shares What To Expect