First trimester morning sickness

Morning sickness | March of Dimes

Morning sickness is when you have nausea and vomiting during pregnancy. Even though it’s called morning sickness, it can happen any time of day.

Morning sickness usually starts at about 6 weeks of pregnancy and goes away in the second trimester.

Lots of pregnant women have morning sickness. It usually doesn’t cause harm to you or your baby.

Hyperemesis gravidarum is severe nausea and vomiting that needs treatment (sometimes in a hospital) to help you get better.

If your morning sickness is severe or if it goes into your fourth month of pregnancy, tell your health care provider right away.

What is morning sickness?

Morning sickness (also called nausea and vomiting of pregnancy, or NVP) is nausea (feeling sick to your stomach) and vomiting that happens in the first few months of pregnancy. Even though it's called morning sickness, it can last all day and happen any time of day.

At least 7 in 10 pregnant women have morning sickness in the first trimester (first 3 months) of pregnancy. It usually starts at about 6 weeks of pregnancy and is at its worst at about 9 weeks. Most women feel better in their second trimester, but some have morning sickness throughout pregnancy. If you have morning sickness, tell your health care provider.

Mild morning sickness doesn’t harm you or your baby. But if nausea and vomiting becomes severe (called hyperemesis gravidarum), it can cause serious problems during pregnancy. You may need to stay in the hospital for treatment.

What is hyperemesis gravidarum?

About 3 in 100 women may have hyperemesis gravidarum. This is extreme, excessive nausea and vomiting during pregnancy. It can cause you to lose weight and become dehydrated (not have enough water in your body). It can start early in pregnancy and last the entire pregnancy. If you have hyperemesis gravidarum, you need treatment to help keep you and your baby safe.

You may be at risk for hyperemesis gravidarum if you:

• Are pregnant for the first time.
• Are pregnant with a girl.
• Are pregnant with multiples (twins, triplets or more). Being pregnant with more than one baby may increase your risk for severe morning sickness because you may have a large placenta and increased pregnancy hormones. The placenta grows in your uterus (womb) and supplies your babies with food and oxygen through the umbilical cord.  
• Had mild or severe morning sickness in a previous pregnancy, or your mother or sister had severe morning sickness during pregnancy. Take your family health history to help you find out about health conditions that run in your family. This is a record of any health conditions and treatments that you or your family members have had.
• Have motion sickness or migraines.  A migraine is a severe headache that may make you sensitive to bright lights and sound.
• Are overweight.
• Have trophoblastic disease, a condition that leads to abnormal cell growth in the uterus (womb).

Signs and symptoms of hyperemesis gravidarum include:

• Vomiting more than 3 to 4 times a day
• Vomiting that makes you dizzy or lightheaded
• Vomiting that makes you dehydrated. Signs and symptoms of dehydration include feeling thirsty, dry mouth, a fast heart beat or making little to no urine.
• Losing more than 10 pounds in pregnancy

If you have hyperemesis gravidarum, your provider may treat you with medicine to help relieve your nausea and vomiting. You may need treatment in a hospital with intravenous (also called IV) fluids. IV fluids go through a needle into your vein. They help you stay hydrated and can give you nutrients that you usually get from food.  If you continue to lose weight, you may need a feeding tube to make sure you’re getting enough nutrients for you and your baby.

What causes morning sickness? 

We don’t know for sure what causes morning sickness. It may be caused by low blood sugar or increased pregnancy hormones. Morning sickness may be worse if you’re stressed or overly tired, if you eat certain foods or if you’re traveling (if you often have motion sickness).

Can you prevent or relieve morning sickness?

Yes. Here’s what you can do to help you feel better and even prevent morning sickness:

• Take a prenatal vitamin before you get pregnant. Talk to your health care provider about which one to take. Sometimes vitamins can upset your stomach, so take it with a snack.
• Keep snacks by your bed. Eat a few crackers before you get up in the morning to help settle your stomach. 
• Eat 5 or 6 small meals each day instead of 3 larger meals. 
• Eat foods that are low in fat and easy to digest, like cereal, rice and bananas. Don’t eat spicy or fatty foods.
• Eat healthy snacks between meals. This can help keep your stomach from being empty and helps prevent nausea. Try snacks that are high in protein, like milk or yogurt.
• Drink plenty of fluids, especially water.  
• Avoid smells that upset your stomach. 

