Nausea and vomiting in pregnancy

Morning sickness is nausea, with or without vomiting, in early pregnancy. It is very common, it can last all day, and it usually eases by week 14.

What it is

Morning sickness is nausea, with or without throwing up, in early pregnancy. The name is wrong. It can hit any time of day, and for many mothers it lasts all day. About 7 in 10 pregnant women feel nauseous. About half vomit at some point.

Nobody knows the exact cause. Rising hormones, especially hCG and estrogen, are the usual suspects. A hormone called GDF15, made by the placenta, got attention in 2023 research as a likely driver. A slower gut and a sharper sense of smell add to it.

It is more common with twins, with a first pregnancy, and if your mother or sister had it. It is not a sign that anything is wrong. Some studies link nausea to a lower miscarriage rate. Having none is also normal.

What's typical

Nausea often starts around week 6. It peaks around weeks 8 to 10 and eases by week 12 to 14 for most mothers. About 1 in 10 still feel sick past week 20. A small number feel sick until birth. Smells, an empty stomach, heat, and tiredness all make it worse. Many mothers can only face a few foods, and those foods change by the week. Losing a pound or two is common. Losing more than about 5 percent of your weight is not, and that is when to call.

What's known

ACOG calls nausea and vomiting of pregnancy one of the most common reasons for early prenatal visits. Ginger has some trial support for mild nausea. Vitamin B6, alone or with an antihistamine, is the first thing ACOG lists when a provider is asked for medicine; ask what they suggest. Acupressure bands at the wrist help some mothers and have little downside. In Chinese medicine, nausea is read as stomach energy rising, and warm ginger and small warm meals are the usual answer. Many cultures say the same thing in different words: eat small, eat warm, eat often.

What helps

Eat before you get out of bed. Crackers, dry cereal, or a few nuts by the bed are an old trick that still works for many.
Small amounts, often. An empty stomach is worse than a full one. Protein with each bite tends to hold longer than plain carbs.
Cold foods smell less. Try fruit, yogurt, cold potatoes, or a sandwich when hot food turns your stomach.
Sip, do not gulp. Ice chips, popsicles, and sour drinks go down easier for many mothers.
Ask someone else to cook, open the fridge, or take out the trash. Smell is the trigger you can hand off.
Sleep when you can. Tired makes nausea worse, and nausea makes tired worse.

When to call someone

Nowyou cannot keep any fluids down for 24 hours, you are dizzy or fainting, or you have not peed in 8 hours.
Todayyou are vomiting more than three or four times a day, you have lost 5 pounds or more, or there is blood in what comes up.
Todaybelly pain, fever, or vomiting that starts for the first time after week 10.
At your next visitnausea that keeps you from working or caring for your family. There are options, and you do not have to wait it out.

Who helps

OB-GYNMidwifeRegistered dietitian

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Sources

American College of Obstetricians and Gynecologists — Practice bulletin on nausea and vomiting of pregnancy
HER Foundation — Patient information on nausea and vomiting of pregnancy
NHS — Vomiting and morning sickness in pregnancy

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