Pregnancy vomiting starts

Morning Sickness: Nausea and Vomiting of Pregnancy

• Nausea and vomiting of pregnancy is a common condition. It can occur any time during the day, even though it’s often called “morning sickness.” Nausea and vomiting of pregnancy usually doesn’t harm the fetus, but it can affect your life, including your ability to work or go about your normal everyday activities. There are safe treatment options that can make you feel better and keep your symptoms from getting worse.

• Nausea and vomiting of pregnancy usually starts before 9 weeks of pregnancy. For most women, it goes away by 14 weeks of pregnancy. For some women, it lasts for several weeks or months. For a few women, it lasts throughout the pregnancy.

• Some women feel nauseated for a short time each day and might vomit once or twice. In more severe cases, nausea lasts several hours each day and vomiting occurs more frequently.

• You should talk with your obstetrician-gynecologist (ob-gyn) or other obstetric care provider if nausea and vomiting of pregnancy affects your life and causes you concern.

• Hyperemesis gravidarum is the term for the most severe form of nausea and vomiting of pregnancy. Hyperemesis gravidarum occurs in up to 3 percent of pregnancies.

• This condition may be diagnosed when a woman has lost 5 percent of her prepregnancy weight and has other problems related to dehydration, or loss of body fluids (see below). Women with hyperemesis gravidarum need treatment, sometimes in a hospital, to stop the vomiting and restore body fluids.

• Nausea and vomiting can cause you to lose fluids. If fluids are not replaced, it can lead to dehydration. You should call your ob-gyn or other obstetric care provider if you have the following signs and symptoms of dehydration:

  • You have a small amount of urine that is dark in color.

  • You are unable to urinate.

  • You cannot keep down liquids.

  • You are dizzy or faint when standing up.

  • You have a racing or pounding heartbeat.

• Any of the following can increase the risk of severe nausea and vomiting of pregnancy:

  • Being pregnant with more than one fetus (multiple pregnancy)

  • A previous pregnancy with either mild or severe nausea and vomiting

  • Your mother or sister had severe nausea and vomiting of pregnancy

  • A history of motion sickness or migraines

  • Being pregnant with a female fetus

• Yes, some medical conditions can cause nausea and vomiting during pregnancy. These conditions include:

  Your ob-gyn or other obstetric care provider might suspect that you have one of these conditions if you have signs or symptoms that usually do not occur with nausea and vomiting of pregnancy. Some of these signs and symptoms include:

  • Nausea and vomiting that occurs for the first time after 9 weeks of pregnancy

  • Abdominal pain or tenderness

  • Fever

  • Headache

  • Enlarged thyroid gland (swelling in the front of the neck)

• This condition usually does not harm your health or your fetus’s health. It also does not mean that your fetus is sick.

• Nausea and vomiting can become more of a problem if you cannot keep down food or fluids and begin to lose weight. When this happens, it sometimes can affect the fetus’s weight at birth.

• Weight loss can lead to problems with your thyroid, liver, and fluid balance. Because hyperemesis gravidarum is difficult to treat and can cause health problems, experts recommend early treatment so that it does not become severe.

• Changes to your diet and lifestyle might help you feel better. These change can include:

• Yes, take a prenatal vitamin. Studies show that taking a vitamin supplement before and during pregnancy reduces the risk of having severe nausea and vomiting of pregnancy.

• • Eat dry toast or crackers in the morning before you get out of bed to avoid moving around on an empty stomach.

  • Eat five or six “mini meals” a day to ensure that your stomach is never empty.

  • Eat frequent bites of foods like nuts, fruits, or crackers.

• Try bland foods. The BRATT diet (bananas, rice, applesauce, toast, and tea) is low in fat and easy to digest. If these foods don’t appeal to you, try others. The goal is to find foods that you can eat and that stay down.

• Yes, try adding protein to each meal. Good nonmeat sources of protein include:

  • Dairy foods, such as milk, ice cream, and yogurt

  • Nuts and seeds, including butters like almond butter and peanut butter

  • Protein powders and shakes

• Ginger can help settle your stomach. You can try:

• Yes, your body needs more water during pregnancy. Drink throughout the day, not just when you are thirsty. Aim for 8 to 12 cups of water a day during pregnancy.

