Morning sickness is nausea that occurs during pregnancy. The name is a misnomer, however, since morning sickness can strike at any time of the day or night.
Morning sickness affects a large proportion of pregnant women. It is most common during the first trimester, but for some women morning sickness lingers throughout pregnancy. Treatment isn't usually needed — although various home remedies, such as snacking throughout the day and sipping ginger ale, often help relieve nausea.
Rarely, morning sickness is so severe that it's classified as hyperemesis gravidarum. This type of morning sickness may require hospitalization and treatment with intravenous (IV) fluids and medications.
Morning sickness is characterized by nausea with or without vomiting. It is most common during the first trimester, sometimes beginning as early as two weeks after conception.
When to see a doctor
Contact your pregnancy care provider if:
- The nausea or vomiting is severe
- You pass only a small amount of urine or it's dark in color
- You can't keep down liquids
- You feel dizzy or faint when you stand up
- Your heart races
- You vomit blood
What causes morning sickness isn't clear, but the hormonal changes of pregnancy are thought to play a role. Rarely, severe or persistent nausea or vomiting may be caused by a medical condition unrelated to pregnancy — such as thyroid or liver disease.
Morning sickness can affect anyone who's pregnant, but it might be more likely if:
- You experienced nausea or vomiting from motion sickness, migraines, certain smells or tastes, or exposure to estrogen (in birth control pills, for example) before pregnancy
- You experienced morning sickness during a previous pregnancy
- You're pregnant with twins or other multiples
You might be more likely to experience hyperemesis gravidarum if:
- You're pregnant with a girl
- You have a family history of hyperemesis gravidarum
- You experienced hyperemesis gravidarum during a previous pregnancy
Usually, morning sickness doesn't cause complications for mother or baby.
However, if you're underweight before pregnancy and morning sickness prevents you from gaining a healthy amount of weight during pregnancy, your baby may be born underweight. Rarely, frequent vomiting may lead to tears in the tube that connects the mouth to the stomach (esophagus).
Morning sickness can usually be addressed during routine prenatal appointments.
What you can do
To prepare for your appointment:
- Write down any symptoms you're experiencing. Include all of your symptoms, even if you don't think they're related.
- Make a list of any medications, vitamins and other supplements you take. Write down doses and how often you take them.
- Have a family member or close friend accompany you, if possible. You may be given a lot of information at your visit, and it can be difficult to remember everything.
- Take a notebook or notepad with you. Use it to write down important information during your visit.
- Think about what questions you'll ask. Write them down, listing the most important questions first.
Some basic questions to ask about morning sickness include:
- What's likely causing my symptoms?
- Will I have nausea and vomiting throughout my entire pregnancy?
- Are there any medications I can take to help with my symptoms?
- Does my condition pose any risk to my baby?
- What self-care measures do you recommend trying?
Don't hesitate to ask follow-up questions as they occur to you during your appointment.
What to expect from your doctor
Some potential questions your doctor or pregnancy care provider might ask include:
- How long have you been experiencing symptoms?
- How often do you experience bouts of nausea or vomiting?
- How severe are your symptoms?
- Do you notice certain triggers for your nausea or vomiting?
- Do you experience your symptoms at certain times during the day or all the time?
- Are you taking a prenatal vitamin? Do you regularly take any other medications?
- What, if anything, makes you feel better?
- What, if anything, makes you feel worse?
Morning sickness is typically diagnosed based on your signs and symptoms. If your pregnancy care provider suspects hyperemesis gravidarum, you may need various urine and blood tests. Your pregnancy care provider may also do an ultrasound to confirm the number of fetuses and detect any underlying conditions that may be contributing to the nausea.
Treatment isn't necessary for most cases of morning sickness. If your morning sickness symptoms persist, however, your pregnancy care provider may prescribe vitamin B-6 supplements, antihistamines and possibly anti-nausea medications.
If you have severe morning sickness, your doctor might talk to you about medication to treat it. The combination of doxylamine and pyridoxine (Diclegis) has been approved by the Food and Drug Administration for treating nausea in pregnancy. Drowsiness can occur with this medicine, so it's important to avoid activities that require mental alertness, such as driving, when taking it.
If you have hyperemesis gravidarum, you may need to be treated with intravenous (IV) fluids and anti-nausea medications in the hospital.
