Throwing up end of pregnancy

When Morning Sickness Doesn't Go Away: Third Trimester Nausea

Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT — By Sarah Bradley on July 30, 2020

We’re just gonna come right out and say it: morning sickness sucks. Like, it might actually be the single worst part of pregnancy other than the part where you have to push a human being out of you.

Plus, it has the most inaccurate name of anything ever because it does not just happen in the morning (seriously… who was in charge of this?).

The only saving grace here is that it’s a first trimester problem. Once you get through the first 12 or 13 weeks, you’re good to go, right?

Yeah, no. Sometimes morning sickness lasts well into the second trimester and, for some especially unfortunate pregnant souls, it can drag all the way into the third trimester, too.

Here’s what’s probably going on and what you can do to feel better (other than induce labor and get this nausea-provoking baby out of you, already).

If you’re nearing your due date and wondering why you’re still barfing up your breakfast, know that while most cases of morning sickness get better after the first trimester, some just don’t — and it doesn’t mean anything is wrong.

While your initial nausea might have been caused by the sudden change in hormones as your body adjusted to being pregnant, third trimester nausea may be caused by a variety of things:

Your growing baby. You’re running out of room in your stomach as baby grows, which puts pressure on your digestive system. This can cause everything from constipation to heartburn to nausea.
Your prenatal vitamin. Some people have trouble digesting the high amounts of iron in prenatal vitamins without GI distress. If your nausea never really went away or if you changed brands mid-pregnancy, it could be causing nausea.
Your diet. Is baby craving chili peppers? Well, good for baby, but you’re the one suffering the ill effects of spicy, oily, and acid-based foods. Especially with less room in your stomach these days, foods that tend to be irritating to the GI tract can really do a number on you.
Hormones, again. These do typically level out after the first trimester, but let’s face it: Pregnancy is a hormonal roller coaster because they’re constantly in flux. If your nausea comes and goes by the day, it might be due to the up-and-down nature of your hormones.

If you’ve felt sick during most of your pregnancy, continuing to have symptoms in the third trimester isn’t unusual and can probably be blamed on one of these things.

If feeling excessively nauseated during the third trimester is a new thing for you this pregnancy, you should check in with your doctor.

Your stomach upset could still be caused by your changing body or an external factor like diet. But nausea is also a symptom of a few serious pregnancy conditions. Both preeclampsia (a severe form of high blood pressure) and gestational liver problems, like HELLP syndrome, can cause nausea.

If you’re feeling nauseated during the third trimester, it’s probably a GI issue — everything is getting squished in there, causing your digestion to slow down.

You may also be constipated or have abdominal bloating or gas, or you might have symptoms of reflux, like heartburn and indigestion.

If your changing hormones are to blame, you may also be feeling super tired, just like you did in the first trimester. Pregnancy really is the gift that just keeps on giving, isn’t it?

Your third trimester nausea could also be paired up with loss of appetite, persistent vomiting, and difficulty losing weight. In that case, you might actually have hyperemeis gravidarium, an extreme form of morning sickness that often requires medical treatment.

For the most part, you can treat third trimester nausea the same way you did way back at week 8 of your pregnancy.

Focus on eating smaller, more frequent meals (to avoid becoming overly full) and cutting back on foods that are agitating your digestive system (like those buffalo-style potato chips you can’t stop craving).

You can also:

sip ginger tea or nibble on ginger gummies
avoid any triggering foods or odors
suck on peppermint or lemon hard candies
snack on carb-heavy foods, like pretzels and crackers
get extra sleep
take a B6 supplement (if approved by your doctor)
make changes to your prenatal vitamin, like splitting doses, changing the timing of doses, or switching to a gummy instead of a capsule

If you’re nauseated all the time and none of these remedies help, contact your doctor. Also give them a call if you’re having persistent vomiting or trouble keeping food or fluids down, even if you think you’ve caught a run-of-the-mill stomach bug.

Pregnant people need to be careful not to get dehydrated, so your doctor may want to monitor your symptoms.

Sometimes you can feel nauseated when labor is getting closer, but you’re much more likely to have nausea during active labor or the transition phase of labor.