You may have heard about these ways to prevent or relieve morning sickness. Talk to your provider before trying any of these:

• Acupressure and acustimulation (also called electrical nerve stimulation) wristbands. These involve putting pressure on or stimulating certain points of the body (called pressure points) to help prevent nausea.  
• Acupuncture. This is a kind of treatment in which thin needles are put into your skin. If you’re thinking about acupuncture to help with morning sickness, tell your provider and find an acupuncturist who is trained to work with pregnant women.
• Ginger. Ginger is an herb (plant) used in cooking and medicine. Ginger ale, tea or candies may help relieve morning sickness.

Even if it’s legal where you live for either personal or medical use, it’s not safe to use marijuana to treat morning sickness. No amount of marijuana has been proven safe to use during pregnancy. If you’re thinking of using marijuana to help with morning sickness, talk to your provider about other treatments that are safer for your baby. 

Is there medical treatment for morning sickness?

Yes. If you can’t relieve morning sickness on your own or if you have severe nausea and vomiting of pregnancy, your provider may treat you with these medicines:

• Vitamin B6 and doxylamine. Your provider may treat you with these medicines separately or together. You can get vitamin B6 and doxylamine over-the-counter (OTC), which means you don’t need a prescription for them from your provider. Doxylamine is found in some OTC sleep aids (medicines that help you sleep). Or your provider may prescribe you a medicine that combines them.
• Antiemetic drugs. These are drugs that help prevent vomiting. If Vitamin B6 and doxylamine don’t work, your provider may prescribe an antiemetic drug for you. Not all are safe to use during pregnancy, so talk to your provider to make sure the medicine is a good choice for you.

Talk to your provider before you take any medicine during pregnancy, even medicine to help treat morning sickness.

When should you call your health care provider about morning sickness?

For most women, morning sickness is mild and goes away over time. But call your provider if:

• Your morning sickness continues into your 4th month of pregnancy.
• You lose more than 2 pounds.
• Your vomit is brown in color or has blood in it. If so, call your provider right away.
• You vomit more than 3 times a day and can’t keep food or fluids down.
• Your heart beats faster than usual.
• You’re tired or confused.
• You’re making much less urine than usual or no urine at all.

Last reviewed: September, 2020

Severe Morning Sickness (Hyperemesis Gravidarum) (for Parents)

What's Morning Sickness?

During the first trimester of pregnancy, many women have the bouts of nausea and vomiting known as morning sickness.

Despite its name, morning sickness can happen day or night. It usually starts around the 6th week of pregnancy, is at its worst around week 9, and stops by weeks 16 to 18. Although unpleasant, morning sickness is considered a normal part of a healthy pregnancy.

What’s Severe Morning Sickness?

Severe morning sickness is when nausea and vomiting get so serious that a pregnant woman vomits several times a day, loses weight, and gets dehydrated or is at risk for dehydration.

If this rare pregnancy-related condition isn’t treated, it can affect a woman's health and her baby's ability to thrive.

The medical term for severe morning sickness is "hyperemesis gravidarum" (hi-per-EM-eh-sis grav-ih-DARE-um), which means "excessive vomiting during pregnancy." It usually follows a similar timeline to normal morning sickness. But it can go longer, sometimes lasting for the whole pregnancy. Often, the symptoms get less severe as the pregnancy continues.

Most cases of hyperemesis gravidarum affect a woman's first pregnancy. But women who have it in one pregnancy are more likely to have it in future pregnancies.

What Causes Severe Morning Sickness?

The cause of severe morning sickness isn’t known. But it might be related to the hormone changes of pregnancy. A hormone called human chorionic gonadotropin, or HCG, might be to blame because severe morning sickness most often happens when HCG levels are at their highest in a pregnant woman's body.

Severe morning sickness also might run in families. It’s more common in women whose close family members (such as mothers and sisters) have had it.

Other things that can increase a woman's chances of having severe morning sickness include:

• carrying multiples (twins, triplets, etc.)
• history of motion sickness
• migraine headaches with nausea or vomiting

What Problems Can Happen?

