Morning Sickness
Nausea and vomiting common in early pregnancy
Quick Facts
- Type: Common symptom of early pregnancy
- Usual timing: First trimester, easing by mid-pregnancy
- Despite the name: Can occur any time of day
- Severe form: Hyperemesis gravidarum
Overview
Morning sickness is the nausea, and sometimes vomiting, that many people experience during pregnancy, most often in the first trimester. Despite its name, it can occur at any time of day or night.
It is very common and, while unpleasant, is usually not harmful to the parent or baby. Symptoms most often start in the early weeks of pregnancy and ease by around the middle of pregnancy. A small number of people develop a severe form called hyperemesis gravidarum, with persistent vomiting that can lead to dehydration and weight loss and needs medical treatment.
Symptoms
Morning sickness varies from mild queasiness to frequent vomiting. Common features include:
- Nausea, with or without vomiting
- Symptoms that may be worse on an empty stomach or triggered by certain smells, foods, or motion
- A heightened sense of smell and food aversions
- Symptoms occurring at any time of day, not only the morning
Warning signs that point beyond ordinary morning sickness include inability to keep fluids down, vomiting many times a day, signs of dehydration (such as dark urine, dizziness, or passing little urine), and weight loss. These should be evaluated, as they may indicate hyperemesis gravidarum or another problem.
Causes
The exact cause of morning sickness is not fully understood, but it is closely linked to the hormonal and physical changes of early pregnancy. Contributing factors are thought to include:
- Rising pregnancy hormones in the early weeks
- A heightened sense of smell and sensitivity to certain foods
- Changes in the digestive system during pregnancy
Morning sickness is a normal part of many pregnancies and is not caused by anything the pregnant person did wrong. Some studies suggest mild nausea is associated with a lower risk of miscarriage, though its absence does not mean a problem.
Risk Factors
- A previous pregnancy with morning sickness or severe nausea
- Carrying twins or more (a multiple pregnancy)
- A history of motion sickness or migraine
- A family history of severe pregnancy nausea
- Nausea with prior use of estrogen-containing medication
Diagnosis
Morning sickness is usually identified from the symptoms and the stage of pregnancy. A clinician may:
- Review the history: How often vomiting occurs and whether fluids can be kept down.
- Check for dehydration and weight loss: Which help distinguish ordinary morning sickness from the severe form.
- Run tests when needed: Urine and blood tests, and occasionally an ultrasound, to assess hydration, rule out other causes, and confirm the pregnancy.
Treatment
Many cases respond to simple measures, and effective treatments are available when needed.
- Diet and lifestyle: Eating small, frequent meals; keeping plain crackers handy; avoiding triggers and strong smells; staying hydrated with small sips; and getting rest.
- Ginger: Ginger in foods or supplements helps some people with mild nausea.
- Vitamin B6: Often recommended, sometimes combined with an antihistamine, for more bothersome nausea.
- Prescription anti-nausea medicines: Used when symptoms are persistent; several options are considered safe in pregnancy and should be guided by a clinician.
- Hospital care: Severe cases (hyperemesis gravidarum) may need fluids given by vein and medication.
Always check with a healthcare provider before taking any medication or supplement during pregnancy.
Prevention
- Eat small, frequent meals and avoid an empty stomach
- Identify and avoid your personal triggers, such as certain smells or foods
- Stay hydrated with frequent small sips of fluid
- Take prenatal vitamins at a time of day you tolerate best, with food
- Rest, as tiredness can worsen nausea
When to See a Doctor
Contact your healthcare provider if you cannot keep food or fluids down, are vomiting many times a day, are losing weight, or have signs of dehydration such as dark urine, dizziness, a racing heart, or passing little urine. These may indicate hyperemesis gravidarum, which needs treatment.
Seek prompt care for severe abdominal pain, fever, vomiting blood, or fainting, and contact your provider about any nausea and vomiting that is new or severe later in pregnancy.
Frequently Asked Questions
Does morning sickness only happen in the morning?
No. Despite the name, nausea and vomiting in pregnancy can occur at any time of day or night, and for some people it lasts much of the day.
When does morning sickness usually stop?
It most often begins in the early weeks of pregnancy and eases by around the middle of pregnancy for most people, though some have symptoms for longer.
Is morning sickness harmful to the baby?
Mild to moderate morning sickness is usually not harmful and does not mean anything is wrong. The main concern is severe, persistent vomiting that causes dehydration and weight loss, which should be treated.
What helps relieve morning sickness?
Eating small frequent meals, avoiding triggers, staying hydrated with small sips, getting rest, and trying ginger help many people. Vitamin B6 and, when needed, prescription anti-nausea medicines can be used under medical guidance.
When should I worry about pregnancy nausea?
Contact your provider if you cannot keep fluids down, vomit many times a day, lose weight, or have signs of dehydration. These can signal hyperemesis gravidarum, a severe form that needs medical care.
References
- American College of Obstetricians and Gynecologists (ACOG). Morning Sickness: Nausea and Vomiting of Pregnancy.
- Mayo Clinic. Morning sickness — Symptoms and causes.
- MedlinePlus, U.S. National Library of Medicine. Morning sickness.
- Office on Women's Health, U.S. Department of Health and Human Services.