Instead of wondering if your queasy stomach is a sign that you’re approaching the Big Day, pay attention to more reliable signs of labor, like:

loss of your mucus plug
rupture of the amniotic sac
back pain
lightening
diarrhea
an increase in the severity and frequency of Braxton-Hicks contractions

Some of us are just unlucky enough to feel sick for 9 months, either intermittently or nonstop through all 3 trimesters.

But feeling nauseated 24/7 during the third trimester — especially if nothing helps alleviate it — is enough of a red flag to see your doctor for an exam. It could just be an unpleasant symptom you have to deal with until the end of pregnancy, but it’s always a good idea to rule out any issues.

Last medically reviewed on July 30, 2020

Parenthood
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3rd Trimester

How we reviewed this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Chik Jwa S, et al. (2016). Validation of a food-frequency questionnaire for assessing vitamin intake of Japanese women in early and late pregnancy with and without nausea and vomiting. DOI:
10. 1017/jns.2016.14
HELLP syndrome. (2018).
rarediseases.info.nih.gov/diseases/8528/hellp-syndrome
Mukhtar F, et al. (2018). Nausea and vomiting during pregnancy and sikanjbeen lemooni — A review.
ijrar.org/papers/IJRAR1944281.pdf

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

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Medically reviewed by Debra Rose Wilson, Ph.D., MSN, R.N., IBCLC, AHN-BC, CHT — By Sarah Bradley on July 30, 2020

Is Vomiting A Sign Of Labor? Experts Explain Third Trimester Nausea

Pregnancy

Kohei Hara/DigitalVision/Getty Images

Third trimester nausea rears its ugly head.

by Abi Berwager Schreier

Updated: Aug. 18, 2022

Originally Published: November 10, 2019

When you're in your third trimester, most of us are on the watch for anything that could possibly be a sign of labor — especially lingering morning sickness that just won't quit or perhaps has returned with a vengeance. Seriously, puking in later pregnancy is the worst, but is third trimester vomiting a sign of labor? I vomited when my nurse told me it was time to push — I think that was more nerves than anything else — but that was end the end of my labor. Could nausea in late pregnancy mean your baby's on the way?

What causes vomiting in the third trimester?

Nausea or vomiting in the third trimester may have a number of causes, says Dr. Idries Abdur-Rahman, a board-certified OB-GYN. Just a few reasons you may be vomiting at the end of your pregnancy could include:

A return of morning sickness
worsening heartburn and reflux
preeclampsia — a “worst-case scenario”, says Abdur-Rahman

“For up to 10% of women, nausea can last throughout pregnancy, and regardless of whether you have morning sickness throughout the pregnancy or if it did wane, most women will experience some nausea as the hormones start to surge during the end of the third trimester,” Abdur-Rahman explains.

Heartburn is also almost unavoidable for most women during pregnancy, and is particularly common at the end of the third trimester. “As the uterus gets larger, it exerts more pressure on the stomach, producing both nausea as well as heartburn/acid reflux.”

Answers to the questions that keep you up and night — and stories you want to share with the group chat.

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When should I be concerned about vomiting in the third trimester?

Occasionally, vomiting in the third trimester is a cause for concern. Preeclampsia can be accompanied by vomiting in the third trimester. Preeclampsia is when you have high blood pressure during pregnancy, and is “characterized by hypertension, protein in the urine, headaches, visual changes, abdominal pain, as well as nausea and vomiting. Preeclampsia is a serious, potentially life threatening condition, and if there is ever a concern, you should contact your medical provider,” Abdur-Rahman says.

If late pregnancy nausea is relentless or severe, you should call your health care provider. “Contact your OB-GYN or midwife and be evaluated,” says Dr. Mia Di Julio, OB-GYN at Providence Saint John’s Health Center in Santa Monica, California.

Is vomiting in the third trimester a sign of early labor?10'000 Hours/DigitalVision/Getty Images

Though vomiting alone isn’t a sign you’re in labor, some physical that signs labor is imminent, according to Di Julio, include “increased pelvic pressure, lower back pain, increased vaginal discharge, passage of the mucus plug, and light vaginal bleeding also known as ‘bloody show,’ which is a result of thinning and dilation of the cervix.”

