Morning Sickness: The Ultimate Survival Guide

Everything You Need to Know About Morning Sickness Morning sickness: one of the most common—and dreaded—symptoms of pregnancy. It’s a phrase that can be a relentless, daily battle against your own body, impacting your work, your relationships, and your mental health. You probably expect to feel queasy and throw up, but how do you know if you’re experiencing morning sickness or something else? What’s considered a normal part of pregnancy, and when should you call your doctor? Here’s everything you need to know about morning sickness and our best tips for managing your symptoms. When Does Morning Sickness Start? Morning sickness is an extremely common pregnancy symptom—7 in 10 women will experience it during their first trimester. It typically begins in the sixth week of pregnancy, peaks at the ninth or tenth week, then gradually subsides. The exact timing, however, is different for every woman (and can be different with every pregnancy!). It’s important to note—grab the saltines!—that despite its name, morning sickness can occur at any time of day, morning, noon, or night. Many women are surprised to find their nausea is worst in the evening, often triggered by the fatigue of a long day. Is Morning Sickness a 'Good' Sign? (And What if You Don't Have It?) You may have heard that morning sickness is a sign of a healthy, thriving pregnancy, likely due to rising hormone levels. While there is some research to support a correlation between nausea and lower rates of miscarriage, the presence or absence of morning sickness is not a reliable indicator of your pregnancy's viability. Many women have perfectly healthy pregnancies with little to no nausea at all. If you are one of the lucky few who feels great, try to enjoy it rather than worry, and if you are feeling very sick, know that it is not a required "symptom of success." What Causes Morning Sickness? While morning sickness is usually blamed on all the new pregnancy hormones flooding your body, the exact cause isn’t fully understood. Healthcare providers believe morning sickness is caused by a number of factors, including: Hormonal changes: fluctuations in pregnancy hormones, namely estrogen, progesterone, and human chorionic gonadotropin (HCG), are thought to play a significant role in triggering morning sickness. Placenta proteins: new studies may have found a link between a protein released by the placenta called GDF15 and morning sickness. Women who reported experiencing morning sickness well into the second semester had higher concentrations of GDF15 in their blood. Changes in digestion and metabolism: pregnancy slows the digestion process and causes huge changes in maternal metabolism. These factors may interact to cause feelings of nausea and the need to vomit. An Evolutionary Advantage: Some scientists theorize that morning sickness developed as a protective mechanism. By creating an aversion to strong tastes and smells, it may have historically protected the developing fetus from potentially harmful foods and toxins What Are the Symptoms of Morning Sickness? Common symptoms of morning sickness can include: Nausea and feeling queasy Vomiting Loss of appetite and food aversions Sensitivity to smells Increased salivation (known as ptyalism gravidarum, which can further contribute to nausea) A metallic taste in the mouth A general feeling of exhaustion and fatigue that accompanies the nausea Every woman will experience morning sickness differently—some may feel queasy on and off all day, others may feel extremely nauseous and throw up. There’s a wide range of intensity and duration of symptoms, and they’ll vary for every woman (and you may experience different symptoms with each subsequent pregnancy). If you have abdominal pain, fever, or have nausea and vomiting that begins after your ninth or tenth week, it’s not just morning sickness and warrants a call to your doctor. New nausea in the second or third trimester could be a sign of other conditions like acid reflux or, more seriously, preeclampsia, so it should always be discussed with your provider. Can Morning Sickness Be Severe? Most women with morning sickness feel queasy for short periods of time, and may throw up once or twice. But if your nausea persists for hours, and vomiting occurs more than three times a day, it may be a condition called Hyperemesis Gravidarum (HG). Symptoms of HG include: Vomiting three or more times a day Vomiting that makes you feel dizzy Dehydration (signs include dark-colored urine, not peeing for more than 8 hours, and extreme thirst) Excessive weight loss (10 pounds or more or more than 5% of your pre-pregnancy body weight) Inability to keep any food or liquids down for 24 hours If your doctor suspects HG, they’ll order additional testing, and may prescribe medications to help relieve nausea. In extreme cases, IV hydration at a hospital may be required. HG is a serious medical condition that requires proactive treatment; it is not something to "tough out." Are Some Women More Likely to