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Ultimate Morning Sickness Survival Guide

Are you pregnant? Are you experiencing waves of nausea, or are wondering when you can expect morning sickness to begin?

Nausea during pregnancy has garnered a reputation as the hallmark symptom of pregnancy, but it presents differently for every mother-to-be. While some women struggle to keep anything down through the day they deliver, others never experience a tinge of discomfort.

If you have questions about morning sickness or pregnancy nausea, you’ve come to the right place. Here’s everything you need to know about nausea during pregnancy — what it is, what causes it, how long you can expect it to last, and, perhaps most importantly, how to survive it.

WHAT IS NAUSEA DURING PREGNANCY?

Nausea during pregnancy is a feeling of queasiness commonly experienced by expectant mothers, particularly during early pregnancy. It is widely referred to as “morning sickness,” though that is a misnomer as the feeling can occur during any time of the day.

This nausea is experienced by up to 90 percent of pregnant women, though the length and severity of the discomfort may vary drastically (source).

THE CAUSES OF NAUSEA DURING PREGNANCY

Pregnancy nausea is directly linked to the pregnancy hormone hCG, though the exact relationship is unclear (source). Early in pregnancy, when morning sickness is typically at its worst, hCG levels rise rapidly to help grow and nourish the fertilized egg.

Around the 12th or 13th week, the placenta is developed enough to take over these tasks. At this point, hCG levels tend to drop a bit, and then remain stable for the duration of your pregnancy. This is also the time most women begin to feel their nausea subside.

Why Does This Happen

Besides the presence of hCG in the body, other things can cause nausea during pregnancy as well, including:

  • An increase in estrogen.
  • Stress hormones including cortisol.
  • Low levels of vitamin B6.
  • An aversion to a specific food.

Interestingly, studies show mother’s that experience nausea have a higher chance of a successful pregnancy (source).

WHAT DOES PREGNANCY NAUSEA FEEL LIKE?

How pregnancy nausea feels varies among women, and can even feel different to the same woman at different times of the day.

Pregnancy nausea or morning sickness can feel like:

  • A general, lingering sense of feeling like you need to vomit, but without the urgency to do so.
  • A sudden, urgent need to vomit.
  • A feeling that you’re hungry, but without the ability to stomach anything.
  • Dizziness or weakness.

Some women experience nausea during pregnancy and never actually vomit, while others vomit several times a day. The vomiting can sometimes provide a reprieve from nausea, until it returns.

Pregnancy nausea is often exacerbated by the intense fatigue that is also experienced during the first trimester.

Exhaustion and tiredness can even cause nausea in a person who isn’t pregnant. So, the fact that women in their first trimester have a double whammy of both exhaustion and nausea can make them compound one another.

WHEN DOES PREGNANCY NAUSEA OCCUR?

Pregnancy nausea is most likely to occur during the first trimester when hCG levels are highest and rising rapidly. It usually starts around the sixth week of pregnancy and subsides by the 16th (source).

You Won The Lottery

While the term “morning sickness” is commonly thrown around to describe nausea during pregnancy, it can occur at any time of day. However, for many women, the nausea is usually the worst during the morning hours because they are waking with an empty stomach.

Nausea tends to be exacerbated by hunger, so after fasting for several hours through the night, it becomes a morning battle to quell the queasies (source). And during this time, women may be caught in a catch-22 of not being able to keep things down, yet needing to fill their stomach to cure nausea.

The good news is that, for the majority of women, this pregnancy discomfort usually resolves by the second trimester. However, for about 10 percent of women, nausea persists throughout their entire pregnancy.

WHO IS LIKELY TO EXPERIENCE NAUSEA?

As many as 90 percent of women experience some level of pregnancy nausea, so your chances of encountering it are quite high. And while there aren’t specific risk factors to notify you in advance whether you’ll be one of those women, there is one group who experiences morning sickness more frequently than others — mamas carrying multiples.

This is theorized to occur because of the higher levels of hCG from carrying more than one baby. Since hCG appears to be the main cause of pregnancy nausea, it makes sense that having more of it coursing through your body could put you at greater risk of morning sickness.

But what about previous bouts of pregnancy nausea? If you’ve had it in one pregnancy, are you guaranteed to have it in subsequent pregnancies?

