What causes nausea and vomiting in pregnant women? Is it a good thing? Learn about the different types, risk factors, and treatments for managing nausea and vomiting during pregnancy.

Understanding Nausea and Vomiting in Pregnancy

Nausea and vomiting, commonly known as “morning sickness,” is a normal and common symptom experienced by up to 70% of pregnant women, typically during the first trimester. This condition, also referred to as Nausea and Vomiting in Pregnancy (NVP), is often considered a good sign, as it is associated with a healthy pregnancy and a reduced risk of miscarriage.

Causes of Nausea and Vomiting During Pregnancy

The exact cause of NVP is not fully understood, but it is believed to be related to the hormonal changes that occur during pregnancy. Specifically, the rapid increase in human chorionic gonadotropin (hCG) and estrogen levels may contribute to the nausea and vomiting experienced by pregnant women.

Types of Nausea and Vomiting in Pregnancy

While morning sickness is a common and manageable form of NVP, some women may experience a more severe condition called hyperemesis gravidarum. Hyperemesis gravidarum is characterized by persistent and severe vomiting, leading to dehydration, electrolyte imbalances, and significant weight loss. This condition affects approximately 3 in 100 pregnancies and requires medical attention.

Risk Factors for Severe Nausea and Vomiting

Certain factors can increase the likelihood of a pregnant woman experiencing more severe symptoms of NVP, including:

• Multiple pregnancy (twins or triplets)
• Previous history of severe nausea and vomiting during pregnancy
• Family history of severe nausea and vomiting during pregnancy
• Personal history of motion sickness or migraines
• Pregnancy with a female fetus

Treating Nausea and Vomiting in Pregnancy

The treatment for NVP depends on the severity of the symptoms. For mild cases of morning sickness, simple dietary and lifestyle changes, such as eating smaller meals, avoiding trigger foods, and getting enough rest, may be sufficient. In more severe cases, a healthcare provider may recommend the use of vitamin B6 and doxylamine or prescribe antiemetic medications to help control the nausea and vomiting.

Alternative Treatments for NVP

Some pregnant women may also find relief from nausea and vomiting through alternative treatments, such as acupuncture, acupressure, or acustimulation. However, it is important to consult with a healthcare provider before trying these methods to ensure they are safe and effective during pregnancy.

Preventing Food-Related Illnesses During Pregnancy

Pregnant women are at a higher risk of developing foodborne illnesses, as their immune system is weaker, and the fetus’s immune system is not yet fully developed. To minimize the risk of food poisoning, pregnant women should avoid certain foods, such as:

• Unwashed fruits and vegetables
• Raw or undercooked eggs
• Unpasteurized milk and cheese
• Raw fish

It is important for pregnant women to research and follow a comprehensive list of foods to avoid to protect themselves and their unborn child from foodborne illnesses.

Seeking Medical Attention for Nausea and Vomiting

While nausea and vomiting are common during pregnancy, it is important for pregnant women to seek medical attention if they experience persistent or severe symptoms, such as:

• Vomiting more than three to four times a day
• Feeling nauseated almost constantly
• Losing a substantial amount of pre-pregnancy body weight
• Becoming dehydrated

These symptoms may indicate a more serious condition, such as hyperemesis gravidarum, which requires prompt medical intervention to ensure the health and well-being of the mother and the developing baby.

Conclusion

Nausea and vomiting, or morning sickness, are normal and common occurrences during pregnancy, affecting up to 70% of pregnant women. While the exact cause is not fully understood, it is believed to be related to the hormonal changes that occur during pregnancy. In most cases, morning sickness is manageable with simple dietary and lifestyle changes. However, in some instances, more severe forms of nausea and vomiting, such as hyperemesis gravidarum, may require medical intervention. Pregnant women should be aware of the risk factors for severe NVP and take steps to prevent foodborne illnesses to ensure a healthy pregnancy.

Vomiting in pregnancy: Causes and treatments

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Vomiting is a normal symptom of pregnancy that people typically refer to as morning sickness. Occasionally, there are other causes of vomiting that require medical attention.

Vomiting is one of the most common symptoms of pregnancy. Approximately 70% of pregnant women experience nausea or vomiting during the first trimester, however it can last throughout pregnancy.