  Not drinking fluids can lead to dehydration, which can make nausea worse. If a bad taste in your mouth makes it hard to drink water, chew gum or eat hard candy.

• Foods or odors that might never have bothered you before might now trigger nausea. Do your best to stay away from them. Use a fan when cooking. Have someone else empty the trash.

• Frequent vomiting can cause some of your tooth enamel to wear away, due to the acid in your stomach. Rinse your mouth with a teaspoon of baking soda dissolved in a cup of water to help neutralize the acid and protect your teeth.

• If diet and lifestyle changes don’t help, or if you have severe nausea and vomiting of pregnancy, you might need medical treatment. Your ob-gyn or other obstetric care provider will first want to know whether your symptoms are due to nausea and vomiting of pregnancy or another medical cause. If other causes are ruled out, you may be able to take certain medications:

  • Vitamin B6 is a safe, over-the-counter treatment that may be tried first for nausea and vomiting of pregnancy.

  • Doxylamine, a medication found in over-the-counter sleep aids, can be added if vitamin B6 alone does not relieve symptoms.

  • A prescription drug that combines vitamin B6 and doxylamine is available. Both drugs, taken alone or together, have been found to be safe to take during pregnancy and have no harmful effects on the fetus.

• “Antiemetic” drugs, which prevent vomiting, may be prescribed for women who aren’t helped by other medications.

• Many antiemetic drugs have been shown to be safe to use during pregnancy. But others have conflicting or limited safety information. For example, a drug called ondansetron is highly effective in preventing nausea and vomiting, but studies are not clear about its safety for the fetus. Ondansetron also has been linked to heart-rhythm problems in people taking the drug, especially in those who have certain underlying conditions.

• The decision to use ondansetron and other drugs during pregnancy is based on whether the benefits of these drugs outweigh their potential risks. You and your ob-gyn or other obstetric care provider can discuss all of these factors to determine the best treatment for you.

• If your nausea and vomiting are severe or if you have hyperemesis gravidarum, you might need to stay in the hospital until your symptoms are under control.

• • Lab tests may be done to check how your liver is working.

  • If you are dehydrated, you may receive fluids and vitamins through an intravenous (IV) line.

  • If your vomiting cannot be controlled, you might need additional medication.

  • If you continue to lose weight, a feeding tube may be recommended to ensure that you and your fetus are getting enough nutrients.

• Dehydration: A condition that happens when the body does not have as much water as it needs.

  Fetus: The stage of human development beyond 8 completed weeks after fertilization.

  Hyperemesis Gravidarum: Severe nausea and vomiting during pregnancy that can lead to loss of weight and body fluids.

  Intravenous (IV) Line: A tube inserted into a vein and used to deliver medication or fluids.

  Multiple Pregnancy: A pregnancy where there are 2 or more fetuses.

  Nausea and Vomiting of Pregnancy: A condition that occurs in early pregnancy, usually starting before 9 weeks of pregnancy.

  Nutrients: Nourishing substances found in food, such as vitamins and minerals.

  Obstetric Care Provider: A health care professional who cares for a woman during pregnancy, labor, and delivery. These professionals include obstetrician–gynecologists (ob-gyns), certified nurse–midwives (CNMs), maternal–fetal medicine specialists (MFMs), and family practice doctors with experience in maternal care.

  Obstetrician–Gynecologist (Ob-Gyn): A doctor with special training and education in women’s health.

  Thyroid Gland: A butterfly-shaped gland located at the base of the neck in front of the windpipe. This gland makes, stores, and releases thyroid hormone, which controls the body’s metabolism and regulates how parts of the body work.

Don't have an ob-gyn? Search for doctors near you.

FAQ126

Published: May 2020

Last reviewed: December 2021

Topics:

Pregnancy Pregnancy Discomforts and Other Concerns

Copyright 2022 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.

This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.

When does morning sickness start?