“With true labor or early labor, the contractions usually start out 10 to 15 minutes apart, lasting about 30 to 60 seconds, and eventually get closer together into a pattern,” adds Patricia A. Evans, nurse practitioner and certified nurse midwife at MemorialCare Medical Group in Fountain Valley, California. “Usually when they are 3 to 5 minutes apart, lasting for about a minute each, and for one hour — or if you can’t walk or talk through them — it’s time to go to where you are delivering."

So while vomiting during labor is pretty common, vomiting in the third trimester isn’t a sign that you’re about to have your baby. However, if you’re nauseous and vomiting a lot, it’s probably a good idea to get your blood pressure checked by your healthcare provider just in case.

Experts:

Dr. Idries Abdur-Rahman, OB-GYN, author of Everything You Ever Wanted to Know About Pregnancy (But Were Too Afraid or Embarrassed To Ask) and one half of the Twin Doctors for TwinDoctorsTV.

Dr. Mia Di Julio, OB-GYN at Providence Saint John’s Health Center in Santa Monica, California.

Patricia A. Evans, nurse practitioner and certified nurse midwife at MemorialCare Medical Group in Fountain Valley, California.

This article was originally published on November 10, 2019

What is preeclampsia? - ADONIS Medical Center in Kyiv

Preeclampsia, or late toxicosis, is a complication of pregnancy that develops in the 2nd and 3rd trimesters. It is possible to suspect its development in the early stages by the formation of edema and increased pressure. At the same time, the diagnosis can be confirmed or refuted only by the results of blood and urine tests.

Late toxicosis, compared with early, develops infrequently. According to the World Health Organization, its symptoms occur in an average of 8% of pregnant women. At the same time, in the territory of the CIS countries, this figure reaches 10-17%.

Severe forms of preeclampsia are rare, but the risk of such complications cannot be ignored. Unlike early toxicosis, late toxicosis poses a serious threat to the life of the mother and child. It is one of the main causes of perinatal morbidity and maternal mortality.

Although the consequences of preeclampsia seem frightening, do not worry ahead of time. First, edema and hypertension can occur for other reasons. Secondly, with the timely diagnosis of late toxicosis and the selection of the correct therapy, a woman can fully bear the pregnancy and give birth to a healthy baby.

At what time does late toxicosis begin? It is believed that the early onset of preeclampsia is associated with a severe course and often leads to premature birth, including by caesarean section.

Causes of late toxicosis in pregnant women

What exactly provokes the development of preeclampsia in pregnant women has not been established. There are several theories that have a different number of supporters, but none of them allows you to accurately determine which woman will develop late toxicosis and which will not.

At risk are pregnant women with:

Hypertension;

Diseases of the kidneys, liver, biliary tract, thyroid gland, adrenal glands, lungs and/or heart;

Violation of fat metabolism and obesity;

Anemia;

Fetal growth retardation;

Rh incompatibility;

Multiple pregnancy;

Birth or abortion within the last two years;

Under the age of 19 or over 36.

The likelihood of developing late toxicosis increases against the background of chronic diseases. However, even if there are several risk factors, it cannot be said with certainty that there will be a complication.

How preeclampsia manifests itself

When preeclampsia develops in a woman, first there is a spasm of all vessels and a violation of blood circulation, as well as its clotting and fluidity. Because of this, hypoxia can develop, affecting the functioning of the heart, kidneys, liver, brain and placenta. As a result, dystrophic changes may occur in these organs.

There are 4 stages of preeclampsia:

Edema;

Nephropathy;

Preeclampsia;

Eclampsia.

At the first stage, late toxicosis is manifested by edema on the legs, arms, abdomen and in the face and neck. Most often, they do not provoke a significant deterioration in the well-being of a pregnant woman or the development of severe complications in her. In addition, with timely therapy, the following forms of preeclampsia develop in no more than 20% of cases.

With nephropathy, in addition to edema, hypertension and impaired renal function appear, which is determined by the release of protein in the urine.