However, not all vomiting and nausea during pregnancy are due to morning sickness. In some cases, more serious underlying causes are to blame.

Vomiting in pregnancy is normal. People reportedly described the condition, also known as NVP (nausea and vomiting in pregnancy), as early as 2000 BCE.

Although there is no clear reason for NVP, one theory is that it is due to hormonal changes that a women undergoes during pregnancy.

Despite being commonly known as morning sickness, NVP can happen at any time of the day or night. These symptoms are often limited to the first trimester, but they can occasionally extend throughout the pregnancy, including in the third trimester.

Standard morning sickness usually starts before 9 weeks of pregnancy. Women typically feel nauseated for a short time each day and may vomit once or twice a day.

Hyperemesis gravidarum affects about 3 in 100 pregnancies and causes extreme and excessive vomiting and nausea. Whereas morning sickness is manageable, hyperemesis gravidarum is much more severe. Symptoms include:

• vomiting more than three to four times a day
• feeling nauseated almost constantly
• losing a substantial amount of prepregnancy body weight
• dehydration

Although the cause of morning sickness is not fully understood, certain risk factors increase the likelihood of a person experiencing more severe symptoms:

• having a multiple pregnancy, i.e., twins or triplets
• having had a previous pregnancy with nausea and vomiting
• having a family history of severe nausea and vomiting during pregnancy
• having a personal history of motion sickness or migraine
• being pregnant with a female fetus

NVP during pregnancy can also occur due to certain medical conditions, including:

• an ulcer
• food-related illness
• thyroid disease
• gallbladder disease

Food poisoning

Food-related illnesses, also known as food poisoning, occur from eating food or drinking water containing harmful substances, such as:

• bacteria
• parasites
• viruses
• certain chemicals

Pregnant women are at higher risk than others of food-related illnesses because their immune system is weaker. In addition to this, the fetus’s immune system is not yet strong enough to fight the germs.

Along with nausea and vomiting, foodborne illness can cause the following symptoms:

• fever
• headache
• body aches
• diarrhea
• abdominal cramps
• dehydration

To minimize their risk of food poisoning, pregnant women should avoid certain food products, including:

• unwashed fruits and vegetables
• raw or undercooked eggs
• unpasteurized milk
• unpasteurized cheese
• raw fish

It is advisable to research a full list of foods to avoid to limit the risks of food-related illness as much as possible. Learn more about food poisoning here.

Both the cause and the severity of NVP usually determine the treatment. It can be as simple as making a few dietary amendments or as serious as receiving nutrients and fluid intravenously at the hospital.

Some medical treatments include:

• Vitamin B-6 and doxylamine: Both of these are safe to take individually or together during pregnancy, as they have no harmful effects on the fetus.
• Antiemetic drugs: These drugs prevent vomiting, and a doctor may prescribe them if the above combination does not work.

It is important to seek medical advice before trying the following treatments, which some say can help relieve NVP:

• Acupuncture: This form of alternative medicine involves the insertion of thin needles into specific points on the skin. It is best to choose a practitioner who has trained to work with pregnant women.
• Acupressure and acustimulation: These techniques involve putting pressure on or stimulating certain points of the body, called pressure points, to help prevent nausea.

Normal morning sickness is nothing to worry about and does not warrant a visit to the doctor.

However, severe morning sickness could be hyperemesis gravidarum. If hyperemesis gravidarum seems likely, it is important to see a doctor as soon as possible, as it can have serious complications and require medical treatment.

Pregnant women should see a doctor if any of the following symptoms occur:

• weight loss of more than 2 pounds
• inability to keep foods and fluids down
• being tired or confused
• blood in the vomit

Sickness during pregnancy usually does not harm either the pregnant woman or the developing fetus.

Medical treatment is only necessary when the cause is something else, such as food poisoning or hyperemesis gravidarum.

Anyone with concerns about vomiting during pregnancy should see a doctor to rule out causes other than morning sickness.

Morning sickness | March of Dimes

Morning sickness is when you have nausea and vomiting during pregnancy. Even though it’s called morning sickness, it can happen any time of day.