Nausea is a well-known symptom of pregnancy, affecting at least 70% of expecting mothers. Also called morning sickness, nausea usually begins at around six weeks, peaks between weeks 8-11, and typically fades near the end of the first trimester. However, some women experience nausea as both a second trimester and third trimester symptom.

The early weeks of pregnancy can be an exciting and confusing time. You’re beginning a journey that involves many physical and emotional changes,, and you don’t always know how you’ll feel from one day to the next. But we’re here to help you understand the changes you’re going through, and morning sickness can be one of the most noticeable.

Below, we cover what to expect and what you can do to find some relief from this common pregnancy symptom.

What is morning sickness and what are the symptoms?

Morning sickness is a feeling of nausea, sometimes also accompanied by vomiting. It can be one of the earliest signs of pregnancy for many women, appearing a couple weeks after a positive pregnancy test.

Despite being called morning sickness, nausea in pregnancy can happen at any time of day. Women often feel the most nauseous on an empty stomach, which is most apparent when you wake up after not eating all night, hence how it got its name.

Symptoms of morning sickness frequently occur on their own, but can also be triggered by certain foods, smells, heat, stress and other factors. The feeling can range from slight queasiness, like being a little carsick, to more intense nausea and vomiting.

Can you be pregnant and not have morning sickness?

Morning sickness is made out to be very common in movies and television, and it is. But it’s also possible to be pregnant without experiencing it. Three out of 10 pregnant women don’t experience morning sickness, so it’s not rare or concerning if that’s the case.

The same goes for aversions to certain foods or smells. Every pregnancy is unique, so not every pregnant woman will experience the same symptoms. If you think you could be pregnant but aren’t experiencing morning sickness or other symptoms, taking a pregnancy test is the only way to find out for sure.

What causes morning sickness?

While the exact cause isn't well understood, many doctors believe morning sickness happens because of hormones. The pregnancy hormone human chorionic gonadotropin (hCG) reaches its highest level around the same time morning sickness is most severe. And, increases in the hormones estrogen and progesterone can make it harder for your body to digest food, adding to stomach discomfort.

When does morning sickness start?

If you’re one of the many pregnant women who experience morning sickness, you may start feeling nauseous somewhere around the sixth week of your pregnancy, typically two weeks after your first missed period. Symptoms may appear gradually or seem to happen overnight.

Is it normal to be nauseous all day when pregnant?

Don’t be fooled by the name. Morning sickness doesn’t only happen in the morning, and it’s very normal for it to last all day. No two women experience it in the same way. Also, some women who had morning sickness in their first pregnancy may not have any nausea at all in their second, and vice-versa.

When does morning sickness end?

Morning nausea usually peaks between weeks 8-11, and typically fades by the end of the first trimester. However, some women can experience nausea in their second trimester, and some even notice nausea near the end of pregnancy.

If your morning sickness lasts beyond your first trimester, you may be more sensitive to the effects of hormonal changes during pregnancy. Or you may just have a more delicate stomach. But it’s a good idea to bring up your morning sickness with your doctor or midwife to learn about your options for relief.

Hyperemesis gravidarum (HG)

If you’re throwing up more than two to three times a day and aren’t able to keep anything down, you may have hyperemesis gravidarum (HG), a form of severe morning sickness. Some cases can be treated with pressure-point wristbands, like those worn to prevent motion sickness. In other cases, you might need medication, bed rest or intravenous (IV) fluids to help reduce or eliminate symptoms.

Many women tolerate morning sickness because they know that nausea in pregnancy is very common, however they may not realize that severe vomiting is not as normal and requires attention. That’s why it’s important to know the signs of HG. Talk to your care provider right away if you are vomiting so much that you:

• Become persistently dehydrated
• Can’t keep any foods or liquids down for 24 hours
• Feel weak, dizzy or faint and/or lightheaded
• Lose three or more pounds in a week

It’s important to know what’s normal and what’s not. If you have any concerns about your morning sickness, our experienced team of OB-GYNs and midwives can help you get personalized care that’s right for you.

Is morning sickness bad for the baby?

It’s natural to wonder about whether your nausea and loss of appetite could be harmful to your baby. But rest assured, if you’re still able to eat and stay hydrated, your baby will still get all their needed nutrients. In rare and severe cases of morning sickness, your doctor or midwife will work to ensure that you and baby are getting the necessary nutrition and hydration to stay healthy.