Preeclampsia is the third stage of preeclampsia, which develops in only 5% of pregnant women. It is characterized by changes in the central nervous system that cause nausea, vomiting, headache, and other symptoms.

The most difficult stage of late toxicosis is eclampsia. With its development, pathological disorders are aggravated, and, in addition to the listed symptoms, the woman also has convulsions, a sharp increase in pressure and the risk of stroke.

Late toxicosis may result in:

Severe edema;

High blood pressure;

Disorders of the functions of the kidneys, liver and other organs;

Detachment of the placenta, leading to fetal hypoxia, slowing down its development, premature birth and perinatal pathologies.

In severe preeclampsia, the condition of a pregnant woman may become critical.

Features of preeclampsia treatment

For the diagnosis of preeclampsia, a number of laboratory blood and urine tests are prescribed, ultrasound is performed, an examination of the fundus and, if necessary, other examinations.

In case of mild late toxicosis of pregnant women, which is manifested only by edema, obstetrician-gynecologists recommend treatment in a day hospital or at home. If a pregnant woman also develops hypertension, protein is excreted in the urine, or other symptoms of pathologies appear, she may need to be hospitalized in an obstetric hospital.

toxemia, bowel problems and heartburn

Find out how pregnancy affects the digestive tract, which trimesters are more likely to cause symptoms of indigestion and nausea, and what to do to manage them.

During pregnancy, the burden on the mother's body increases. The body needs more nutrients, the body produces additional hormones. And the growing fetus puts pressure on neighboring organs, including the stomach and intestines. We tell you what symptoms are observed in each trimester, how to cope with toxicosis and get rid of heartburn.

Contents:

2. Toxicosis and pregnancy

3. Causes, risks and treatment of diarrhea during pregnancy

4. Heartburn and stomach pain during pregnancy

5. Bloating, constipation and microbiota during pregnancy

6. Note

Changes in the work of the gastrointestinal tract by trimesters of pregnancy

The average duration of pregnancy is 40 weeks, which are usually divided into trimesters in accordance with the stages of intrauterine development of the child.

The Atlas Genetic Test will help you find out how your genes affect the level of female sex hormones necessary for fertility and pregnancy.

Causes of gastrointestinal problems during pregnancy

Every pregnancy is accompanied by inevitable changes in the functioning of the digestive system. They are most often caused by hormonal changes and increased stress on the organs, but they can also be associated with lifestyle and health conditions, for example:

Sedentary lifestyle and unbalanced diet;

Certain drugs, including calcium or aluminum antacids;

Viral and bacterial infections;

Intolerance to certain nutrients and allergic reactions;

Stress;

Diseases of the thyroid gland.

If you have chronic diseases of the gastrointestinal tract and you are planning a pregnancy, try to consult your doctor in advance. Symptoms of conditions such as irritable bowel syndrome (IBS) or acid reflux are more likely to get worse during pregnancy. Your doctor will help prepare your body and create a prevention plan to help relieve symptoms during this time.

Irritable bowel syndrome, or IBS, is a functional bowel disease that causes frequent abdominal pain, impaired peristalsis, bloating, constipation, or diarrhea.

Morning sickness, vomiting and general malaise during pregnancy

Morning sickness and morning sickness during early pregnancy are common, because the body undergoes important changes necessary for the development of the child.

up to 90%

women experience nausea during pregnancy

Doctors find it difficult to say with certainty why pregnant women feel sick in the morning. The main theory is hormonal changes. But there are some patterns associated with an increased risk of morning sickness:

Multiple pregnancy;

Toxicosis during previous pregnancy;

History of morning sickness during pregnancy in close relatives;

Tendency to motion sickness in transport;

Use of oral contraceptives containing estrogen before pregnancy;

Frequent migraines;

BMI 30 and above;

Elevated levels of stress hormones

Risks of severe morning sickness and how to reduce nausea

Nausea and vomiting are usually not associated with a risk for mother and child and disappear by 16-20 weeks of pregnancy, but it is not necessary to wait so long - there are ways that can help reduce nausea and enjoy the process of waiting for a new person:

Get plenty of rest - fatigue increases toxicosis;

Avoid smells and foods that cause nausea;

Eat something right after waking up. A toast or a slice of bread will help reduce nausea;

Avoid hunger - empty stomach increases nausea. Eat small meals often, prefer low-fat, high-carbohydrate foods;

Try ginger - studies show it helps with nausea;

Sip as often as possible and prefer still water.