If You’ve Had It Before, You Might Dodge It Next Time

The only exception to this is for women who experience Hyperemesis Gravidarum (HG), which is a severe form of pregnancy sickness that occurs in about one percent of pregnancies. Unfortunately, if you’ve had HG during one pregnancy, you’re likely to have it in subsequent ones — Kate Middleton, the Duchess of Cambridge, has suffered from the condition in all three of her pregnancies (source).

No matter how nauseous you are, remember what food you do take in the nutrients will get to the baby! Try your best to stay hydrated as best you can.

WHAT ARE FOOD AVERSIONS?

Food aversions during pregnancy are waves of nausea that are caused by eating, smelling, being around, or even just thinking about a specific food. While typical pregnancy sickness has no specific trigger, nausea due to food aversions can be avoided once you identify exactly what the trigger is.

It’s unclear exactly what causes food aversions, but it’s likely related to the good ol’ hCG that causes regular pregnancy nausea. There may also be a psychological component, where you experienced severe nausea or vomiting after eating a particular food and then can’t stomach the idea of being around it again.

A heightened sense of smell during pregnancy possibly may cause these aversions, a sensory overload you’re not used to (source).

Then again, it may have no known cause — because it’s also entirely possible to crave the exact food you hated later in your pregnancy.

Some food aversions last throughout the entire pregnancy, while others may come and go.

Some of the most common food aversions are:

  • Meat — raw or cooked.
  • Coffee.
  • Milk.
  • Onions.
  • Foods with strong scents or flavors, like vinegar-based foods or citrus fruits.

SHOULD I BE CONCERNED ABOUT PREGNANCY NAUSEA?

Nausea and vomiting are rarely a cause for concern during pregnancy as they’re considered common — though unfortunate — occurrences, but there are a couple of instances in which you may want to seek medical attention.

Dehydration

If you are unable to keep down any food or water, you risk dehydration, the loss of electrolytes, as well as reduced nutrients to nourish both you and your baby. In severe cases, women need to be hospitalized to rehydrate.

Dehydration has the potential to cause congenital disabilities and premature labor, so it’s essential to keep yourself nourished and hydrated — and if you can’t, contact your doctor for medical treatment to keep you and your baby as healthy as possible. Aim for two extra glasses of water a day.

Sudden-Onset Late In Pregnancy

If you experience sudden nausea or vomiting that develops toward the end of your pregnancy, check in with your doctor immediately.

This can be a symptom of severe preeclampsia, which can be life-threatening for both you and your baby. It is diagnosed by screening your urine for the presence of protein, and by taking your blood pressure. Another symptom of severe preeclampsia is an unrelenting headache.

If you are concerned about your blood pressure but don’t have a blood pressure monitor at home, most retail pharmacies have staff that will check it for free, or machines set up in their waiting area for customers to use. This isn’t a replacement for your regular doctor, but can be used in a pinch if you are concerned and want to check your blood pressure on a whim.

While many women worry about pregnancy-related nausea, it can often be considered a good sign. Since rising hCG levels are linked to a healthy pregnancy, having nausea because of high hCG levels can indicate your pregnancy is going as expected.

WHAT IS HYPEREMESIS GRAVIDARUM?

Hyperemesis Gravidarum (HG) is a serious condition that develops in approximately one percent of pregnant women (source).

While commonly described as “severe morning sickness,” that terminology fails to describe the reality of the situation. HG is often debilitating and can threaten the life of both the mother and baby.

HG is different from traditional pregnancy nausea in that:

  • The nausea is constant and severe.
  • You cannot eat or drink anything without vomiting.
  • You feel an excess of saliva in your mouth.
  • You lose more than 5 percent of your pre-pregnancy body weight.
  • You cannot function in your regular life.

This condition is also accompanied by side effects, including:

  • Depression.
  • Dehydration.
  • Lower birth rate for baby.

Aside from the physical symptoms, HG can make it nearly impossible to do regular activities such as going to work, caring for yourself, or taking care of your family. This can contribute to depression, feelings of failure, and isolation.

For most women experiencing HG, the symptoms subside by the 20th week of pregnancy. However, for some women, it will last until they deliver.

In some cases, women need to be hospitalized to ensure they remain properly hydrated and nourished since they can’t keep anything down when eating.

HG moms are warriors, pregnancy is already a sacrifice of yourself and having to push through an unrelenting sickness like HG is extremely difficult. There are resources to support you, such as hyperemesis.org. Your care provider can assist you with more.