What can I do to find relief from pregnancy nausea?

You don’t have to tough it out and wait for the day your morning sickness subsides. There are plenty of simple, safe and effective strategies you can try to combat nausea.

Eat smaller meals throughout the day

Having an empty stomach for too long can make anyone feel sick. Eating small snacks throughout the day in between larger meals can keep you from feeling queasy. But remember, eating too much can make you feel just as nauseous. It’s all about finding a balance that will keep you feeling good.

Avoid trigger foods

Some food and drinks are difficult to digest and may make you feel sicker. Try to stay away from caffeine, acidic foods such as tomatoes, and greasy or spicy foods.

Iron supplements can also contribute to nausea and constipation, so talk to your doctor or midwife if you’re taking one.

Try the B.R.A.T. diet

If you can’t seem to find anything that agrees with you, try these foods that are bland and easy to digest: bananas, rice, applesauce and toast.

Stay hydrated

Drink a lot of fluids. In addition to water, sports hydration drinks, broth and juice can help replace nutrients that you may lose from vomiting.

Consume ginger

Eating and drinking foods with ginger can help calm the feelings of nausea. Easy options include ginger ale, ginger hard candy, ginger lollipops or ginger tea.

Take a vitamin B6 supplement

Though it may already be present in your prenatal vitamin, taking additional vitamin B6 has shown to be effective in reducing nausea during pregnancy. You can take up 25 to 50 mg of vitamin B6 per day, but it’s best to talk to your care provider before taking additional supplements.

Wear a wristband

As mentioned above, there are a variety of wristbands available over the counter that are designed to prevent motion sickness. They work by applying pressure to specific pressure points that can help ease nausea.

Experiment with different temperatures

You may have an easier time eating or drinking cold foods and beverages, or your stomach may feel calmer after a hot meal. Room temperature or warm food and drinks can sometimes cause nausea.

Keep a morning sickness record

What time of day does nausea strike? What are you doing when it does? By tracking your symptoms, you just might identify triggers that make you queasy – like certain foods or smells – so you can avoid them going forward.

Pack the essentials

If morning sickness does end up causing you to vomit, you can make it easier by carrying a few supplies with you. Feeling prepared by bringing a toothbrush and toothpaste, mouthwash, a backup shirt and even a plastic bag can give you peace of mind and make morning sickness feel more manageable.

Ask your doctor or midwife about finding relief from pregnancy nausea

These remedies may not work for everyone, and there are other solutions for more persistent symptoms. Talk to your care provider about anti-nausea medications that are safe to take while pregnant.

While morning sickness can be a challenging part of any pregnancy, it’s also a sign that your body is doing what it needs to support your growing baby. That said, you shouldn’t have to suffer through pregnancy nausea that interferes with your daily life and your ability to be present at work or with family.

Fortunately, there’s help available to make your pregnancy a bit smoother and more comfortable. If you’d like to explore your options for improving symptoms of pregnancy nausea, our women's health experts are here to help.

When early toxicosis begins and how to deal with it during pregnancy

Early toxicosis of pregnancy is a condition that causes a lot of suffering to a woman. Some feel "trick" even before the delay, while for others it all starts from 5-6 weeks. Obstetrician-gynecologist Galina Vladimirovna Ovsyannikova talks about the causes of toxicosis and ways to alleviate it.

Symptoms of toxicosis

Eating habits change drastically, hypersensitivity to odors, nausea, irritability appear, constantly wanting to sleep. nine0007 Rarely appear uncontrollable salivation, subfebrile temperature, vomiting.

Usually this condition takes a woman by surprise. After all, she needs to continue working, taking care of her family, she has a lot of things planned. With this, she goes to the doctor, already pretty tired and with a sad look. And we're starting to figure it out.

First of all not everyone suffers from toxicosis. Some simply eat everything and do not gain weight, or even lose weight, and this manifests their toxicosis. These women are lucky. Although they also manage to worry about this, as they have heard enough "as it should be" from their friends. nine0003

Secondly, the severity of toxicosis depends on the state of the nervous system, lifestyle and "similarity" of the baby to his mother in terms of protein composition.