The nausea and vomiting that happen in severe morning sickness are so extreme that they can harm the mother and the baby. Not being able to keep down food makes it hard for the mom to meet her nutritional needs. So she might lose weight. And a loss of fluids, combined with the loss of stomach acid from vomiting, can cause dehydration and electrolyte imbalances.

If severe morning sickness isn’t treated, it can cause many problems, including organ failure and the early birth of her baby.

When Should I Call the Doctor?

Call the doctor right away if you’re pregnant and have any of these symptoms:

• nausea that lasts throughout the day, making it impossible to eat or drink
• vomiting three to four times per day or not being to keep anything in the stomach
• brownish vomit or vomit with blood or streaks of blood in it
• weight loss
• fainting or dizziness
• peeing less than usual
• a fast heart rate
• a lot of headaches
• unpleasant, fruity mouth or body odor
• extreme tiredness
• confusion

How Is Severe Morning Sickness Treated?

Treatments used for morning sickness, such as eating dry crackers in the morning or a bland diet, may be recommended for women with extreme morning sickness. But these might not help with severe symptoms.

Medical treatment can include:

• a short period of not eating to rest the gastrointestinal system
• intravenous (IV) fluids
• vitamin and nutritional supplements

Some women might get medicine to stop the vomiting, either by mouth or through an IV. The doctor might recommend eating foods with ginger or taking vitamin B6 supplements to help ease nausea. It can also help to:

• Eat a bland diet.
• Eat frequent small meals.
• Drink plenty of liquids when not feeling nauseated.
• Avoid spicy and fatty foods.
• Eat high-protein snacks.
• Avoid sensory stimuli that can act as triggers (like specific smells or noises).

If a woman feels anxious or depressed about her condition, talking to a therapist or counselor might help her cope with her feelings.

What Else Should I Know?

With treatment, women with severe morning sickness can feel better and get the nourishment they need so they and their babies thrive. And lifestyle changes can help ease nausea and vomiting and make the pregnancy more enjoyable.

With time, symptoms usually do improve. And, of course, they stop by the time a woman's next journey starts: parenthood.

We fight against toxicosis - articles from the specialists of the clinic "Mother and Child"

Alexandrova Anna Evgenievna

Embryologist

Clinic "Mother and Child" South-West

rest more

Very often in the first trimester, the expectant mother feels weak, drowsy, she wants to lie down to rest, and sometimes she simply does not even have the strength to move. This, of course, is not toxicosis, but if such sensations arise, then they must be indulged so as not to inadvertently provoke another attack of nausea. Get plenty of rest and do not make any sudden movements, because even if you just fail to get up from a chair, you can provoke an attack of nausea.

Sleep with the windows open: the air in the bedroom should be fresh and cool. Go to bed on time, do not sit at midnight in front of the TV or at the computer, eliminate all irritating factors: an uncomfortable mattress, blanket, pillow, hard bedding - lack of sleep can respond with morning sickness.

eat right

Eat small meals, 5-6 times a day, or even more often. When you wake up, don't get out of bed right away. One of the most effective methods against toxicosis is breakfast in bed. In the evening, put crackers, yogurt, or any product that you can tolerate well next to your bed. Eat it before you get up, and then lie down for a while. Most likely, morning sickness will either not appear at all, or will be very weak.

Usually, in case of toxicosis, it is not recommended to eat fatty, smoked, salty, pickled, drink soda (the usual set of food hazards). But it is likely that some not very healthy product will now be well tolerated, and something from healthy food, on the contrary, will cause nausea. "Pregnant whims" - a cake with herring or pineapples at night - these are the requests of the body that it needs one or another component in food. For example, the desire to chew chalk is a sign of calcium deficiency. So eat what you like and what you want, within reason, of course. And if you don’t feel like something, even if this product is extremely useful and necessary, don’t eat it. If you feel sick from some dish, it means that the body signals you: I don’t need this now!

drink more often

Toxicosis may not be limited to nausea, some may also vomit. This means fluid is lost. Therefore, between meals, drink more often: a sip or two of mineral water or tea with lemon will help to cope with nausea and replenish lost fluids. But drink in small sips. Also, you should not drink food and you should give up soups for a while - a large amount of food drunk and eaten, on the contrary, only provokes nausea and vomiting.

