Morning Sickness: Causes, When It Starts, and How to Treat It

For some women, morning sickness is overwhelming. Others may not notice it at all.

If your days are increasingly spent with your head in the toilet bowl, you’re not alone. Read on to learn more about morning sickness, what causes it, and (most importantly) how you can manage your symptoms.

Morning sickness refers to nausea and vomiting during pregnancy (abbreviated as NVP) that affects 70–80% of expectant mothers. Usually, you won’t experience it past the first trimester, although it’s possible some symptoms may linger until you give birth. 1

Despite its name, morning sickness can strike at any time of day. Your symptoms may be worse in the morning and gradually improve, but you may also experience nausea all day long—and even at night.

Beyond nausea and vomiting, common morning sickness symptoms include: 2 3

• Feeling tired or dizzy
• Feeling disgusted by specific foods (food aversion)
• Becoming more sensitive to smells
• Excessive drooling (ptyalism)

Fortunately, most of the time, morning sickness doesn’t require medical attention, and you can manage it with a few home remedies. However, in rare cases, it’s more severe.

Morning sickness vs. hyperemesis gravidarum

An unfortunate few experience a more debilitating version of morning sickness known as hyperemesis gravidarum (HG). Fortunately, HG is much rarer, affecting around 0.3–10.8% of pregnant women. Here’s how to tell the difference: 4

• Severity: With HG, you’ll have persistent, severe nausea and vomiting (more than three times a day).
• Dehydration: You might be unable to keep down food or fluids, leading to constipation and other signs of dehydration, such as dark urine, dry skin, or lightheadedness.
• Weight loss: Losing more than 5% of your pre-pregnancy weight is a sign of severe morning sickness. Weigh yourself regularly to keep track.

If it’s left untreated, hyperemesis gravidarum can lead to electrolyte imbalances, malnutrition, and other health problems for both you and your baby.

If you suspect you may have hyperemesis gravidarum, see your doctor immediately. They may need to treat your dehydration by giving you intravenous (IV) fluids. If your nausea is too severe to eat or drink, they may also give you anti-nausea medications and nutritional support through an IV or a tube to your stomach.

How long do morning sickness symptoms last?

Morning sickness is often one of the earliest pregnancy symptoms, starting as early as four to seven weeks after your last menstrual period. It often gets more intense over the following month, and usually is at its worst around weeks 9–12, coinciding with your peak hormone levels. 1

Once you reach week 20, you’ll be able to (hopefully) breathe a sigh of relief. Most women find that their nausea disappears completely by this point. But if you’re not so lucky, you may still have to contend with your tummy turmoil throughout pregnancy. 1 5

Here are the key factors that may contribute to morning sickness:

Hormones

During early pregnancy, your body goes through many hormonal changes. Doctors point to several hormones as the primary causes of morning sickness.

• hCG: Your human chorionic gonadotropin (hCG) levels spike after conception, which may exacerbate your morning sickness. 6 You’re more likely to get severe nausea if you have higher levels of hCG, such as if you’re carrying multiple babies. 1
• Progesterone: One of your ovarian hormones—progesterone—could also play a role in your morning sickness. Progesterone affects your digestive system, resulting in heartburn, indigestion, constipation, and gas. 7
• GDF15: Other doctors point to GDF15, a hormone released by your baby. Recent research has suggested that women who suffer from severe morning sickness have abnormally high levels of GDF15. Unfortunately, there’s still a lack of research on how to safely lower your levels of GDF15 during pregnancy or how to desensitize women to this hormone. 8

These hormones may also enhance your sense of smell and make you extremely sensitive to particular scents. The result of this hyper-sensitive sense of smell is sometimes debilitating nausea. 9

Your diet

Your morning sickness might get worse if you have lower blood sugar levels. However, trying to correct this is no easy task if you can barely keep down foods or liquids.

Unfortunately, even your prenatal vitamins may cause nausea since the iron in them can upset your stomach. 10 Work with your doctor to find the right ones for you, and again, let them know if your nausea is severe enough that you can’t get adequate nutrition.

Your lifestyle (stress and exhaustion, etc.)

It probably won’t surprise you that you may experience worse morning sickness if you’re stressed or particularly tired (something that’s particularly likely if you have to travel or if work is a nightmare). Listen to your body and rest when you can.

If you just sent the remnants of your breakfast into the toilet bowl, the last thing you’re probably thinking is that this is a sign that everything’s going swimmingly.

