What Is Morning Sickness?

Morning sickness is nausea and/or vomiting experienced during pregnancy. About eight out of 10 women experience morning sickness during pregnancy, and for many, it is the first symptom of pregnancy.

On average, most women find morning sickness to become less bothersome by somewhere around the end of the first trimester, but that change can also happen sooner or later.

Symptoms

Morning sickness begins shortly after your first missed period and usually lasts through the first trimester (12 weeks) before beginning to fade. However, some women experience it through the fifth month of gestation or even throughout the entire pregnancy.

Despite its name, morning sickness can happen any time of the day or night and include the following:

• A queasy feeling similar to being carsick or seasick
• Nausea upon waking or after meals
• On-and-off vomiting along with nausea lasting all day
• Strong aversion to certain smells and foods

Severe nausea and vomiting, especially if you can't keep down any liquids, can also result in dehydration, which can be especially harmful during pregnancy. Contact your OB-GYN if you're experiencing the following signs of dehydration:

• Passing only small amounts of urine or very dark urine
• Dizziness when you stand up
• Racing heart rate

Hyperemesis Gravidarum

Roughly one in 300 women experience an extreme form of morning sickness called hyperemesis gravidarum, which causes weight loss of 5% or greater as well as problems like malnutrition, retinal hemorrhage, and potential renal and liver damage.

Other symptoms of hyperemesis gravidarum include:

• Bad taste in the mouth
• Distinct odor to breath (ketotic odor)
• Excessive salvation (ptyalism)
• Difficulty reading (from dehydration and changes to the eye)
• Rapid heart rate
• Shivering

Severe hyperemesis gravidarum may require hospitalization to address dehydration, electrolyte imbalance, and nutrition. Since thyroid problems can lead to hyperemesis gravidarum, people with this condition are typically tested for levels of thyroid hormone.

Diagnosis

Morning sickness is easy to recognize and does not require an official diagnosis, unless symptoms severely impact daily life, begin after nine weeks of gestation, or become severe in the case of hyperemesis gravidarium.

In this case, your doctor may need to rule other causes of nausea and vomiting during pregnancy including:

Common:

• Gall stones
• Gastroenteritis
• Gastroesophageal reflux
• Migraine headaches

Less common:

• Biliary tract disease
• Drug toxicities or intolerances
• Hepatitis
• Hyperthyroidism
• Kidney stones
• Molar pregnancy
• Pancreatitis
• Peptic ulcer disease
• Preeclampsia/HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count)
• Pyelonephritis

Causes and Risk Factors

The cause of morning sickness is not yet known, but it's believed to be related to a heightened sense of smell as well as a sudden increase of the following pregnancy hormones that can slow digestion and result in nausea and vomiting:

• Cortisol
• Estrogen
• Human chorionic gonadotrophin (hCG)
• Progesterone
• Prostaglandins

Risk Factors

While anyone can experience morning sickness, research has found it's more likely in women who:

• Are expecting more than one child
• Have a history of migraines or motion sickness
• Have a history of nausea when taking estrogen birth control pills
• Have experienced morning sickness in previous pregnancies
• Have mothers who experienced morning sickness during pregnancy

Mornings Sickness and Miscarriage Risk

Although morning sickness is uncomfortable and painful, it does not put the baby at risk and does not increase the risk of miscarriage. In fact, many doctors think it is a good sign that your pregnancy is progressing well, with the placenta producing hormones to sustain the pregnancy.

One study from the National Institutes of Health found that women with a pregnancy confirmed by an hCG test with morning sickness had a reduced risk of pregnancy loss.

Sometimes pregnant women worry that if you've had morning sickness and it suddenly ends, it could be a sign of a miscarriage. Usually, that is not the case. But it does make morning sickness more challenging.

Just because some of your pregnancy symptoms have disappeared, even early in the first trimester, does not mean you have had a miscarriage. It is true that fading pregnancy symptoms can occur with a miscarriage, but symptoms can fluctuate or disappear early in a viable pregnancy as well.

If you have bleeding or cramping along with your loss of morning sickness, however, there is more reason to be concerned about miscarriage—and you should contact your physician right away. If you have no other miscarriage symptoms, chances are nothing's wrong. If you're still worried, however, you can check with your physician about it.

Some physicians might be willing to order an early ultrasound or check your hCG levels to help you feel more reassured, especially if you have had a previous missed miscarriage.

Treatment

While there's no standard treatment or magic cure for morning sickness, there are several diet modifications and medications shown to ease nausea and vomiting in pregnancy.

Diet

When it comes to keeping morning sickness at bay, it's important to consider what, when, and how much you're eating.

• Avoid foods and odors that trigger your nausea, or make it worse.
• Consider ginger tea or lollipops. Research shows that taking up to one gram of ginger daily is safe for reducing morning sickness during pregnancy.
• Drink small amounts of fluids throughout the day, and avoid drinking liquids with your meals.
• Eat 20 minutes before you get up in the morning. Consider keeping plain crackers near your bedside.
• Prevent an empty stomach by eating small, frequent meals.
• Skip greasy, spicy, or fatty foods, which can trigger the release of stomach acid and aggravate your digestive system.
• Try the BRAAT diet, which consists of bland foods like bananas, rice, applesauce, toast, and tea.

Medications

During the first trimester of pregnancy, the embryo (and later the fetus) are particularly sensitive to teratogens, or substances that can cause birth defects. Therefore, it's a good idea to limit your exposure to medications, including those taken to treat nausea and vomiting, during the first trimester.

During the first trimester, you should only take medications that your OB-GYN recommends and that you absolutely need.

Some medications your doctor might recommend include: 

• Doxylamine-pyridoxine (Diclegis, Bonjesta, and Diclectin)
• Vitamin B6 (10 to 20 mg, or an injection)
• Reflux medications (Pepcid)
• Emetrol
• Unisom Nighttime Sleep Aid (which combines vitamin B6 and doxylamine.

Antiemetics (anti-vomiting medications), antispasmodics, and antihistamines are generally avoided when treating nausea from morning sickness.

Coping

Beyond dietary changes and medications, there are several other ways to cope with morning sickness.

• Be honest. Morning sickness is nothing to be ashamed of and it's OK to ask for help or to tell your loved ones if they're doing anything to set off your gag reflexes.
• Distract yourself. Whether you get some fresh air and take a short walk or organize the baby's room, distracting yourself may help keep your mind off the nausea until it passes.
• Go the alternative route. Many women find peppermint essential oils and acupressure wrist bands, often marketed as "sea bands," to be natural, helpful ways to to relieve morning sickness. Talk to your OB-GYN about these remedies to help you better cope with nausea and vomiting.
• Stay hydrated. Especially if you're vomiting, it's important to stay hydrated. What's more, dehydration can cause nausea. Sip water throughout the day.
• Track your nausea. Do you feel queasy after you smell your partner's morning coffee, or does it happen at 3 p.m. each day? While morning sickness can seem random, tracking your symptoms may help you note some patterns or triggers you can potentially avoid.

A Word From Verywell

Take heart: While morning sickness can be a difficult symptom to cope with, it will most likely subside by the fourth month of pregnancy. Do your best to hang in there and practice self-care. Get plenty of rest and keep calm by practicing relaxation techniques like deep breathing and meditation. And, remember, as unpleasant as it can be, morning sickness is most often a good sign that your pregnancy is on the right track.