HOW TO TREAT NAUSEA DURING PREGNANCY

There are many ways to treat nausea during pregnancy, but what works for one woman doesn’t necessarily work for all. Here are some things to try to relieve your nausea:

1. Get Plenty Of Rest

Exhaustion, tiredness, and fatigue are all hallmarks of early pregnancy, but they can also make your nausea worse. Rest as much as you can, and take it easy on yourself.

Growing a human is hard work, so try to lay aside your personal expectations of productivity and give in to your need to rest and care of yourself.

2. Eat What You Can

I know you want to eat a healthy diet, but if your nausea and food aversions are making that impossible, just give in to them and eat what you can stomach. Try for small high protein foods, like a cheese-stick or nuts/seeds.

Your baby is receiving nutrients from your pre-pregnancy reserves, and once you feel better you can re-balance your eating habits. For the immediate time, though, fed is best.

3. Eat Regularly

Nausea is most likely to occur on an empty stomach, so to combat it try to keep food in your stomach and your blood sugar stable throughout the day. Do this by eating small meals at regular intervals.

Try not to skip meals, and remember to eat before you feel hunger since hunger can trigger nausea.

When choosing foods, choose ones high in protein and fiber to keep you feeling full longer and to stave off that empty feeling in your stomach. Have a protein-rich snack before bed and see if it helps prevent nausea you experience immediately upon waking. Or eating a couple crackers before getting out of bed in the morning can really help morning sickness, so a simple trick is keeping crackers in your nightstand ready for your morning wake up.

4. Keep A Stash Of Emergency Snacks

No matter how meticulously you plan your meals, you may still experience nausea due to an unexpectedly empty stomach or drop in blood sugar. Keep a stash of snacks with simple carbs that will hit your blood sugar quickly to help manage these waves of nausea.

Good examples include crackers, juice, or a granola bar. These could also be good snacks to keep in your nightstand if you feel nausea in the morning.

5. Eat Cold Foods

For some reason, cold foods tend to be more palatable than hot or cooked foods during pregnancy. If you can’t seem to find anything that you can keep down, see if there are foods in your fridge or freezer that might help settle your stomach. Hello, ice cream!

6. Try Ginger

Ginger has been used for centuries to help settle upset stomachs and treat nausea. These days there are lots of different ways to enjoy it including sodas, teas, and candies. See which one you can stomach the best and use it to help tame your tummy.

7. Suck On Pregnancy Pops

Pregnancy Pops Drops are candy designed specifically for the pregnant woman. With flavors like sour lemon or ginger and infused with vitamin B6, they are typically palatable for even the most nauseated woman and help raise your blood sugar to relieve your nausea quickly.

8. Eat Mint

Not only can mint help freshen your breath after vomiting, but it can even help with your nausea battle. Mint tends to have a cooling effect, and the freshness often helps with the sick feeling.

So carry around some lozenges or a pack of gum, and pop one in your mouth whenever the nausea hits.

9. Exercise

I know exercise is probably the last thing you want to do when you’re feeling ill, but it can actually help you combat morning sickness. The good news is that your workout doesn’t have to be crazy. Just a 20-minute walk might even do the trick.

10. Try Hypnosis

Severe pregnancy nausea can result in high levels of anxiety around food and lots of food aversions, which can compound your difficulty with eating.

Hypnosis has been used to help free the mind of these aversions and address eating anxiety, allowing you to relax and eat the foods you need to nourish your body. If you do this, you’ll be in good company — Kate Middleton used hypnotherapy to help treat her Hyperemesis Gravidarum.

11. Take Vitamin B6

A vitamin B6 deficiency may be the cause of some women’s nausea, so it makes sense that a supplement could help ease it. The typical treatment dose is 10-25 milligrams three times a day (source).

But before you start a regimen on your own, talk with your doctor to get their exact dosage recommendation. While vitamin B6 is widely considered safe to take during pregnancy, it’s always a good idea to check with your doctor before taking any new supplements.

12. Take Medication

I understand many women are hesitant to take medications during pregnancy, especially when they’re concerned about the effects the meds may have on the baby. However, for many women, this becomes necessary in order to just perform the basic functions of everyday life.

The good news is there are lots of options — both over-the-counter and prescription. Talk with your doctor about the options available to you, and together you can work to find one to get your life back.

WHAT MEDICATIONS CAN HELP WITH PREGNANCY NAUSEA?