Develop Morning Sickness than Others? Yes. There are certain factors that make it more likely for you to experience morning sickness, including: Being pregnant with multiples Having a history of migraines Being overweight Having high levels of stress or anxiety Having a history of motion sickness Living in a hot climate Not getting enough sleep A personal or family history of Hyperemesis Gravidarum Having a pre-existing gastrointestinal disorder, like acid reflux And it turns out that an old wives tale could be true: some studies have shown that women with severe morning sickness are more likely to give birth to a girl. When Does Morning Sickness End? Morning sickness usually begins to subside by the end of the first trimester, between weeks 12-14. However, in some cases it may last longer and continue into the second trimester. For a smaller percentage of women, nausea can persist in some form throughout the entire pregnancy, which can be incredibly challenging emotionally and physically. Keep in mind that every pregnancy is unique, and you may experience morning sickness for a shorter or longer duration. If you’re experiencing severe or prolonged symptoms, it’s best to consult with your healthcare provider for personalized advice and guidance. Can You Prevent Morning Sickness? Unfortunately, there’s no way to completely prevent morning sickness, but there are certain environmental and lifestyle factors that will worsen symptoms, including: Hunger: low blood sugar levels contribute to nausea, so going for long periods without eating may worsen morning sickness symptoms. Certain smells: strong odors may trigger nausea in pregnant women—typical offenders include perfumes, cooking and food smells, and cigarette smoke. Anxiety and stress: emotional stress and anxiety can intensify nausea during pregnancy. Being overtired: fatigue and lack of sleep can worsen nausea. Motion sickness: if you’ve struggled with motion sickness while traveling in your pre-pregnancy life, expect it to worsen morning sickness when you’re pregnant. Heat and hot weather: hot temperatures, especially when combined with humidity, can aggravate morning sickness and nausea. Flickering screens or bright lights: For some women, the visual stimulation from screens or fluorescent lights can trigger or worsen nausea. Sudden movements: Getting up too quickly can lead to dizziness and a wave of queasiness. Are There Foods that Help Morning Sickness? Eating a diet of unprocessed, nutrient-rich, and high-protein foods may help with morning sickness. While a healthy diet is always a goal, don’t forget to pay attention to your body’s cues: if subsisting on Pop-Tarts is keeping the queasiness at bay, stock up your pantry. Your healthcare provider may suggest trying: Bland foods like dry toast, crackers, pretzels, applesauce, and bananas Produce with high water content, like watermelon, celery, citrus fruits, and bell peppers High protein smoothies made with yogurt or your favorite nut butter (Protein helps stabilize blood sugar, which can ward off nausea.) Cold foods: Often, cold foods are more palatable than hot foods because they emit fewer odors. Salty foods: A handful of potato chips or salty crackers can sometimes settle a queasy stomach. Tips for Managing Morning Sickness Unfortunately, there’s no magic bullet for alleviating the symptoms of morning sickness, but there are several strategies and remedies that can help. Here are some suggestions: Try eating small, frequent meals: having an empty stomach or low blood sugar can often trigger nausea, so making sure that you always have a little something in your stomach may help. Think of it as "grazing" throughout the day rather than eating three large meals. Eat as soon as you wake up: keep a few crackers or pretzels by your bed and have a snack before getting up. This helps raise your blood sugar before your feet even hit the floor. Avoid certain foods: some foods—like anything greasy, fatty, or spicy—are more likely to activate nausea. Stick with bland foods like bananas, rice, dry toast, and applesauce (don’t worry—it doesn’t last forever!). Don’t take your prenatal vitamin on an empty stomach: take your vitamin with a snack or meal to help with queasiness. The iron in many prenatal vitamins can be particularly tough on a sensitive stomach. Some women find that taking it right before bed helps them sleep through any potential nausea. Add a little protein: protein-rich foods like yogurt, eggs, cheese, nuts, and peanut butter can reduce nausea. Stay hydrated: drink plenty of fluids, especially water, throughout the day. If plain water is unappealing, try ice chips, popsicles, sparkling water with a squeeze of lemon, or a very diluted juice. Try certain flavors: ginger and peppermint can curtail nausea and vomiting. You can find these flavors in teas, candies, and ginger ale. Avoid triggers: if certain foods or smells trigger nausea, stay away. This may mean asking your partner to take over cooking duties or using unscented soaps and lotions for a while. Rest and