However, having morning sickness might indicate that your body is producing healthy levels of pregnancy hormones. There’s even some research linking it to a lower risk of miscarriage.  12

That’s not to say that not having nausea is a bad sign—plenty of women have perfectly healthy pregnancies without experiencing morning sickness at all. However, if you do have it, the silver lining is that it’s a bit of extra confirmation that your pregnancy is on track.

If morning sickness is getting to you, sometimes a few simple home remedies are all that you need. Here’s what you can try out to alleviate your nausea: 13

Change your eating habits

An empty stomach may just make your nausea worse. Rather than having three large meals, try to eat five or six small pregnancy-friendly snacks throughout the day. This translates to eating every two to three hours.

You should also avoid lying down after you eat, as this can cause acid reflux and heartburn when your stomach acids travel up the esophagus. Good foods to add to your pregnancy diet when you’re feeling nauseous include:

• Bland foods: Crackers, toast, rice, and bananas are gentle on the stomach and can help settle your nausea. 9
• Cold foods: When you’re feeling especially queasy, cold foods may be more appealing (partly because they usually don’t have strong smells or tastes).
• Natural remedies: Try products made with real ginger—like tea, ginger ale, candies, or supplements. You may also find relief by sucking on peppermint candies or drinking peppermint tea. You can also suck on a slice of lemon or lime.

It’s equally important to be mindful about what you shouldn’t eat. Pay attention to foods and smells that trigger your nausea and avoid them as much as possible. Common triggers include foods that are spicy, fried, greasy, or too hot.

Brush your teeth after meals to help remove lingering tastes and smells that could trigger your nausea. (But try not to brush immediately afterward if you ate anything acidic—it’s best to wait 30 minutes to protect your teeth.) 14

For the same reason—maintaining your dental health—brushing after you vomit is also very important.

Stay hydrated

Drink plenty of water throughout the day—about 12 cups of 8 ounces each. 15 You should also hydrate with other fluids like clear broths, carbonated drinks, or ginger ale, like we just mentioned. Doctors recommend electrolyte drinks if you’re vomiting frequently. Sip your beverages slowly so you don’t upset your stomach.

Another way to stay hydrated is to eat water-packed fruits like watermelon, cantaloupe, strawberries, peaches, etc.

Consult your doctor before drinking any herbal teas, as some aren’t recommended during pregnancy.

Take your prenatal vitamins carefully

As we mentioned earlier, the iron in your prenatal vitamins can make your morning sickness worse. Try taking them before bed instead of in the morning, ideally with a little food rather than on an empty stomach. You may find that you can sleep through the discomfort instead of dealing with it while you’re trying to get through the day.

You can also cut your prenatal vitamins in half, taking one half in the morning and the other at night.

You may need to experiment with different brands of prenatal vitamins until you find one that works for you. 10 If you’re struggling with nausea, try opting for gummies instead of pills (notably, most gummies don’t contain iron).

Alternative remedies

Some people believe that wearing acupressure bands—like Sea-Bands—on your wrists may alleviate nausea by stimulating specific pressure points. Other women find relief through aromatherapy and claim that certain scents, such as lemon or peppermint, may help ease nausea.

There’s limited scientific evidence behind these methods, but there’s no harm in trying them—as long as you double-check with your doctor to ensure that they’re safe for you before using them.

Your doctor may recommend medical treatments if your home remedies aren’t cutting it. The American College of Obstetricians and Gynecologists (ACOG) recommends 10–25 mg of vitamin B6 every eight hours to help with morning sickness. 16 Your doctor will recommend the appropriate dosage for your personal situation.

They may also prescribe you combination drugs with doxylamine (an antihistamine) and B6, like Bonjesta and Diclegis. 17

In more severe cases, your doctor may prescribe anti-nausea medications. You’ll have to discuss the potential risks and benefits with your doctor, as some have been linked to potential birth defects and other issues. 18 19

Even if your doctor gives you the go-ahead, watch out for signs that you’re having a bad reaction to these medications:

• Seizures
• Diarrhea
• Rashes
• Dizziness, headaches, or lightheadedness
• Vision problems, blurred vision, or dilated pupils
• Pain in your stomach or muscles
• Dryness in your mouth, throat, or nose
• Difficulty breathing, peeing, or passing stool

Call your doctor if you experience these symptoms, or even if your medication just doesn’t help your morning sickness as you expected.

Morning sickness likely won’t be one of your fondest pregnancy memories. When you sit back after a long day spent clutching your tummy, remember that you’re not alone—many women experience this.

With the right remedies, self-care, and help from your doctor, you can enjoy a healthier, more comfortable pregnancy.