breathe fresh air

Outdoor walks are good for everyone, but especially for toxicosis. Firstly, when walking, the blood of the expectant mother and baby is saturated with oxygen, which is very important for health, and secondly, walking calms the nervous system. Together, this helps to reduce the unpleasant symptoms of toxicosis. You need to walk at least two hours a day - but not just along the street, but in the place where the air is really fresh: in the forest, park, square, and best of all outside the city. Before you go out, think over the route: go away from gas-polluted highways, street cafes, food stalls and other "fragrant" places.

eliminate fragrances

Taste and smell preferences change during the first trimester. Now even your favorite perfumes can cause nausea, headaches and allergic reactions. Therefore, put away all fragrant cosmetics that irritate you: perfumes, deodorants, creams, and so on. You will have to stop using your favorite perfume for both your husband and loved ones. Explain to others that this is not a whim, but a temporary measure, very soon everything will return to normal.

And do not worry that now you will be left without your usual beauty products. Both the cosmetic store and the pharmacy are full of different creams, tonics, shampoos without fragrance or with a minimal smell.

work with yourself

Psychologists believe that the cause of toxicosis is not only in hormonal changes, but also in the psychological state of a woman. The more a woman experiences, the more anxieties and fears she has, the more pronounced toxicosis can be. Ideally, it is better to limit yourself during pregnancy from any stress. Of course, it’s not always possible to eliminate nervous work or crowding in public transport, but watch less TV, don’t read negative news and various pregnant “horror stories” on the Internet, and don’t react to minor or even major everyday troubles everyone can do. Therefore, if you are worried about toxicosis, create your own comfortable world during pregnancy. If you can’t cope on your own, contact a specialist (psychologist). Toxicosis is really well treated with psychotherapy. The main thing is that the expectant mother should want to get rid of her own anxiety.

No matter how unpleasant toxicosis is, it does not last forever. It is necessary to suffer until the beginning or (less often) the middle of the II trimester. And very soon all the unpleasant symptoms of toxicosis will remain in the past!

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What helps with nausea

Every second woman feels sick during pregnancy. An unpleasant symptom appears even before a woman finds out that she is in a position. We tell you why the malaise begins, how many months it lasts and how you can cope with unpleasant symptoms.

What is toxicosis?

Morning (and sometimes afternoon and evening) ailments, along with sore breasts and the absence of menstruation, are considered the main signs by which a woman understands that she is pregnant. But from what day of pregnancy does she start to feel sick? The period at which toxicosis begins varies.

Nearly a third of women experience nausea approximately 4 weeks after the end of their last period. In the remaining 70%, toxicosis occurs at week 8. At the same time, in addition to nausea, half of the women also experience vomiting. In the vast majority of pregnant women, all unpleasant symptoms disappear by the 14th week.

However, in the third trimester, nausea may return. Most often, nausea during pregnancy occurs after eating for a long time.

This is due to the fact that the growing uterus and the child in it begin to squeeze the stomach, which causes a feeling of overeating and nausea. But it also happens that this is a sign of preeclampsia, which must be treated.

Most often, morning sickness and vomiting occur. Unpleasant odors, being in a stuffy room, motion sickness in transport, as a reaction to a certain type of food, and other factors can also provoke an attack. However, discomfort can occur unexpectedly or in cases where everything was normal before.

Among the risk factors that lead to the development of toxicosis are migraines, overweight, endocrine disorders, bronchial asthma, depression, eating disorders, underweight, multiple pregnancy. However, these factors do not mean that a pregnant woman will definitely have toxicosis.

Nausea is not only an unpleasant symptom that overshadows the joy of future motherhood. It can lead to serious consequences. Among them are weight loss, insomnia, fluid and electrolyte imbalance, multiple organ failure, and spontaneous abortion.

Important! Be sure to tell the gynecologist in charge of the pregnancy if any meal causes vomiting, you have begun to significantly reduce body weight

Causes of toxicosis

Almost every woman is faced with the question of what causes nausea during pregnancy? Several factors play a role in the etiology of toxicosis. What exactly provokes its development in a particular woman is impossible. Among the main reasons are the following:

However, it is important to distinguish the symptoms of toxicosis from other diseases. Nausea and vomiting can also be a sign of other illnesses, such as kidney failure or peptic ulcers. Therefore, with severe toxicosis, it is imperative to undergo examinations to exclude other pathologies.

