As many expectant mothers can attest, morning sickness is a common companion during pregnancy. Often characterized by nausea and vomiting, it's a frequent topic of concern and curiosity, especially when it comes to duration, intensity, and variability throughout the stages of your pregnancy.
For some women, morning sickness can become unbearable – one study even compared its intensity to that of chemotherapy patients. So, as a pregnant woman, it’s important that you know why your nausea and vomiting are happening, when symptoms will stop, and how to manage them.
First, you should know that morning sickness is very normal, and it’s unlikely to put your baby at risk (only about 3% of cases turn into hyperemesis gravidarum, which is when too much vomiting interferes with the pregnancy). If you have concerns about the intensity or duration of nausea and/or vomiting during pregnancy, don’t hesitate to ask your provider for help.
All-Day Discomfort: Morning Sickness Can Happen at Any Time
Despite its name, morning sickness isn't confined to the morning. Many women experience symptoms throughout the day and even at night, and it’s normal to have it some days and not others. In fact, in medical terms, morning sickness is referred to as nausea and vomiting of pregnancy, or NVP. This misconception can often lead to under-preparedness for nighttime discomfort.
Morning Sickness Management Strategies
There are quite a few coping strategies you can try out to decrease your nausea and vomiting during pregnancy. The easiest ways involve avoiding trigger foods and smells, eating smaller and more frequent meals, staying hydrated, and getting fresh air. Of course, if your symptoms are bad enough, those things might not cut it.
Antiemetic (or anti-nausea) medications like pyridoxine, doxylamine, and vitamin B6 are some over-the-counter options that are both safe for your baby and easy to get. Ginger and peppermint tea, which we’ll explore below, have also proven to be effective among many women.
Acupressure has also been shown to be effective in treating nausea and vomiting in pregnant women. You can either wear an acupressure wristband or use your other hand to apply pressure to the P6 area of your inner forearm. This point is in the middle of the two large tendons below your palm, about three fingers down.
What Triggers Should I Avoid to Prevent Morning Sickness?
Identifying trigger foods, such as spicy or fatty meals, and implementing a diet with more settling options like ginger, bread, pasta, or other bland foods, can help to reduce the severity and frequency of nausea.
Besides the food you eat, certain smells can trigger intense nausea and vomiting for pregnant women. One study even suggests that smells provoke nausea and vomiting more than actual tastes. A few common trigger smells are:
- Sesame oils
Does Aromatherapy Work for Morning Sickness?
Aromatherapy (or the use of essential oils and natural scents) is a popular way to take advantage of your smell to subdue nausea and vomiting symptoms during pregnancy. Whereas some smells might make morning sickness worse, others are tolerated well and might even help, especially citrus, peppermint, and ginger.
A randomized clinical trial found that lemon inhalation aromatherapy (lemon essential oil in a diffuser, or just smelling fresh lemons) reduced symptoms of nausea and vomiting in about one in four women involved in the study. Other research suggests that peppermint can be used generally for anti-nausea purposes, whereas ginger works especially well for nausea caused by pregnancy.
The reason aromatherapy works depends on the aroma you’re using – ginger, for example, works by stimulating your stomach muscles to help with digestion and helping to kill off harmful bacteria. Peppermint oil, on the other hand, relaxes the stomach muscles and has anti-inflammatory properties.
Why Do I Get Morning Sickness?
Genetics, hormones, the baby's gender, and certain foods like those listed above all play significant roles in causing nausea and vomiting during pregnancy. Women with additional health conditions or women carrying baby girls or multiples may experience more pronounced symptoms
Genetics: There’s lots of data showing that morning sickness is hereditary. One study revealed that daughters of mothers with hyperemesis gravidarum or HG, (the severe form of nausea and vomiting during pregnancy) are three times more likely to experience it themselves, while sisters of HG patients are seventeen times more likely to have it.
Hormones: GDF15, which stands for growth/differentiation factor 15, is a hormone mainly secreted by the placenta during pregnancy. Research has shown higher concentrations of GDF15 in women who used more anti-nausea meds during pregnancy and who reported more nausea and vomiting into their second trimester.
