PK Women's Clinic > Pregnancy Care > Morning Sickness

Morning Sickness

What is morning sickness?

Morning sickness is nausea in pregnancy, which usually happens in the first few months.

Despite the name, morning sickness can affect pregnant women any time of the day. Usually, the nausea is worse in the early hours of the day and starts to fade as night comes.

The intensity of the morning sickness varies from woman to woman, so don’t be surprised if you have a different experience compared to other women.

About 75% of pregnant women experience some form of nausea or vomiting during early pregnancy and it can leave some women feeling tired and miserable.

Your doctor will be able to advise you on the best options for relief.

What period of pregnancy does morning sickness happen?

Morning sickness can begin as early as 4 weeks, but on average starts at about 6 weeks into your pregnancy. The symptoms of morning sickness also intensify over the next 4 to 5 weeks.

The usual end of morning sickness happens around 14 weeks, although some pregnant women can continue to experience it up to 18 weeks into pregnancy.

For others, the symptoms can come and go throughout the pregnancy.

For very rare cases, it is possible to have morning sickness that last up to the second, or even third trimester.

Talk to your doctor if you still experience nausea or vomiting past the first trimester.

What causes morning sickness during pregnancy?

The exact cause of nausea and vomiting during pregnancy is unknown, but doctors have identified that it’s probably a combination of several changes happening inside your body. These changes include:

An increase in human chorionic gonadotropin (hCG)– During early pregnancy, hCG is produced by cells in the placenta, which nourishes the newly fertilized egg. Pregnancy tests work by checking the presence of hCG on your urine, and research has shown a correlation between the intensity of nausea and the amount of hCG present in your body.
An increase in estrogen production– Estrogen also rises rapidly during pregnancy and might be another culprit for the nausea and vomiting.
An enhanced sense of smell – It’s not a secret that a lot of women have an enhanced sense of smell during pregnancy, and you might feel overwhelmed and nauseous when smelling certain odors. No one knows the exact reason for this heightened sensitivity, but researchers suggest that it is caused by the increased estrogen levels.
A more sensitive digestive system – During early pregnancy, the stomachs of women become more sensitive and could be the cause of morning sickness.
Increased stress – Some doctors suggest that the pregnant body’s natural, albeit abnormal, response to stress is nausea and vomiting, however there is no evidence that supports this claim.

What factors influence the intensity of morning sickness?

There are a few factors that can affect the amount of nausea and vomiting you experience during pregnancy. These include:

Being pregnant to twins or other multiples–

If you are carrying multiple babies in your pregnancy, there is also an increased amount of hCG in your body, which is presumed to be the main cause of nausea and vomiting. There are some instances though where mothers carrying multiples experience no morning sickness.

Having morning sickness in previous pregnancies– If you’ve previously experienced nausea and vomiting in an earlier pregnancy, chances are you’ll experience them again in subsequent pregnancies.
Being prone to motion sickness– If you have a history of motion sickness while not pregnant, then pregnancy might intensify the feeling of nausea.
Having family with a history of nausea during pregnancy– Research suggest that morning sickness runs in the family, and there is a bigger chance of having nausea and vomiting during pregnancy if your mother or sisters have too.

Will morning sickness affect my baby?

Experiencing some mild nausea and vomiting during the first trimester of pregnancy is normal and won’t affect your baby’s health.

Morning sickness can affect your appetite though, and it is important to not starve yourself and your baby.

You can also take prenatal vitamins to supply the right nutrients needed by you and your baby.

However, studies have shown a correlation between severe morning sickness and increased risk of low birth weight and premature birth.

Talk to your doctor so that he can advise you on what to do.

If you experience little to no nausea during your pregnancy, don’t worry, because there is no truth to the statement that morning sickness is the sign to a healthy pregnancy.

What can I do to get relief from morning sickness?

Here are a couple of suggestions that could help you in dealing with mild nausea or vomiting during pregnancy:

Make sure that your stomach is never empty by eating small meals and snacks frequently. Some recommended snacks are those that are high in protein and complex carbohydrates.
Make sure to eat slowly.