Usually, a general and biochemical blood test, a blood test for infections, ultrasound of the abdominal cavity and urinary system, as well as fibrogastroduodenoscopy and consultations with specialized specialists are prescribed. Treatment and examinations are carried out with care so that it does not harm the child.

Be sure to consult a gastroenterologist, endocrinologist and nephrologist if the symptoms of toxicosis persist after the 14th week of pregnancy so that this does not pose a danger to the baby. Our doctors will answer all your questions by phone at any time of the day.

What to do in order not to feel sick

You can prevent the development of nausea and toxicosis even during preparation for it. It is necessary to undergo examinations and treat all pathologies found. Particular attention should be paid to diseases that are a risk factor in the development of discomfort.

Another important point is adjusting the diet. In general, it is recommended to give up fried, fatty and spicy foods, as well as start eating often and in small portions. Food should be at room temperature. In addition, it is recommended to drink more.

Plain water and tea can be replaced with mineral water and herbal infusions of mint, lemon balm, chamomile, cranberry and ginger. However, you should not get carried away with herbs, as they may have an impact on the course of pregnancy.

If these methods do not help, the gynecologist may recommend taking antiemetics, vitamin preparations, isotonic solutions, and sedatives. Consultation with a psychologist is also recommended to exclude psychogenic factors.

In severe cases and with signs of exhaustion, the pregnant woman is placed in a hospital where more intensive therapy is carried out. If the woman's condition does not improve, termination of the pregnancy may be recommended as a last resort.

If toxicosis does not cause trouble, it is not treated in any way. They only offer to slightly adjust the diet and try folk methods of dealing with toxicosis. These include a few sips of mineral water, saltine crackers, or a lemon wedge right after waking up.

Case study:

The patient went to the gynecologist with complaints of severe nausea, persistent vomiting and weight loss. The gynecologist did not write off everything for pregnancy and conducted a full examination. FGDS with a biopsy revealed the presence of Helicobacter pylori and signs of gastritis in a woman. After treatment of the underlying disease, the symptoms of toxicosis also decreased.

FAQ

At what time can pregnancy be determined?

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A blood test for chorionic gonadotropin can show pregnancy as early as 6–8 days after conception. However, it is more reliable to carry it out 3-5 days after the delay or on the 12th day after conception.

How many days after conception does it start to vomit?

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Nausea can develop from 4 to 7 weeks after the last menstruation, that is, even before the delay appears. Symptoms of toxicosis usually disappear by 12-14 weeks. Also, unpleasant symptoms may return in the third trimester.

What to do if the chest stops hurting during pregnancy?

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If the chest stops hurting at any stage of pregnancy, this may indicate hormonal disorders in the expectant mother. It can lead to problems with gestation, so any changes in well-being must be reported to the gynecologist.

After how many weeks can you find out about pregnancy?

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The first signs of pregnancy appear at least 4 weeks after the end of the last menstruation, even before the delay. They will fail in the form of nausea, mood changes, tearfulness. In addition, in the early stages of pregnancy, the breast hurts and enlarges.

How to distinguish toxicosis from ordinary nausea?

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By external signs, it is almost impossible to distinguish them from each other. But there is a slight difference. Toxicosis usually manifests itself in the morning, and nausea - at any time of the day, including in the evening. If nausea is not complicated by vomiting, but does not go away within a few days, it is recommended to do a home pregnancy test or donate blood for hCG.

Expert opinion

Nausea in the later stages may indicate the development of preeclampsia. This complication affects all organs and leads to the development of severe multiple organ failure. In addition to nausea and vomiting, a pregnant woman is worried about swelling, severe headaches, rapid weight gain, high blood pressure and visual impairment.

Preeclampsia has the most serious consequences for both the mother and the unborn baby. Therefore, if late toxicosis is suspected, a woman is placed under the constant supervision of a doctor in the department of pregnancy pathology.

We publish only verified information

Article author

Menshikova Maria Viktorovna obstetrician-gynecologist

Experience 38 years

Consultations 1816

Articles 46

Specialist with extensive practical experience.

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