manage stress: fatigue and stress can intensify morning sickness. Try getting plenty of rest, take breaks when needed, and find ways to relax and manage stress, such as yoga, deep breathing exercises, gentle exercise, and meditation. If your morning sickness is persistent and severe, your healthcare provider may prescribe: Vitamin B6: vitamin B6 (also called pyridoxine) may help with nausea and vomiting. Doxylamine: doxylamine (brand name Unisom) is an over-the-counter sleep aid that’s used to treat occasional insomnia, but it may also reduce the severity of morning sickness. The combination of Vitamin B6 and Doxylamine is the primary ingredient in the prescription drug Diclegis and is often the first-line medical treatment recommended by doctors. Diclegis and other antiemetics: if your morning sickness is so severe that it’s affecting your ability to function, your healthcare provider may prescribe Diclegis or another antiemetic that is safe to take during pregnancy. Keep in mind that you shouldn’t take anything, even an over-the-counter supplement, without discussing with your healthcare provider. Alternative and Complementary Therapies When you're feeling desperate, you may want to explore every option. While robust scientific evidence varies, many women report finding relief from these methods. Always discuss them with your provider first. Acupressure: This involves applying pressure to a specific point on the inner wrist (the P6 or Neiguan point). This is the principle behind popular "sea bands" worn for motion sickness, and many women find them helpful for pregnancy nausea. Aromatherapy: Certain scents can be calming. Try sniffing a cotton ball with a drop of lemon, peppermint, or spearmint essential oil when a wave of nausea hits. Conversely, some scents might be triggering, so listen to your body. Practical Strategies for Work and Home Managing nausea while trying to live your life is the real challenge. Here are some survival strategies: At Work: Keep a "survival kit" at your desk with bland snacks (crackers, almonds), peppermint tea, and anything else that helps. If possible, confide in a trusted manager or colleague early on so you have an ally if you need to make a quick escape or take a break. Step outside for fresh air frequently. Caring for Other Children: This can be incredibly difficult. Lower your expectations—more screen time or simpler meals for your older kids is okay during this temporary phase. Lie on the couch and have them bring you books to read, or do quiet floor activities together. Enlist help from partners, family, or friends whenever possible. Commuting: If you commute via car, keep the windows cracked for fresh air and avoid heavy traffic if possible. On public transit, try to get a seat and face forward. Keep a sick bag with you for peace of mind. How to Support Someone with Morning Sickness Watching someone you love feel sick and helpless is hard. Partners and support people can play a crucial role. Become the In-home Chef: Keep her stocked with whatever she can tolerate. Run to the store for that one specific brand of crackers she needs right now. Keep her water bottle full. Take over cooking duties entirely, as cooking smells are often a major trigger. Handle Smells: Take out the trash frequently, avoid wearing strong cologne or perfume, and be mindful of food smells you bring into the house. Offer Empathy, Not Solutions: Avoid saying "Have you tried ginger?" She has. Instead, say "I'm so sorry you're feeling this awful. What can I do for you right now?" Validate her misery without trying to "fix" it. Take on Extra Household & Mental Load: Manage other kids, do the laundry, handle chores. The more rest she can get, the better she might feel. Be Her Advocate: If you feel her symptoms are being dismissed or are getting severe, encourage her to call the doctor and support her during the appointment. When Should You Call Your Healthcare Provider? Morning sickness is definitely aggravating (and not fun), but it shouldn’t be debilitating. Trust your instincts. If you feel that something is not right or that your symptoms are beyond the scope of "normal," it is always better to call. Get in touch with your healthcare provider if you’re experiencing: Severe and persistent nausea that prevents you from eating and drinking Vomiting three or more times a day Fainting or feeling dizzy Weight loss Confusion or disorientation Abdominal pain Fever Producing little to no pee when going to the bathroom Your healthcare provider will want to investigate severe morning sickness to rule out any underlying conditions and come up with a treatment plan. Morning sickness can make the first trimester of your pregnancy pretty uncomfortable—most women feel queasy and nauseous until the beginning of the second trimester. Fortunately, there are changes you can make to your diet and lifestyle that will help offer a little relief until your symptoms subside. Remember, if your symptoms are persistent and severe, contact your healthcare provider to discuss your options.