Morning Sickness: Nausea and Vomiting in Pregnancy

Morning sickness is nausea and vomiting that occurs during pregnancy. Since your sense of smell is extra keen when you're expecting, you may also have strong aversions to certain foods and smells; despite its name, morning sickness can strike at any time of the day or night.

When does morning sickness start?

Morning sickness symptoms typically start between weeks 6 to 9 of pregnancy.

How long does morning sickness last?

For most expecting mothers, nausea and vomiting typically subside between weeks 12 to 16 of pregnancy, with symptoms at their worst between weeks 10 to 16.

Morning sickness symptoms

A nauseous, queasy feeling in the first trimester of pregnancy that many pregnant women liken to seasickness or carsickness
Queasiness often comes in the morning but can surface at any time of the day or night
Strong aversions to certain smells and foods that are so powerful they can make you sick to your stomach
A seasick feeling that's often either accompanied or immediately followed by hunger pangs
Nausea that strikes after eating
Sickness that's so strong it can lead to vomiting

When to visit a doctor

Morning sickness itself doesn't harm your baby. However, you should see your doctor if you can't keep foods or liquids down and are starting to lose weight.
Your doctor will want to rule out hyperemesis gravidarum, or severe morning sickness that may require medical attention and possibly hospitalization to protect you and your baby.
Nausea or vomiting is severe.
You pass only a small amount of urine, or it's dark in colour.
You can't keep down liquids.
You feel dizzy or faint when you stand up.
Your heart races.

Many pregnant women have morning sickness, especially during the first trimester. But some women have morning sickness throughout pregnancy.

Management options

Include various home remedies, such as snacking throughout the day and sipping ginger ale.
Taking over-the-counter medications to help relieve nausea.
Rarely, morning sickness is so severe that it progresses to a condition called hyperemesis gravidarum. This is when someone with nausea and vomiting of pregnancy has severe symptoms that may cause severe dehydration or result in the loss of more than 5 percent of pre-pregnancy body weight.
Hyperemesis gravidarum may require hospitalization and treatment with intravenous (IV) fluids, medications, and rarely a feeding tube.

Causes

What causes morning sickness isn't clear, but the hormonal changes of pregnancy are thought to play a role.

Increased level of the pregnancy hormone hCG, which peaks around the time morning sickness is worst
Rising levels of estrogen and progesterone, which relax the muscles of the digestive tract and make digestion less efficient
The metallic taste that many women experience during pregnancy

Rapid stretching of the uterine muscles A sharper sense of smell due to pregnancy hormones Heartburn or gastrointestinal reflux (GERD), which are more common during pregnancy Excess saliva, which can increase feelings of queasiness

Not all pregnant women experience morning sickness — and not in the same way. Some have only occasionally queasy moments. Others feel queasy round the clock but never vomit or vomit once in a while. A few vomit very frequently.

Several factors may increase your risk of experiencing morning sickness, including:

Hormone levels can increase the risk of morning sickness

Higher-than-average pregnancy hormone levels (because, for example, you're carrying multiples) can increase morning sickness.

While lower-than-average hormone levels may reduce or eliminate nausea, you can also have perfectly normal hormone levels and experience minimal (if any) morning sickness.

A sensitive brain can increase the risk of morning sickness

Some brains are simply more sensitive than others, which means they're more likely to respond to hormones and other pregnancy triggers queasiness.

If you have a sensitive stomach — you always get carsick or seasick, for example — you're more likely to have more severe nausea and vomiting in pregnancy. If you're rarely queasy, you're less likely to have morning sickness when you're expecting.

Stress can increase the risk of morning sickness

Emotional stress can trigger gastrointestinal upset. So it's not surprising that morning sickness tends to worsen when you're especially stressed.

That's not to say that morning sickness is in your head. But if you're feeling particularly on edge, it might intensify nausea and vomiting.

Fatigue can increase the risk of morning sickness

Physical or mental fatigue can trigger morning sickness symptoms. On the flip side, severe morning sickness can increase fatigue.

First-time pregnancy can increase the risk of morning sickness

For the first time, women who are pregnant tend to be more prone to morning sickness and have more severe morning sickness symptoms.

If your body has never gone through pregnancy before, it may be less "prepared" for the surge of hormones and other changes you're experiencing. You may also feel a bit anxious about the many unknowns of pregnancy, resulting in an upset stomach.

If this isn't your first baby, you may be distracted from nausea by the demands of caring for older children. And since your body has been there, done that, it may not be so shocked by the physical changes of pregnancy.