Morning sickness usually starts at about 6 weeks of pregnancy and goes away in the second trimester.

Lots of pregnant women have morning sickness. It usually doesn’t cause harm to you or your baby.

Hyperemesis gravidarum is severe nausea and vomiting that needs treatment (sometimes in a hospital) to help you get better.

If your morning sickness is severe or if it goes into your fourth month of pregnancy, tell your health care provider right away.

What is morning sickness?

Morning sickness (also called nausea and vomiting of pregnancy) is nausea (feeling sick to your stomach) and vomiting that happens in the first few months of pregnancy. Even though it’s called morning sickness, it can last all day and happen any time of day.

At least 7 in 10 pregnant women have morning sickness in the first trimester (first 3 months) of pregnancy. It usually starts at about 6 weeks of pregnancy and is at its worst at about 9 weeks. Most women feel better in their second trimester, but some have morning sickness throughout pregnancy. If you have morning sickness, tell your health care provider.

Mild morning sickness doesn’t harm you or your baby. But if nausea and vomiting becomes severe (called hyperemesis gravidarum), it can cause serious problems during pregnancy. You may need to stay in the hospital for treatment.

What is hyperemesis gravidarum?

About 3 in 100 women may have hyperemesis gravidarum. This is extreme, excessive nausea and vomiting during pregnancy. It can cause you to lose weight and become dehydrated (not have enough water in your body). It can start early in pregnancy and last the entire pregnancy. If you have hyperemesis gravidarum, you need treatment to help keep you and your baby safe.

You may be at risk for hyperemesis gravidarum if you:

• Are pregnant for the first time.
• Are pregnant with a girl.
• Are pregnant with multiples (twins, triplets or more). Being pregnant with more than one baby may increase your risk for severe morning sickness because you may have a large placenta and increased pregnancy hormones. The placenta grows in your uterus (womb) and supplies your babies with food and oxygen through the umbilical cord.   
• Had mild or severe morning sickness in a previous pregnancy, or your mother or sister had severe morning sickness during pregnancy. Take your family health history to help you find out about health conditions that run in your family. 
• Have motion sickness or migraines. A migraine is a severe headache that may make you sensitive to bright lights and sound.
• Are overweight.
• Have trophoblastic disease, a condition that leads to abnormal cell growth in the uterus (womb).

Signs and symptoms of hyperemesis gravidarum include:

• Vomiting more than 3 to 4 times a day
• Vomiting that makes you dizzy or lightheaded
• Vomiting that makes you dehydrated. Signs and symptoms of dehydration include feeling thirsty, dry mouth, a fast heart beat or making little to no urine.
• Losing more than 10 pounds in pregnancy

If you have hyperemesis gravidarum, your provider may treat you with medicine to help relieve your nausea and vomiting. You may need treatment in a hospital with intravenous (also called IV) fluids. IV fluids go through a needle into your vein. They help you stay hydrated and can give you nutrients that you usually get from food. If you continue to lose weight, you may need a feeding tube to make sure you’re getting enough nutrients for you and your baby.

What causes morning sickness? 

We don’t know for sure what causes morning sickness. It may be caused by low blood sugar or increased pregnancy hormones. Morning sickness may be worse if you’re stressed or overly tired, if you eat certain foods or if you’re traveling (if you often have motion sickness).

Can you prevent or relieve morning sickness?

Yes. Here’s what you can do to help you feel better and even prevent morning sickness:

• Take a prenatal vitamin before you get pregnant. Talk to your health care provider about which one to take. Sometimes vitamins can upset your stomach, so take it with a snack.
• Keep snacks by your bed. Eat a few crackers before you get up in the morning to help settle your stomach. 
• Eat 5 or 6 small meals each day instead of 3 larger meals. 
• Eat foods that are low in fat and easy to digest, like cereal, rice and bananas. Don’t eat spicy or fatty foods.
• Eat healthy snacks between meals. This can help keep your stomach from being empty and helps prevent nausea. Try snacks that are high in protein, like milk or yogurt.
• Drink plenty of fluids, especially water. 
• Avoid smells that upset your stomach. 