If you’re considering taking medication for your pregnancy nausea, always talk to your doctor first to discuss the risks and benefits of each option. Here are some of the medications you may discuss:

Diclegis

This prescription medication was previously marketed under the name Bendectin but then was pulled from the market. Its formula was re-worked to ensure the safety of both mother and baby, and currently is the only prescription medication available that is FDA-approved to treat pregnancy nausea (source).

One of the major drawbacks of this medication is it can be costly if you don’t have good drug coverage on your insurance, and there is currently no generic version.

Zofran (Ondansetron)

Zofran is a drug that was developed to treat severe nausea in patients undergoing cancer treatment (source). Because of its effectiveness, many doctors have prescribed it for pregnancy nausea as well.

It went out of vogue for awhile due to fears about birth defects but has recently made a comeback following a study that indicated there was no cause for concern. The brand name drug can be pricey, but the active ingredient (ondansetron) is available in generic form at considerable cost savings.

Vistaril (Hydroxizine)

Though it seems silly, antihistamines can be used to treat nausea because they affect the vestibular system and therefore the vomiting reflex (source). For this reason, Vistaril is sometimes prescribed to help ease morning sickness even though it was initially developed to treat anxiety.

There is also a generic form called Hydroxizine, which can help make this option affordable.

Over-The-Counter Antihistamines

Because antihistamines can help with nausea, your doctor may recommend you try over-the-counter versions like Benadryl or Unisom. However, they can also cause drowsiness — Unisom in particular, as it’s specifically marketed as a sleep aid.

Before opting to take any over-the-counter option, speak with your doctor about its use over the long haul. These options may be better for intermittent nausea.

Unisom was actually developed to help women with morning sickness, but because of the drowsy effect, it was remarked as a sleep drug. Pairing Unisom with B6 supplements is a new way to combat morning sickness, ask your provider if this is an option for you.

Acid Reflux Medications

Frequent vomiting can cause damage to your esophagus and teeth, and also make you feel horrible all around. Acid reflux medications can reduce the acidity in your stomach, helping to keep you from vomiting, but also helping to prevent damage if you do.

There are many acid reflux medications, both over-the-counter and prescription medications. Most over-the-counter antacids like TUMS, Rolaids, and Maalox are safe to take in pregnancy but avoid Alka Seltzer, which contains aspirin. Your doctor may prescribe one of two types of medications, such as Histamine-2 blockers and proton pump inhibitors, which have been found to be safe in pregnancy as well.

Motion Sickness Remedies

There are lots of over-the-counter medications to help with motion sickness, including pills like Dramamine along with medicated patches that are placed on the skin. These are generally considered safe for pregnancy and may help with your nausea, but you should still check with your doctor before taking them.

Non-medicated motion sickness treatments include wearable wristbands that may help to relieve your feelings of sickness.

THE BOTTOM LINE

Few people would disagree that nausea is one of the worst parts of pregnancy, as it can keep you from enjoying this special time and severely limit your ability to participate in everyday life. Thankfully, for most women, it’s short-lived and eases by the second trimester.

Source: Nausea During Pregnancy: Ultimate Morning Sickness Survival Guide from Mom Loves Best

Appetite changes and food aversions during pregnancy

Appetite changes and food aversions during pregnancy | Pregnancy Birth and Baby beginning of content

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Key facts

  • Appetite changes are very common during pregnancy and may affect weight changes.
  • A food aversion is an intense dislike of a specific food, together with unpleasant physical symptoms when you see or smell a particular food.
  • Eating for 2 during pregnancy is a myth. It is the quality not quantity of food that matters.
  • When you are pregnant, your body needs certain vitamins, minerals and nutrients, including iron, folate and iodine.
  • If your nausea prevents you from getting enough nutrition, or if you are vomiting, not able to keep food or fluids down or losing weight, see your doctor or maternal health nurse.

What are food aversions, and why does appetite change during pregnancy?

A food aversion is an intense dislike of a specific food, together with unpleasant physical symptoms when you see or smell a particular food. These reactions are usually triggered by emotions associated with food rather than the food itself. You might also experience food cravings (an intense urge to eat a specific food). While these appetite changes are quite common, they can make healthy eating during pregnancy a challenge.

Is it normal for my appetite to change during pregnancy?

It is normal to experience either a loss of appetite or a change in food preferences during pregnancy. This may play a part in how much your weight changes during pregnancy.

Food aversions are common, and around 6 in 10 people experience a food aversion while pregnant.

When are food aversions likely to start and end?

You can experience food aversions resulting from generalised nausea (also known as 'morning sickness') at any time of day, and it tends to peak between week 6 and week 14 of pregnancy.

