During early pregnancy, it is common to experience nausea and vomiting. This is often referred to as morning sickness, but symptoms can occur at any time of the day.
Hormone levels increase in the first 3 months to help maintain the pregnancy, but these increases can make you feel sick or throw up. Most women feel better by 12–16 weeks, but a few women may continue to have symptoms until their baby is born.
Normal morning sickness won't harm your baby's health as long as you are able to keep food down, eat a well-balanced diet and drink plenty of fluids. However, if you are pregnant and experience nausea and vomiting that is severe and ongoing, you should see your midwife or doctor.
What are the symptoms of morning sickness?
Symptoms can occur at any time of the day and often include:
- nausea (feeling sick)
- vomiting (being sick)
- dry retching (like vomiting, but nothing is thrown up)
- food smell or sight sensitivity (certain smells or the sight of some foods can trigger nausea).
Not everyone experiences morning sickness in the same way.
- You may have only occasional queasy moments while others feel nauseous and sick almost constantly but never vomit.
- You may vomit now and again, while others vomit more frequently and feel better afterwards.
- Sometimes the nausea and vomiting are severe and ongoing. You can't keep down fluids or food, causing you to lose weight and become dehydrated. This is called hyperemesis gravidarum and occurs in less than 2% of pregnant women (2 in every 100 pregnant women). Read more about hyperemesis gravidarum.
When to see a doctor for morning sickness
If you are vomiting and can’t keep any food or drink down, there is a chance that you could become dehydrated or malnourished. Contact your GP or midwife immediately if you:
- have very dark-coloured urine (pee) or do not pee for more than 8 hours
- can't keep food or fluids down for 24 hours
- feel severely weak, dizzy or faint when standing up
- have abdominal (tummy) pain
- have a high temperature (fever) of 38°C (100.4°F) or above
- vomit blood
- have pain when passing urine or any blood in your urine (this may be a urine infection).
What causes morning sickness?
The exact cause of morning sickness is unclear, but the symptoms are thought to be due to a combination of factors such as:
- high levels of pregnancy hormones, in particular, human chorionic gonadotrophin (hCG) and oestrogen
- fluctuations in blood pressure, particularly lowered blood pressure
- altered metabolism of carbohydrates
- the enormous physical and chemical changes that pregnancy triggers.
Morning sickness may be more likely to happen:
- when you have an empty stomach
- if you are stressed or anxious
- if you experience strong smells.
What increases my risk of morning sickness?
You are more likely to develop morning sickness if:
- it is your first pregnancy
- you experienced nausea and vomiting in a previous pregnancy
- your unborn baby is a girl
- you have a family history of nausea in pregnancy
- you have a history of travel or motion sickness
- you get nausea when using contraceptives
- your BMI is 30 or higher
- you have a multiple pregnancy, such as twins or triplets.
Self-care – what can you do to feel better?
Tips to manage morning sickness:
- Try eating a bland, protein-rich diet.
- Eating 5 to 6 small meals a day can help.
- Have something to eat before getting out of bed in the morning (toast, cracker).
- Try eating a light snack high in protein and complex carbs (a banana muffin and a glass of milk, cheese and a handful of dried apricots) just before you go to sleep. You are less likely to be hungry in the morning.
- Avoid foods that are fatty or make you feel nauseous.
Fluids and hydration
- Keep yourself well hydrated.
- If you find it difficult to drink water, try sucking on crushed ice.
- Many women find icy cold fluids easier to get down.
- Small frequent sips of water, between meals, are easier to keep down.
- You can also keep yourself hydrated by drinking soups, smoothies and shakes.
- Ginger taken as ginger tea, ginger-containing foods or ginger capsules (from a pharmacy) may help calm your tummy.
- Studies have shown that eating about 1 gram of ginger per day for at least 4 days can reduce nausea and vomiting in early pregnancy.
Vitamin B6 (pyridoxine)
- Bananas, potatoes, watermelon and chickpeas are all rich in this nutrient. Talk to your lead maternity carer about taking vitamin B6 supplements.
Exercise and fresh air
- Keep active – regular, gentle exercise helps.
- Getting fresh air may help you feel better. Take a short walk, turn on a fan, or try to sleep with the window open.
- When you are cooking, open windows to get rid of smells that may cause nausea.
- Do not smoke cigarettes. Ask other people not to smoke around you.
Rest and relaxation
- Get enough sleep, take rests if needed and avoid getting over tired.
- Don't try to maintain the same schedule or level of activity as you did before your pregnancy.
- Avoid stress and try stress-reduction techniques, like meditation.
- Wear comfortable clothes without tight waistbands.
Brushing your teeth
- Delay brushing your teeth in the morning if you find it makes you sick. Instead, wait to brush until your stomach feels more settled.
- Also, wait about half an hour after eating to brush your teeth.
Acupressure bracelets or acupuncture
- Try sea-sickness acupressure bracelets or acupuncture. Some women find these helpful and there does not appear to be evidence of harm.
- Effects of ginger for nausea and vomiting in early pregnancy: a meta-analysis. J Am Board Fam Med. 2014 Jan-Feb;27(1):115-22.1.