Morning Sickness

Morning sickness is pregnancy-related nausea and vomiting, typically occurring between weeks 5 and 20. Despite the name, the symptoms of morning sickness can present themselves at any time of the day, and some women may feel sick throughout the day.

The condition affects roughly 50 to 90 percent of pregnant women. It is generally mild and usually poses no risk to the developing baby, unless it develops into a more severe and longer lasting condition called hyperemesis gravidarum, which may affect the baby’s birth weight. 1 However, morning sickness can cause discomfort and significantly interfere with the day-to-day lives of pregnant women. There are a range of treatment options available to help manage the condition.

The specific cause of morning sickness is not clear, though it is likely to be due to the hormonal changes the body undergoes during pregnancy.

There are, nonetheless, certain things that can make morning sickness more likely. These include: 2 3

• It being a first pregnancy
• Having a female baby
• Having twins or multiple babies
• Having a history of motion sickness
• Having a history of migraines
• Having had nausea when taking the combined contraceptive pill
• Family history of morning sickness
• Stress
• Obesity
• Having gastroesophageal reflux disease (GERD)

The key symptoms of morning sickness are nausea and vomiting. Symptoms typically come and go throughout the day and last for between one and four hours. Some women, however, may feel sick throughout the day.

The symptoms of morning sickness usually begin during weeks 5 to 6, peak during week 9 of pregnancy and disappear by week 16 to 20. Morning sickness can, however, in rare cases, last for the entire duration of a pregnancy. If you or a loved one is experiencing symptoms that may be linked to morning sickness, download the free Ada app for a symptom assessment.

Although it can cause significant discomfort and interfere with everyday life, morning sickness is a typically mild condition. If the condition is severe, this could be a sign of hyperemesis gravidarum – a more serious form of morning sickness.

Hyperemesis gravidarum can lead to serious complications for mother and baby, including dehydration and a low birth weight. If any of the following symptoms are experienced, a doctor should be contacted as a matter of urgency.

Signs and symptoms of hyperemesis gravidarum include: 1 4

• Severe and prolonged nausea and vomiting
• An inability to keep fluids down
• Signs of dehydration such as infrequent urination because of not producing much urine, dark urine and dizziness due to low blood pressure
• Abdominal pain or cramping
• Weight loss of more than five pounds (2.3 kg)
• Fever and diarrhea

If treated effectively, hyperemesis gravidarum is unlikely to cause any harm to the baby.

Treatment for morning sickness is aimed at providing as much relief from the symptoms of the condition as possible and avoiding any loss of weight or deficiency of any vitamins or minerals. There is no specific treatment method that works for all women. Instead, women are encouraged to try a variety of methods to see what works for them.

To help manage mild cases of morning sickness, simple lifestyle changes may be recommended. These include: 5

• Getting plenty of rest
• Avoiding smells, foods or anything else that may trigger nausea, which could include stuffy and/or noisy rooms, heat and humidity
• Eating small and frequent meals, perhaps every one to two hours and high in carbohydrates and low in fat
• Drinking plenty of fluids
• Eating food or drink containing ginger, which, evidence suggests, is a natural antiemetic (vomiting suppressant)

If lifestyle changes do not help to remedy the morning sickness, a doctor may prescribe pregnancy-friendly anti-sickness medication (antiemetics). Often, this will be a form of vitamin B6 called pyridoxine, which may be used in combination with a specific antihistamine – doxylamine – which is usually used to treat allergies, but which can also be effective at preventing sickness. The medication will generally be in tablet form, though an injection or suppository may be used if the individual is unable to keep down fluids. 5

The medications used to treat morning sickness are safe for use in pregnancy and will have no effect on the development of the baby. However, before taking any type of medication, always seek the opinion of a doctor.

In a small number of cases, those that resemble hyperemesis gravidarum, morning sickness may need to be treated in a hospital. This will only be necessary if the individual does not respond to treatment and is consequently losing weight and becoming dehydrated. In the hospital, fluids will be administered intravenously (through a drip) to prevent dehydration.

There are a number of alternative treatment methods for morning sickness.

Acupuncture and acupressure have become particularly popular. The first is a technique derived from ancient Chinese medicine involving the insertion of fine needles into certain points on the body; the latter is a technique similar to acupuncture, involving the application of pressure to certain points on the body, often using a specially designed wristband.

Both techniques can be self-administered and do not require a prescription, making them easily accessible to most women. Although neither technique is medically proven beyond doubt to be effective besides the possibility of a placebo effect, both are considered to be safe during pregnancy and may help on an individual basis. 6

Hypnosis is also considered safe and may be helpful in the relief of symptoms for some patients. Psychotherapy, likewise, can also be useful and supportive for some women, especially those whose symptoms are exacerbated by anxiety and stress surrounding the pregnancy. 6

Most other alternative treatment methods have not been studied comprehensively and should therefore be avoided. This includes marijuana, which is not considered safe for consumption during pregnancy by most medical professionals. 6

The majority of women who experience morning sickness will recover completely and experience no further problems related to the condition. Some women may not gain weight in the first half of pregnancy as a consequence of morning sickness, but this is only cause for concern if the individual is already significantly underweight. 1

If there is any concern about morning sickness, contact a doctor or midwife for help and advice.

Q: Is morning sickness a complication of pregnancy?
A: No, morning sickness is a normal part of pregnancy that affects a large amount of women. However, complications can occur if the condition is severe and progresses into a condition known as hyperemesis gravidarum, which can cause dehydration and low birth weight.

Read more about Pregnancy Complications »

Q: Will morning sickness affect my baby?
A: Morning sickness will usually cause no harm to the baby. If you experience hyperemesis gravidarum and it is left untreated or treated late, however, this may have a negative effect on the pregnancy. This effect may be a low birth weight.

Q: Are there any natural remedies for the relief of morning sickness?
A: There are a variety of natural remedies that may help with the management of mild morning sickness. These include: 7

• Ginger: Research suggests eating or drinking foods containing ginger can act as a natural antiemetic.
• Relaxation: Taking steps to relax can help to reduce stress, something that may contribute to morning sickness.
• Vitamin B6: Eating foods rich in vitamin B6, such as bananas, avocado and chicken, may help ease morning sickness.
• Peppermint: Tea or other drinks containing peppermint may help ease morning sickness.

Always talk to a doctor or midwife before beginning to use any morning sickness remedies.

Q: Can I experience morning sickness at night?
A: Yes, a rarer kind of morning sickness may also occur at night, or indeed at any time of the day. 8 Morning sickness at night can be particularly troublesome, as it can prevent women from falling asleep or even wake them during the night. As feelings of nausea often occur on an empty stomach, one possible way to help prevent sickness at night is to eat a light snack in the evening, before bed. 9 While this method is worth trying, it will not be effective for all women. Women experiencing persistent morning sickness at night should speak to their doctor or midwife.

Q: What does it mean if I experience no morning sickness?
A: Research has suggested that there may be a link between morning sickness and a lower chance of miscarriage, based on the idea that it protects the fetus against bacteria and toxins contained in food and drink. 10 Nonetheless, women who do not experience morning sickness should not worry excessively. Every pregnancy is different, and the evidence for this protective factor theory is yet to be fully confirmed. 11