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What is morning sickness?For many mums-to-be, a dash to the bathroom to be sick is one of the first signs of pregnancy.
During early pregnancy, up to nine out of 10 women will feel sick or be sick at some point (Einarson et al 2013, NICE 2013). So if you spend your early weeks of pregnancy feeling anything but blooming, you’re not alone.
Morning sickness is the most common symptom of pregnancy (Einarson et al 2013). How bad the sickness is varies from woman to woman. About one woman in three feels sick but doesn’t actually vomit (Einarson et al 2013, NICE 2013).
You may get the odd bout of mild queasiness when you first wake up, or certain smells may trigger your nausea throughout the day. You may have to endure weeks, or even months, of feeling or being sick.
The term “morning sickness” is misleading, as only one woman in 25 feels sick just in the morning (NICE 2013), so it doesn’t accurately describe what most women experience. Nausea and vomiting can strike at any time of the day (NHS 2015, NICE 2013).
If you get it badly you may find yourself unable to work, care for your other children or do everyday activities (NICE 2016, NHS 2016, NICE 2013).
Morning sickness can be a great strain, and not just for you. It can affect your relationships with your partner, family and friends, and even lead to depression (NICE 2013, RCOG 2016).
However, there is help available from your midwife and GP. Sharing with other women suffering from nausea can help too. As morning sickness is so common, you're bound to find fellow sufferers in your BabyCentre Birth Club.
The most severe form of morning sickness is hyperemesis gravidarum (HG). If you’re vomiting many times a day, unable to eat or drink without being sick and if you’re losing weight, you may have HG (NICE 2013, Harding 2016).
Unlike normal morning sickness, HG can affect you and your baby’s health unless it’s treated. So talk to your doctor or midwife as soon as you can.
Will morning sickness affect my baby?Morning sickness won’t affect your baby as long as you’re able to keep some food and fluid down (NHS. 2015, RCOG 2016). Even in very severe cases it’s unlikely to cause any harm as long as it’s treated (NHS 2016, NICE 2013, Harding 2016).
Feeling sick is a good sign that the placenta has developed well and that your pregnancy hormones are working to keep your pregnancy going (NICE 2013).
Research suggests that women who experience morning sickness may be less likely to have a miscarriage (NICE 2013, Harding 2016, NICE 2016) than those who don’t.
But that’s not to say that if you don’t feel sick you won’t have a perfectly healthy pregnancy. You may just be one of the lucky ones!
Eat a balanced diet if you can, but if you’re feeling very sick, just eat whatever you can cope with. This means that you may have odd or limited food choices for a while. You may only be able to manage crackers, bread or potatoes for a month. Try not to worry - there’ll be plenty of time for you to eat healthily once you’re over your sickness.
In the meantime, your baby will get the nutrients he needs from your body’s reserves, even if you aren’t eating well (Harding 2016). When you get your appetite back, our trimester-by-trimester meal planners can help you to get the nutrients you need throughout your pregnancy.
An important nutrient in the first trimester is folic acid. Take a daily supplement of 400 micrograms (mcg) of folic acid, as this will help your baby’s spine and nervous system to develop (NICE 2016). You should also take a daily supplement containing 10mcg of vitamin D (PHE 2016).
You can take a pregnancy multivitamin which contains 10mcg of vitamin D and 400mcg of folic acid. Taking a multivitamin has the benefit that you’ll only have one tablet to swallow, if you’re finding it hard to keep anything down.
If you’re vomiting often, are unable to eat and drink without vomiting, and are losing weight, you may become dehydrated (NICE 2013).
It’s important to call your doctor straight away. There are treatments that can help you at home and the earlier you start them, the better they'll work (Gadsby and Barnie-Adshead 2011, NHS 2016, NICE 2013). Warning signs that you need help include:
- your urine is very dark in colour or you pass no urine for more than eight hours
- you can’t keep anything down for 24 hours
- you're suffering repeated, unstoppable vomiting
- you're vomiting blood
- you have abdominal pain or fever
- you feel weak or faint (NHS 2015, NICE 2013)
If home treatments don’t work or you’ve developed complications because of the vomiting, you may need to be admitted to hospital to control your sickness and to top up on fluids and nutrients via a drip.
Why am I feeling sick?Though it won’t help your nausea, feeling sick is actually a good sign that your pregnancy hormone levels are high and your pregnancy is likely to continue.
The exact cause of morning sickness is unknown, but it’s thought to be connected to the pregnancy hormones, human chorionic gonadotrophin (hCG) and oestrogen (NICE 2013, Niebyl 2010).
Good levels of hCG ensure that your pregnancy continues and develops until the placenta can maintain it. Levels of hCG tend to decrease at around 16 weeks to 20 weeks of pregnancy, which is when the sickness usually comes to a halt.
It's possible that your increased sense of smell and nausea is a protective measure during your pregnancy. This makes you less likely to eat something harmful or to expose yourself to toxins (NICE 2013).
Another factor could be that the pregnancy hormone progesterone relaxes the muscles of your digestive system, so it takes longer for food to move through your system. This could also make you more likely to feel sick and nauseous (NICE 2013).