You may have heard about these ways to prevent or relieve morning sickness. Talk to your provider before trying any of these:

• Acupressure and acustimulation (also called electrical nerve stimulation) wristbands. These involve putting pressure on or stimulating certain points of the body (called pressure points) to help prevent nausea.  
• Acupuncture. This is a kind of treatment in which thin needles are put into your skin. If you’re thinking about acupuncture to help with morning sickness, tell your provider and find an acupuncturist who is trained to work with pregnant women.
• Ginger. Ginger is an herb (plant) used in cooking and medicine. Ginger ale, tea or candies may help relieve morning sickness.

Even if it’s legal where you live for either personal or medical use, it’s not safe to use marijuana to treat morning sickness. No amount of marijuana has been proven safe to use during pregnancy. If you’re thinking of using marijuana to help with morning sickness, talk to your provider about other treatments that are safer for your baby. 

Is there medical treatment for morning sickness?

Yes. If you can’t relieve morning sickness on your own or if you have severe nausea and vomiting of pregnancy, your provider may treat you with these medicines:

• Vitamin B6 and doxylamine. Your provider may treat you with these medicines separately or together. You can get vitamin B6 and doxylamine over-the-counter (OTC), which means you don’t need a prescription for them from your provider. Doxylamine is found in some OTC sleep aids (medicines that help you sleep). Or your provider may prescribe you a medicine that combines them.
• Antiemetic drugs. These are drugs that help prevent vomiting. If Vitamin B6 and doxylamine don’t work, your provider may prescribe an antiemetic drug for you. Not all are safe to use during pregnancy, so talk to your provider to make sure the medicine is a good choice for you.

Talk to your provider before you take any medicine during pregnancy, even medicine to help treat morning sickness.

When should you call your health care provider about morning sickness?

For most women, morning sickness is mild and goes away over time. But call your provider if:

• Your morning sickness continues into your 4th month of pregnancy.
• You lose more than 2 pounds.
• Your vomit is brown in color or has blood in it. If so, call your provider right away.
• You vomit more than 3 times a day and can’t keep food or fluids down.
• Your heart beats faster than usual.
• You’re tired or confused.
• You’re making much less urine than usual or no urine at all.

Last reviewed: September, 2020

Second trimester of pregnancy (from 13 to 28 weeks)

The beginning of the second trimester is traditionally considered one of the calmest. Walk more. Walking is very helpful. Sit down to rest only when you are tired. Movement in the fresh air improves the supply of oxygen to the fetus, which is very necessary for its normal development.

Nausea disappears, appetite improves. Do not eat a lot of salty, refuse marinades, smoked meats, if you have not done this before. The increased need of the child’s body for proteins and vitamins begins. The daily diet should include meat or fish (boiled or stewed), dairy products, especially cottage cheese, eggs. Do not forget about vegetables, fruits, greens. An excellent source of vitamin C is sauerkraut (rather than salted) cabbage. Salads from carrots, cabbage, beets, apples, green radish should be on your table every day.

At 17-20 weeks you will feel your baby’s first kicks. From them you can determine how comfortable the baby feels. Intense tremors are a signal of lack of oxygen. Maybe you haven’t walked for a long time or, on the contrary, you are engaged in hard physical labor. Get out into the fresh air or lie down to rest and you will immediately feel how the child has calmed down.

But the lack of movement is an alarm. See a doctor immediately!

The fetal need for calcium sharply increases – intensive growth of the skeleton has begun. If you don’t have enough free calcium in your body right now, you could lose your teeth. To prevent this from happening, start taking calcium supplements in consultation with your doctor.

At this time, toxicosis of the second half of pregnancy may occur, the child suffers greatly from it. Therefore, if the doctor suggests hospitalization, do not refuse. Toxicosis can, if not be avoided, then at least reduce its manifestations. Be sure to follow your diet. Completely exclude salty, smoked, fried, spicy, canned food, chocolate. Do not eat a lot of grapes and drink fresh milk. Limit flour and rich products. As before, your diet should include boiled meat and fish, oatmeal and buckwheat porridge, vegetables and fruits

Periodically, once a week, check for fluid retention in the body. It is allowed to release liquid 200-300 ml less than what was drunk. If little urine is released, this is a signal of latent edema and the onset of toxicosis.

