If you’re nauseous during pregnancy, know that you are not alone: 70% to 80% of pregnant people get morning sickness.
Despite nausea being a normal part of pregnancy, it doesn’t make it any less unpleasant or sometimes scary to deal with. People often choose to suffer in silence rather than seek out help for their symptoms. Hopefully, some data can help ease worries or frustrations.
What is morning sickness?
Morning sickness refers to that general feeling of wanting to puke. Although it’s a common condition, the term “morning sickness” is a pretty big misnomer. Studies show that most people report feeling sick all day, not just the morning.
Pregnancy-related nausea usually starts around six weeks, peaks between eight and nine weeks, and then fades away gradually in the second trimester, between 13 and 14 weeks (timing depends on the person). Symptoms can also include vomiting, being sensitive to smells, avoiding foods, loss of appetite, and even weird cravings.
Of the up to 80% of women who deal with some form of nausea, more than half also experience vomiting. For most women, vomiting is not constant; actual vomiting is reported on an average of only six days during pregnancy.
If you are experiencing nausea — especially bad nausea — you may wonder, Why me? Unfortunately, we don’t fully understand why some people get nauseous and others don’t. The answer very likely lies in your hormones, but the endocrine system is notoriously challenging to understand.
This lack of understanding extends to hyperemesis gravidarum, a rare condition in pregnancy that involves persistent severe vomiting, dehydration, and inability to gain weight. Why some people get it and some do not is not fully known. One study points the finger at a particular hormone called GDF15, which is present at higher levels in women with severe nausea and vomiting. This is also linked to nausea at any level; more research is needed to be confident in the importance of this link, however, and to consider whether there are actionable ways to use that understanding.
How do you treat nausea in pregnancy?
While not preventable, there are numerous ways to treat morning sickness and nausea. Most of the baseline advice is similar to what you’d hear anytime you have a stomach bug, for any reason. Staying hydrated is key, as well as eating more frequent, smaller meals to avoid an empty stomach.
Some other things you can try on your own:
- Keep away from potential triggers, like unpleasant smells
- Try ginger mints, tea, or gum (there are some small studies showing a benefit, though they are of limited quality)
- Vitamin B6 supplements (randomized trials suggest a reduction in nausea from relatively high doses) and/or Unisom — both available over the counter
- Take your prenatal vitamin with food
Not all of these tips have studies that support them. Some, like the advice to eat crackers, are simple common sense that apply to non-pregnancy nausea as well. On the flip side: There is no support in the data for acupressure or acupuncture to treat nausea, although there is also no harm in trying them.
Some pregnant women have used marijuana to help with nausea. Generally, I urge caution with recreational marjuana use in pregnancy, as we don’t have enough good data on the effects. For extreme nausea, this is a conversation you might have with your doctor, especially if you are struggling to stay sufficiently hydrated and nourished.
When to talk to your doctor
The short answer is, you should talk to your doctor if you feel it would be helpful. In the case of nausea during pregnancy, women may assume there is nothing that can be done. That is not the case.
Your doctor or midwife may prescribe a medication like Zofran or promethazine, both of which can improve symptoms. Although some women are reluctant to take these medications, the safety profile on both is good, and they can prevent more serious outcomes like dehydration.
There are some symptoms that should prompt a more immediate call to your doctor. These include:
- Weight loss
- Feeling dizzy
- Vomit with blood
- Fever or body aches
- Faster-than-normal heartbeat
If you are experiencing these symptoms, your doctor or nurse will likely check your weight and ask you a series of questions to help determine the best treatment plan. If you have severe nausea and vomiting, you may be diagnosed with hyperemesis gravidarum. This condition affects about 1% of pregnant people and is characterized by severe, constant vomiting to the point of being unable to eat or drink. This can lead to severe dehydration, and you may need IV fluids.
The bottom line
- Some nausea during pregnancy, including vomiting, is completely normal and points to a healthy pregnancy.
- There are several safe options to treat nausea at home or with prescription medications like Zofran.
- Vomiting several times daily is not the normal experience, and extra care is likely needed.
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