You may also have heard of hCG, or human chorionic gonadotropin since it happens to be what they look for in pregnancy tests. It’s secreted in high amounts by the placenta in the early weeks of pregnancy, and peaks in hCG are associated with peaks in NVP symptoms in weeks 12 and 14 of pregnancy.
Some evidence of increased levels of the thyroid hormones T3 and T4 caused by the high metabolic state required by pregnancy is associated with higher rates of hyperemesis gravidarum (HG) and nausea and vomiting during pregnancy. The hormones produced by the thyroid gland are involved in tons of bodily processes, however, so more research is needed to understand their precise role in NVP.
Besides making you sick to your stomach, these hormones are incredibly important for the development of your baby, and they’re not the only factors involved. There’s still much research to be done to fully understand the causes and potential treatments for nausea and vomiting during pregnancy.
Morning Sickness and Your Baby’s Gender: Although you probably won’t know your baby’s gender until the mid-pregnancy ultrasound between weeks 18 and 20, there is some evidence that morning sickness is associated with having a girl. Scientists think this has to do with higher levels of hCG produced during female pregnancy, thus leading to more nausea and vomiting.
Morning Sickness and Multiples Although there hasn’t been extensive research on the subject, this 2019 study found that there’s a positive correlation between having multiples and experiencing more nausea and vomiting during pregnancy. This is likely due to increased levels of hCG that come with having multiple fetuses.
Why Do I Get Morning Sickness at Night?
You might find that your morning sickness is worse at night, which can greatly affect your sleep quality and stress levels during pregnancy. It can happen throughout the day and tends to be worse in the morning. So, nighttime nausea and vomiting are expected, especially if you’ve just eaten a large meal like dinner or you’ve been around lots of pungent smells.
Nausea and vomiting during pregnancy are also closely linked to daily hormonal fluctuations and immune responses. These fluctuations often happen before bedtime and cause additional spikes in morning sickness symptoms.
When Will Morning Sickness End?
The timeline for morning sickness usually begins between 4 and 6 weeks, peaks in intensity between weeks 7 and 12, and fades away by the end of weeks 10 and 16. There’s a chance morning sickness will return in the third trimester (weeks 28-31), but evidence suggests that it only occurs in up to 10% of women.
Early Weeks: The Onset
Morning sickness typically begins around the 4th to 6th week of pregnancy. At this stage, hormonal changes are in full swing, and the body is adjusting to the developing fetus. Symptoms often start mild and gradually intensify. By the 7th or 12th week, many women report a peak in severity.
Mid-Pregnancy: A Lull for Some
As you cross into the second trimester, or somewhere around weeks 12-16, morning sickness tends to decrease or suddenly stops. Clinical evidence shows us that half of women report that their symptoms resolved by week 14, and 9 out of 10 reported that they were gone by week 22. By the second trimester, the body starts to adapt, and hormonal fluctuations stabilize, offering relief. However, every pregnancy is unique, and some might continue to experience nausea, with triggers varying widely among individuals.
The Third Trimester: A Surprising Return?
Contrary to popular belief, morning sickness can sometimes return in the 3rd trimester due to the growing size of the uterus, which puts pressure on the stomach. Although less common, it's a reality for some and should not be overlooked. Nighttime symptoms might also be more pronounced during this stage.
When Should I Go to the Doctor Because of Morning Sickness?
Recognizing severe or highly frequent nausea and vomiting during pregnancy, also known as hyperemesis gravidarum (HG), is crucial. HG affects 1-3% of women and requires careful attention. A couple of things to ask your doctor about are:
- Dehydration or light-headedness
- Nausea and vomiting that lasts longer than the 16-20 week mark
- Weight loss because of inability to eat
Too much weight loss during pregnancy can result in a miscarriage, so don’t hesitate to seek out help if you’re concerned about the severity of your morning sickness.
Understanding the typical timeline and variability of morning sickness provides a framework, but each pregnancy is unique. The most important thing is to listen to your body and seek support when needed, whether that be through dietary changes, lifestyle adjustments, or medical consultation. Remember, what works for one may not work for another, and managing morning sickness often requires a personalized approach.