In rare cases, pregnant women may develop hyperemesis gestationis or excessive vomiting. This is a serious condition that can lead to dehydration, kidney damage, seizures, abnormal heart rhythms, and even death.

Signs of dehydration include: dry mouth, dizziness, dark urine, infrequent urination and/or dizziness.

Symptoms of excessive pregnancy vomiting:

frequent nausea for a long time and regular vomiting after meals;

dry skin and lips;

sudden weight loss;

low blood pressure (below 90/60).

If symptoms of excessive pregnancy vomiting occur, do not wait until the condition resolves on its own. It is necessary to seek medical help as soon as possible - the doctor will prescribe treatment, help adjust the diet and lifestyle of the expectant mother.

0.5–2%

pregnant women experience excessive vomiting

Diarrhea in pregnancy

The word "diarrhea" comes from the Greek language and literally means "to flow through". This is a condition during which bowel movements or bowel movements occur three times a day or more often. This phenomenon is especially typical for the third trimester of pregnancy, but it can also occur earlier.

Symptoms of diarrhea:

Three or more bowel movements per day

Urgent urge to have a bowel movement

Abdominal pain and cramps

Bloating

Causes of diarrhea during pregnancy poisoning, dysbacteriosis, bacterial and viral infections:

Gastroenteritis Use of lactose and gluten in case of intolerance to these nutrients

Bacterial infections: listeriosis or salmonella Chronic gastrointestinal diseases: Crohn's disease, IBS, ulcerative colitis

Some antibiotics and antacids to reduce acidity Laxatives

Sugar substitutes such as sorbitol Overconsumption of certain foods

Tip: If you have recently returned from a vacation in an exotic country with nausea and diarrhea and find out you are pregnant, see your doctor as soon as possible.

Gastroenteritis

One common cause of diarrhea during pregnancy is gastroenteritis or stomach flu. It is caused by bacterial or viral infections: norovirus, rotavirus, E. coli, salmonella, which enter the body through contact with contaminated surfaces, dishes, food and water.

Gastroenteritis usually lasts about three days. However, severe illness is a health hazard, especially during pregnancy, as it can cause dehydration, electrolyte imbalance, and lead to preterm labor.

The main symptoms of gastroenteritis are diarrhea without blood, nausea and vomiting, stomach cramps and pain, slight fever, headache and muscle pain.

Take extra precautions to reduce your risk of getting sick: frequent handwashing and surface disinfection. If the expectant mother has small children, they are not recommended to use the same cutlery.

Risks of diarrhea during pregnancy

Usually diarrhea during pregnancy is not a cause for concern. However, you should consult a doctor if the following symptoms occur during this period:

Diarrhea for more than two days;

Blood or mucus stools;

Sudden weight loss;

Abdominal pain;

Dehydration.

How to treat diarrhea during pregnancy

If you have diarrhea during pregnancy, drink plenty of fluids, avoid foods high in fat and sugar, avoid dairy products, and caffeinated drinks.

Dehydration is a serious risk, especially during pregnancy, so electrolyte balance should be restored first with fluids and simple foods:

Moderate fruit juices Drinks without alcohol and caffeine

Bananas Potato

Rice Toast

Rusks Light soups and broths

Pasta Applesauce

Find out about your body's ability to break down lactose and gluten with the Atlas Microbiota Test.

Stomach pain and heartburn during pregnancy

Many women experience stomach pain during pregnancy, especially the upper part of the stomach, as well as heartburn - a burning sensation in the chest and esophagus.

This is more common in the third trimester, after about 27 weeks. This is an unpleasant but natural phenomenon during pregnancy: the baby grows inside the uterus and presses on other organs, including the stomach. And hormones cause the muscles to relax, which causes acid from the stomach to enter the esophagus and irritate it. In addition, pain can be caused by problems with certain organs such as the gallbladder, or inflammation of the pancreas.