Whatever the cause, it can be a shock to find yourself overwhelmed by morning sickness. It’s unclear why some women get it and others don’t, but there are lots of factors that can make it more likely that you’ll get it.
Risk factors for morning sickness include:
- You’re expecting your first baby.
- You’re expecting a girl.
- You’re expecting twins or triplets, as the pregnancy hormone levels will be higher.
- Your sister or mum had HG during their pregnancies.
- You suffered from HG in a past pregnancy.
- You have a history of nausea when using oestrogen-based hormonal contraceptives.
- You’re prone to travel sickness or migraines.
- You were overweight at the start of pregnancy.
- You’re young. (NHS 2015, NICE 2013)
A molar pregnancy is another risk factor for severe nausea and vomiting, although this condition is rare (NICE 2013, Harding 2016).
If you are tired or hungry your nausea may become worse (NHS 2015, NICE 2013).
Stress may make your morning sickness worse. However, severe morning sickness itself causes a lot of distress (NHS 2016).
How long will my morning sickness last?Morning sickness usually starts in early pregnancy and peaks at about nine weeks (Niebyl et al 2010). It usually improves toward the end of the first trimester, and clears up completely for many women by 16 weeks to 20 weeks of pregnancy (NHS 2015, NICE 2013, Niebyl et al 2010).
However, you may find that it doesn't clear up completely. About one woman in 10 continues to have nausea and sickness after 16 weeks to 20 weeks of pregnancy (NHS 2015, NICE 2013).
If you have pain, a fever or a headache, or nausea and vomiting for the first time after 10 weeks of pregnancy, see your doctor. These symptoms may mean you have something other than normal morning sickness (NICE 2013, RCOG 2016).
What can I do to reduce the nausea and vomiting?Try eating smaller amounts, but more often. Plain foods, such as potatoes, pasta, rice, and dry crackers, are often easier to stomach. Avoid strong smells and tastes that trigger your nausea (RCOG 2016).
Self-help measures and natural remedies include:
- foods and drinks containing ginger
- acupressure and acupuncture
These remedies are safe to try, and may help you to tolerate your sickness better, although the evidence is not strong that they actually work (Festin 2014, Matthews et al 2015, NHS 2015, NICE 2013, RCOG 2016).
Get plenty of rest – tiredness will make the nausea and vomiting worse (NICE 2013).
If nothing works, and you’re still suffering, see your doctor or midwife as soon as you can (Gadsby and Barnie-Adshead 2011, NICE 2013). They can discuss with you other ways of coping, including medication.
Where can I get help and support?Tell your partner, family and friends how you’re feeling and what you need, as they may not know how to help you.
You are ill, so there’s no need to feel guilty about asking for help with practical things like shopping, cooking and chores. You may need to tell your employer about your pregnancy and your sickness earlier than you’d like, but at least you may get the support you need.
If you had severe morning sickness with your first baby, there are things you can do to help prevent or lessen it the second time around, such as getting treatment early (Gadsby and Barnie-Adshead 2011, NHS 2016).
It can sometimes be hard to get help for morning sickness. Pregnancy books and magazines often skim over the issue, as do medical textbooks. And you may find that your doctor or midwife doesn’t have all the information you need.
However, morning sickness is very common and there is help at hand. Pregnancy Sickness Support offers information and a telephone helpline.
You can also get support and sympathy from other women suffering with sickness in your BabyCentre Birth Club. Find your BabyCentre Birth Club.
Last reviewed: January 2017
Next review: January 2020
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Festin M. 2014. Nausea and vomiting in early pregnancy. Systematic review 1405. clinicalevidence.bmj.com [Accessed January 2017]
Gadsby R, Barnie-Adshead T. 2011. Severe nausea and vomiting of pregnancy: should it be treated with appropriate pharmacotherapy? TOG 13:107–111. onlinelibrary.wiley.com [Accessed January 2017]
Harding M. 2016. Nausea and vomiting in pregnancy - including hyperemesis gravidarum. Professional reference. patient.info [Accessed January 2017]
Matthews A, Haas DM, O’Mathúna DP, et al. 2015. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev (9): CD007575. ncbi.nlm.nih.gov [Accessed January 2017]
NHS. 2015. Nausea and morning sickness. NHS Choices, Health A-Z. nhs.uk [Accessed January 2017]
NHS. 2016. Severe vomiting in pregnancy. NHS Choices, Health A-Z. nhs.uk [Accessed December 2016]
NICE. 2013. Nausea/vomiting in pregnancy. National Institute for Health and Care Excellence, Clinical Knowledge Summaries. cks.nice.org.uk [Accessed January 2017]
NICE. 2016. Antenatal care for uncomplicated pregnancies CG62. National Institute for Health and Care Excellence. nice.org.uk [Accessed January 2017]
Niebyl JR. 2010. Nausea and vomiting in pregnancy. N Eng J Med 363(16):1544-50.
PHE. 2016. PHE publishes new advice on vitamin D. Public Health England, Gov UK press release. gov.uk [Accessed April 2017]
RCOG. 2016. Pregnancy sickness (nausea and vomiting of pregnancy and hyperemesis gravidarum). Royal College of Obstetricians & Gynaecologists. Information for you. rcog.org.uk [Accessed January 2017]