And more about that.

Toxicosis: why and for what?

• Nervous system. It has been noticed that toxicosis is most pronounced in anxious women, leaders, doctors, teachers, that is, people with increased nervous stress. And, by the way, note that animals do not have such toxicosis as humans do. They do not take on "the entire world responsibility" and therefore they do not feel sick or vomit. At most, females sleep a lot and retire to save energy. nine0025
• Lifestyle. If a woman enters pregnancy not in a resource state, tired, exhausted, slagged from poor nutrition and lack of water, and even after some kind of illness, poisoning, herpetic manifestation, SARS, then the body will try to "put the woman to bed" in order to sleep, rest, gain strength, eat different foods to replenish supplies. Everything is logical. This is a smart move in the fight for survival.
• Any person has a unique genetic code, which is laid already at the moment of fertilization. And how different it will be from the mother's code, toxicosis will be so pronounced. To make it clearer, there are people who are so similar in this code, protein composition, that their organs can be transplanted to each other and they will take root. And others, on the contrary, are not at all similar, and if, for example, a kidney is transplanted from such a person, then it will be rejected. Also here. If a child has inherited a similar genetic code, then intoxication from getting his protein into the mother's blood will be less. And vice versa. As pregnancy progresses and the placenta forms between the body of the mother and child, a placental barrier is formed. And toxicosis decreases: therefore, in most women, it disappears by the 12th week. nine0025

How to survive?

There are no common recipes for all: we are all different and each has its own reason for toxicosis. But still there are rules that help most women:

• Get more rest and sleep. Sleep whenever possible and the body asks. A woman with severe toxicosis is almost always helped by a sick leave of 5 days.
• Avoid long breaks in eating. Eat light and high-calorie meals every 3 hours. Banana, dates, dried fruits, sweet yogurt often help. It's not scary if there is a roll or a cookie. All this is quickly digested, assimilated and gives you energy. But it is better to refrain from meat, fish, fatty and multi-component dishes (for example, Olivier salad). It is a difficult food to digest and assimilate. You will have to experiment with fiber. During pregnancy, constipation is often due to a relaxed - in company with the uterus - intestines. And in this case, rough raw fruits and vegetables will start peristalsis and regulate stools, but in some they cause gas and unpleasant colic in the stomach. So you have to try. nine0025
• Nausea is very often especially pronounced in the morning, after sleep. This is due to the large hungry interval. To ease the feeling, try to have a light snack right before bed. If you get up at night to go to the bathroom, chew half a banana or a cracker along the way. And in the morning, waking up, still not getting out of bed, eat yogurt, cottage cheese, a bun. Lie down for another 20 minutes. Then get up, have a light breakfast, and only then brush your teeth.
• The more dehydrated the body, the greater the intoxication. Start drinking in small sips, warm-hot, good quality water. Definitely between meals, not during. For taste, you can first add lemon or lime, you can buy mineral water in a glass in a pharmacy and drink it, preferably after stirring and releasing gases from the bottle. But if you haven’t drank water before, or drank it very little, then you shouldn’t abruptly start drinking more of it. nine0025

Medical treatment of early toxicosis also takes place, but only in severe forms!

And most importantly, remember that this state, although unpleasant, is temporary, absolutely safe for both you and the child. It will go away on its own very soon. And you will no longer feel like a weakened, sick pregnant woman, but will feel your pregnancy as a big, important and very joyful “work”.

Early toxicosis of pregnant women - causes and treatment

1. When early toxicosis begins during pregnancy
2. Manifestation of early toxicosis
3. Causes of toxicosis in the early stages
4. Severity of toxicosis during pregnancy
5. How to manage morning sickness and relieve symptoms
6. Principles of treatment of early toxicosis

Most women, having barely learned about the onset of pregnancy, are waiting for poor health, nausea and even vomiting. Indeed, early toxicosis often becomes a constant companion of many expectant mothers in the early stages of pregnancy. Is there any way to alleviate these unpleasant symptoms? nine0067