Keep snacks, such as biscuits and crackers near you so that you can eat them whenever you need to. Place these snacks on your bedside table, your living room side table and other easy to reach areas.
After waking up from a good sleep, eat a few snacks then take a short 15-minute rest (but don’t lie down) before getting up.
If you wake up nauseated at night, nibbling on some crackers might help you feel better.
Lying down after eating can slow your digestion. Just sit down for about 10 minutes before you lie down, and it could help reduce the effects of morning sickness.
Avoid food or odor that make you feel nauseous.
Hot food usually has a more intense aroma, so eating warm or cold dishes may help in reducing the nausea and vomiting.
Avoid eating spicy, acidic and oily food as these can upset your stomach. Eating fatty food is also discouraged since they take longer to digest and might tire you out.
Remember to brush your teeth after eating to reduce the nauseous smell and taste of food.

Drink water and other fluids regularly throughout the day in small Drinking so much in one time might make you lose your appetite and would prevent you from ingesting the nutrients you need from your food.It is important to stay hydrated though, so it is advised to drink water in between meals, instead of during them.One way to check if you are adequately hydrated is by checking the color of your urine. Its color should be a clear or pale yellow. If not, you might need to drink more fluids.
You might vomit a lot of water, so it might be better to drink cold, carbonated beverages as they are easier to keep down. Some women prefer lemonade or other sour drinks. It might also help to use a straw for an easier time in keeping down fluids.

Avoid smells and other triggers that can stimulate your nausea. Heavy perfume, smoke or flickering lights can make you feel nauseous so make sure to minimize encountering these where you are resting.
Take a short nap and relax whenever possible. Getting tired can intensify the nauseous feeling.
Relieve some stress by talking to friends or watching some tv. These activities can help take your mind off the discomfort of the morning sickness.
Always take your prenatal vitamins with food or just before sleeping.
Ginger and peppermint are shown to provide relief for morning sickness according to some women. Try drinking some ginger or peppermint tea after a meal.

Is there any medicine that provide relief for morning sickness?

Remember that in treating morning sickness, non-drug options are recommended over medicine to avoid exposing your baby to medication unnecessarily.

If none of the non-drug suggestions worked (see What can I do to get relief from morning sickness?), you can talk to your doctor about it.
He will prescribe you some medicine that can help relieve nausea and vomiting during your early pregnancy. Some over the counter (OTC) medicines that could help include:

Vitamin B6 – The American College of Obstetricians and Gynecologists (ACOG) consider vitamin B6 to be the first-line treatment to combat nausea and vomiting during pregnancy. This is especially effective for pregnant women who experience mild to moderate morning sickness.
Doxylamine and other antihistamines are also effective in treating morning sickness. Remember that some of these can make you sleepy though, so take that into account if you’re not planning to rest soon.

Your doctor may also prescribe the following drugs if the above medications are ineffective:

Metoclopramide
Promethazine
Trimethobenzamide
Prochlorperazine
Ondansetron

For cases of severe nausea and vomiting and you can’t keep any food or fluid down, you might have hyperemesis gravidarum, which is an intense form of morning sickness. Your doctor may recommend that you be treated in the hospital with intravenous (IV) fluids and medications.

Some IV drugs to treat hyperemesis gravidarum include:

Chlorpromazine
Antihistamines
dopamine antagonists
serotonin antagonists
glucocorticoids.

In which situations about morning sickness should I be concerned and talk to my doctor?

Whenever you are confused about something that happens during your early pregnancy, it is always a good idea to talk to your doctor and be informed about it.

It never hurts to have more knowledge about morning sickness and how to deal with it.

Nevertheless, some situations where it is very important and urgent to call your doctor include:

Losing 2 pounds or more of weight
Developing symptoms of morning sickness on your second or third trimester of pregnancy
Feeling dizzy when you stand up
Vomiting or coughing blood
Dehydration, which can be observed when you have dark urine or if you urinate infrequently
Having fever, headaches, abdominal pain or some swelling in the front of your neck