For this reason, if you've gone off certain foods that are important for your diet, you can try again later in your pregnancy to see if the aversion has passed. If your nausea prevents you from getting enough nutrition, or you are vomiting, not able to keep food or fluids down or losing weight, it's time to see your doctor.

What food aversions are common?

Common food aversions include:

  • alcohol
  • coffee / tea
  • meat
  • fatty food
  • spicy food
  • eggs

What causes food aversions?

While the cause of food aversions during pregnancy isn't clear, hormonal changes could affect the food you enjoy, particularly early in your pregnancy. For example, human gonadotropin (also known as hCG) is a hormone produced during pregnancy. It can cause feelings of nausea, appetite changes and food aversion. Pregnancy can also cause a greater sensitivity to smell and taste, which can influence the foods you prefer to eat.

More research is needed to better understand why food cravings and aversions occur. Some reasons may include hormonal balance or protecting the unborn baby from harmful substances and/or nutritional deficiencies. This is to encourage good nutrition and growth in the pregnancy.

How can I eat well and have a healthy diet?

A healthy diet is important for both you and your baby. Eating for 2 during pregnancy is a myth. It is the quality not quantity of food that matters, and there is no need to eat twice as much. It is the quality not the quantity of food that matters most. Your diet should include a variety of the five food groups:

  • vegetables and legumes
  • breads and cereals
  • milk, yoghurt and cheese
  • meat, poultry, fish and alternatives
  • fruit

During pregnancy, your body also needs plenty of water (8 to 10 glasses each day). You will also need extra vitamins, minerals, and nutrients to help your baby develop, including these:

  • Folate (Folic acid) helps build your baby’s brain cells and prevents risk of the baby being born with a birth defect of the brain and/or spinal cord. This is especially important in the early stages of pregnancy. Folate-rich foods include green leafy vegetables, broccoli, legumes, oranges, avocado, or fortified breads and cereals.

  • Iodine is also important for your baby’s growth and development. Choose foods that are sources of iodine, such as low-fat milk products, eggs, cooked fish and seafood. Foods that contain seaweed, such as sushi, are also a good source of iodine, but if you’re pregnant only eat sushi without raw fish, cold meat or egg, and that is freshly prepared. If you add salt to your food or in cooking, choose iodised salt. If you have a thyroid condition, seek advice from your doctor before taking an iodine supplement.

  • Iron-rich foods are recommended during pregnancy. These include red meat, poultry, tofu, and iron-fortified cereals. Eating foods high in vitamin C such as oranges, kiwi fruit, capsicum and broccoli can help iron absorption. Do not take an iron supplement during pregnancy without first checking with your doctor. Too much iron can pose health risks to you and your baby. A blood test will help your doctor know if you need to take iron tablets.

If you develop an aversion to meat or another essential food, consider how you might substitute these for alternatives. For example, substitute meat for nuts.

It is also important to limit foods containing:

  • saturated fats (biscuits, cakes, pies, butter and cream)
  • added salt (processed meats, pickled fish, fast foods)
  • added sugars (confectionary, sugar sweetened soft drinks, fruit juice and cordial)

Alcohol is not safe for developing babies, and not drinking alcohol is the safest option while you’re pregnant.

There are also certain foods you should avoid during pregnancy, so ask your doctor or maternal health nurse for more information.

Appetite changes during pregnancy are unlikely to harm you or your baby or significantly compromise your nutrition. If you are not sure which foods are most important for your diet, or you have no appetite for foods containing important nutrients, seek advice.

More information on changes in appetite

For more advice on food aversions or appetite loss in pregnancy speak to your:

  • doctor
  • midwife
  • obstetrician
  • accredited practising dietitian

Sources:
Epworth Hospital (Ask an Epworth midwife Your guide to early pregnancy), Royal Women Hospital Melbourne (Common concerns in early pregnancy), Queensland Health (During pregnancy), ACT Government (Good Nutrition in pregnancy), Australasian Society of Clinical Immunology and Allergy (Food Intolerance), University of Queensland (What the health: Why do women crave certain foods when they are pregnant), Australian Government (Healthy eating during your pregnancy), Science and Education Publishing (Psychological Factors in Food Aversions, Nausea, and Vomiting During Pregnancy), National Health and Medical Research Council (Australian guidelines to reduce health risks from drinking alcohol)

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: July 2022


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  • Food cravings during pregnancy
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