Symptoms of heartburn during pregnancy:

Burning in chest and esophagus;

Feeling of overeating, heaviness or bloating;

Belching, including with acid and/or food particles;

Nausea.

Avoid cramps and heartburn during pregnancy is unlikely. However, some tips can help reduce their frequency:

Nutrition : try to avoid overeating - eat easily digestible food in small portions; do not eat three hours before bedtime; watch your posture while eating - so the pressure on your stomach will be less.

Smoking and alcohol: In addition to known harms to mothers and babies, tobacco smoke also relaxes the muscles in the lower esophagus, allowing acid to enter the esophagus. And alcohol provokes heartburn and acid reflux.

Although stomach pain and heartburn often accompany pregnancy, abdominal pain, especially in the third trimester, should be taken seriously. It can be a sign of preterm labor or placental abruption, and puts mother and baby at risk.

If you experience severe abdominal pain during pregnancy that is accompanied by the following symptoms, seek medical attention as soon as possible:

Abdominal pain and fever Bleeding

Regular seizures Unusual vaginal discharge / spotting

Vomiting Low back pain

Pain or burning when urinating Severe pain that lasts 30-60 minutes

Bloating, constipation and microbiota during pregnancy

Excessive gas and constipation during pregnancy can be caused by hormonal changes, such as increased production of progesterone. This hormone, essential for nourishing the uterus and fetus, relaxes the muscles of the body, including the muscles in the intestines, which slows down digestion and increases flatulence. A similar reaction of the body can be observed before each menstruation, when the production of progesterone increases.

Flatulence - bloating of the abdomen due to the accumulation of gases.

Here are a few simple rules that will help improve intestinal motility and avoid constipation and bloating:

If you don't usually eat a lot of fiber and indigestible foods like legumes, try to gradually introduce them into your diet;

Avoid carbonated drinks and fatty foods;

Move more;

Drink plenty of fluids.

If bloating and constipation are accompanied by severe pain that lasts more than 30 minutes, or if you have been constipated for two or more weeks, see your doctor.

Gut microbiota and bacteria during pregnancy

A woman's body goes through many changes during pregnancy, and this can affect the microbiota, the bacterial ecosystem that lives in the gut. Trillions of microorganisms do important work for the whole body: they synthesize vitamins and essential acids, keep your intestines working and protect it from disease and inflammation.

The additional influx of female hormones that accompanies pregnancy alters gut function and affects the microbiota. This is good, because the bacterial community is constantly adjusting to external and internal conditions in order to keep up with the needs of the body.

To keep your gut bacteria running smoothly, they need your help. Provide them with healthy foods and plant fibers. Fruits, vegetables, whole grains, nuts, and seeds contain prebiotics, special substances that beneficial bacteria feed on. When properly balanced, the bacteria even increase your body's defenses against harmful microorganisms that can cause gastroenteritis during pregnancy.

The Atlas Microbiota Test will help you understand how to prepare your intestines for a future pregnancy and reduce the risk of digestive problems.

☝️ Take note

Now you have all the necessary knowledge and tools to help you deal with digestive problems during pregnancy. They are quite varied and quite natural, but in some cases it is necessary to immediately seek medical help:

Vomiting blood;

Blood in stool;

Diarrhea for more than two days;

Constipation for more than two weeks;

Sudden weight loss;

Severe pain interfering with daily activities;

Difficulty breathing;

Pain when swallowing or difficulty swallowing;

Excessive fatigue.

More articles on the causes of digestive problems on the blog:

7 foods that cause gas and bloating
Lindsey J Wegrzyniak, Treatment of Hyperemesis Gravidarum, 2012

Edwards A. et al., The Maternal Gut Microbiome During Pregnancy, 2018

National Health and Safety (NHS), Vomiting and morning sickness in pregnancy

Kudzai Kanhutu, Travel and pregnancy: an infectious diseases perspective, 2011

CDC, Pregnant travelers

U.
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