It is very good if you can measure your blood pressure at home. Show the results of measurements at the next visit to the doctor. Both high and too low pressure should alert. With low pressure, blood sluggishly crosses the placenta, and the baby does not receive enough nutrients.

Do not neglect blood tests – it is important not to miss the development of anemia. In this case, you will be prescribed iron-containing drugs and multivitamins. The diet should include beef liver, tomato juice, buckwheat porridge, apples, preferably Antonovskie (they contain more iron than other varieties).

Women who are at risk of giving birth to a child with a genetic pathology (those who have severe hereditary ailments in their families), as well as women over 35 years old (they have an increased likelihood of having a child with Down syndrome) are referred for a consultation by a geneticist.

In case of a normal pregnancy at 20-22 weeks of pregnancy, a second scheduled ultrasound examination is prescribed.

Why do pregnant women feel sick? – October 18, 2007

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All news However, many women, being in a position, do not feel the best way – they often feel sick! Nausea is the main symptom of early toxicosis and a constant companion of many expectant mothers.

Shortly after conception, a woman’s body undergoes significant changes – the body adapts to support the growing fetus. The uterus expands, the production of hormones increases. Usually, most expectant mothers suffer from nausea and vomiting as early as the sixth week of pregnancy. Remember that there are benefits to your suffering! Doctors believe that early toxicosis regulates the hormonal balance in the body of a pregnant woman: nausea and vomiting provide a low level of the hormone, which the fetus does not need at the moment. Rejecting everything unnecessary, the body consumes only the most necessary for the development of the child.

In addition to nausea and vomiting, symptoms of early toxicosis are excessive salivation, decreased appetite, lowering blood pressure and increased sense of smell. The expectant mother at this time may have strange eating habits. Pregnant women often experience dizziness. This is due to the expansion of blood vessels that are not filled with enough blood. In most cases, morning sickness disappears by the fourth month of pregnancy.

Women prone to migraines and motion sickness experience morning sickness more acutely than others. Toxicosis more often affects women with diseases of the gastrointestinal tract, thyroid gland and liver. Improper nutrition, nervous tension and stress, smoking and alcohol abuse before pregnancy also affect its occurrence.

Expectant mothers often worry that morning sickness will harm their baby. However, there is no cause for concern if a woman drinks a lot of fluids daily and absorbs at least a small amount of food. Some even manage to maintain their weight during this period, but after the symptoms of morning sickness disappear, the appetite returns.

However, if vomiting occurs up to 20 times a day and severe weight loss occurs, urgent medical attention is required. Hyperemesis (excessive vomiting) of pregnancy is a common condition when a woman does not absorb any food and drink. This can often lead to a dangerous situation that can lead to dehydration and electrolyte imbalance. Women who are faced with this problem should definitely go to the hospital, where doctors will ensure careful monitoring of the expectant mother and the growing fetus.

Although morning sickness is referred to as morning sickness, these symptoms can occur at any time of the day. In most cases, pregnant women experience nausea almost immediately after getting up in the morning. Prepare a glass of water and a couple of crackers in the evening by the bed. Or let your husband bring you dry toast in bed – eat it without getting up, then you don’t have to immediately run to the toilet.

In order to have food in the stomach all the time, it is better to take small snacks at short intervals. But don’t force yourself to eat when you don’t feel like it! Eliminate chocolate, pickles, fried foods and all indigestible foods from your diet. Drink plenty of fluids to help your body deal with the dehydration caused by vomiting. Cranberry juice, chamomile tea, green tea with lemon, rosehip infusion or just water with honey and lemon juice are especially useful for toxicosis.

Don’t forget to take your vitamins! Now vitamin B6 and ascorbic acid are especially important for you. Do some light exercise every day, such as walking or yoga. This stimulates blood circulation. Avoid tobacco smoke. You can also be troubled just in a warm room – regular ventilation and fresh air will add, and you will get rid of unpleasant odors.

To stop a sudden attack of nausea, have on hand salted crackers, nuts, dried fruits, lemon, tangerine, mints or chewing gum, caraway seeds (choose what works for you).