Generalities are never 100 percent true for everyone. You may find, for example, that you're queasier in your second pregnancy than you were in your first.h

Genetics can increase the risk of morning sickness

If your mom or sister had morning sickness, some research suggests you're more likely to develop the condition yourself. Of course, you could sail through pregnancy with hardly a sick day.

Hot weather can increase the risk of morning sickness

Some women find that feeling hot brings on feelings of nausea. But as is the case for all of these factors, morning sickness sometimes has no apparent trigger at all.

Morning sickness remedies

While the only way to get rid of the queasy feeling is to give it some time, a few strategies can offer morning sickness relief:

Stamp out offensive smells

Most women develop a stronger sense of smell during pregnancy. Hence, you may become extremely sensitive towards smells like those of poultry or seafood. Also called Hyperosmia, this heightened sense of smell can cause morning sickness, nausea and vomiting.

Thanks to your more sensitive sense of smell, some scents may be suddenly offensive or even sickening. So please stay away from smells that trigger nausea, whether it's the curry from your favorite takeout place or your formerly favorite perfume. Actively make sure to stick to healthier, less pungent smelling foods and make sure you have someone clear your fridge of these offensive smells.

2. Try microwaving food, which usually results in fewer odors, and open the windows when you cook. Leave any place that smells so strong it's making you ill.

3. Wear Sea-Band wristlets

These 1-inch wide bands put pressure on an acupressure point in the inner wrist. They're widely available at drug and health food stores and have been shown to safely lessen pregnancy nausea.

4. Rest and de-stress

Destressing can help minimize queasiness. Try classic stress-reduction techniques, like meditation and visualization or prenatal yoga. And try to hit the sack for as many hours as you can clock every night.

5. Take it slow- Rushing tends to aggravate nausea. So take it easy in the morning: Linger in bed for a few minutes and nibble on a bedside snack before taking a long, warm shower. Follow a Time Table.

A leisurely morning may seem impossible if you have other kids. Try to wake up before they do, which gives you a few moments of quiet time. Or let your partner take the morning shift.

6. Try alternative remedies- A wide variety of complementary medical approaches can help minimize morning sickness symptoms, including acupuncture, acupressure, biofeedback, or hypnosis. They're worth a try, especially if nothing else works.

7. Keep your mouth squeaky clean.

8. Regular bruising helps keep your mouth fresh and reduces queasiness in the future. It also decreases the risk of damage to teeth from vomiting.

9. Brush your teeth or rinse your mouth after bouts of vomiting and after each meal and once your tummy has settled a bit. If your usual toothpaste contributes to nausea (toothpaste is a common trigger), ask your dentist to recommend another option or a good rinse. Or use plain water.

10. Pop a supplement

11. Take your prenatal vitamin to compensate for any nutrients you may not be getting. At whatever time of day, you're least likely to throw it back up. Prenatal vitamins can decrease nausea symptoms — especially if you take a slow-release vitamin that's higher in quease-combating vitamin B6.

12. If your current pill makes you nauseous, try taking it with a meal. Or consider a coated, powder, or chewable supplement.

13. If your symptoms are incredibly rough, ask your practitioner about switching your vitamin for one with more B6 and less (or no) iron, which can be particularly tough on a sensitive tummy. Ask whether you should take an additional vitamin B6 supplement, the antihistamine doxylamine (found in Unisom Sleep Tabs), or supplement with magnesium or a magnesium spray.

14. Don't take any traditional or herbal medication for morning sickness unless your practitioner prescribes it.

15. Ask your doctor about morning sickness medication.

Risk factors

Morning sickness can affect anyone who's pregnant, but it might be more likely if:
You had nausea or vomiting from motion sickness, migraines, certain smells or tastes, or exposure to estrogen (in birth control pills, for example) before pregnancy
You had morning sickness during a previous pregnancy
You're pregnant with twins or other multiples

You might be more likely to experience hyperemesis gravidarum

You're pregnant with a girl
You have a family history of hyperemesis gravidarum
You experienced hyperemesis gravidarum during a previous pregnancy.

Complications

Mild nausea and vomiting of pregnancy typically won't cause any complications to you or your baby.
If left untreated, severe nausea and vomiting can cause dehydration, an electrolyte imbalance, decreased urination, and hospitalization.
Research is mixed on whether hyperemesis gravidarum causes poor weight gain for your baby during pregnancy.

Prevention

There's no way to prevent morning sickness completely.
However, avoiding triggers such as strong odors, excessive fatigue, spicy foods, and foods high in sugar may help.