To help relieve morning sickness:
- Choose foods carefully. Select foods that are high in carbohydrates or protein, low in fat, and easy to digest. Salty foods are sometimes helpful, as are foods that contain ginger — such as ginger lollipops. Avoid greasy, spicy and fatty foods.
- Snack often. Before getting out of bed in the morning, eat a few soda crackers or a piece of dry toast. Nibble throughout the day, rather than eating three larger meals. An empty stomach may make nausea worse.
- Drink plenty of fluids. Sip water or ginger ale. It may also help to suck on hard candy, ice chips or ice pops.
- Pay attention to nausea triggers. Avoid foods or smells that seem to make your nausea worse.
- Breathe fresh air. Weather permitting, open the windows in your home or workplace. Take a daily walk outdoors.
- Take care with prenatal vitamins. If you feel queasy after taking prenatal vitamins, take the vitamins at night or with a snack. It may also help to chew gum or suck on hard candy after taking your prenatal vitamin. If these steps don't help, ask your pregnancy care provider about other ways you can get the iron and vitamins you need during pregnancy.
Various alternative remedies have been suggested for morning sickness, including:
- Acupressure. Acupressure wristbands are available without a prescription in most pharmacies. Although acupressure wristbands haven't been found to be more effective than sham therapies, some women seem to find the wristbands helpful.
- Acupuncture. Acupuncture involves inserting hair-thin needles into your skin. Acupuncture isn't a proven way to treat morning sickness, but some women seem to find it helpful.
- Ginger. Herbal ginger supplements seem to alleviate morning sickness for some women. Most research suggests that ginger can be used safely during pregnancy, but there's some concern that ginger may affect fetal sex hormones.
- Hypnosis. Although there's little research on the topic, some women have found relief from morning sickness through hypnosis.
- Aromatherapy. Although there is also little research on the topic, certain scents, normally created using essential oils (aromatherapy), can help some women deal with morning sickness.
Check with your pregnancy care provider before using any herbal remedies or alternative treatments to relieve morning sickness.
There's no proven way to prevent morning sickness. Before conception, however, it may help to take prenatal vitamins. Several older studies suggest that women who take multivitamins at the time of conception and during early pregnancy are less likely to experience severe morning sickness. The folic acid in prenatal vitamins also helps prevent neural tube defects, such as spina bifida.
Sept. 18, 2014
- Smith JA, et al. Treatment and outcomes of nausea and vomiting of pregnancy. http://www.uptodate.com/home. Accessed July. 10, 2014.
- American College of Obstetrics and Gynecology (ACOG) Committee on Practice Bulletins — Obstetrics. ACOG Practice Bulletin No. 52. Nausea and vomiting of pregnancy. Obstetrics and Gynecology. 2004;103:803.
- Frequently asked questions. Pregnancy FAQ126. Morning sickness. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq126.pdf?dmc=1&ts=20140710T1203324342. Accessed July 10, 2014.
- AskMayoExpert. What medications can be used if lifestyle modification is not effective for nausea and vomiting in pregnancy? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2013.
- Creasy RK, et al. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2014. http://www.clinicalkey.com. Accessed July 10, 2014.
- Goodwin TM. Hyperemesis gravidarum. Obstetrics and Gynecology Clinics of North America. 2008;35:401.
- Ginger. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed July 17, 2014.
- Acupressure. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed July 17, 2014.
- Maltepe C, et al. The management of nausea and vomiting of pregnancy and hyperemesis gravidarum — a 2013 update. Journal of Population Therapeutics and Clinical Pharmacology. 2013;20:e184.
- Slaughter SR, et al. FDA approval of doxylamine-pyridoxine therapy for use in pregnancy. New England Journal of Medicine. 2014;370:1081.
- Czeizel AE, et al. The effect of periconceptional multivitamin-mineral supplementation on vertigo, nausea and vomiting in the first trimester of pregnancy. Archives of Gynecology and Obstetrics. 1992;251:181.
- Emelianova S, et al. Prevalence and severity of nausea and vomiting of pregnancy and effect of vitamin supplementation. Clinical and Investigative Medicine. 1999;22:106.
- Gabbe SE, et al. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed July 10, 2014.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. July 10, 2014.
- Refruezo JS, et al. Clinical features and evaluation of nausea and vomiting of pregnancy. http://www.uptodate.com/home. Accessed July 10, 2014.
- Diclegis (prescribing information). Bryn Mawr, Penn.: Duchesnay Inc., 2013. http://www.diclegis.com/pdf/Diclegis_Full_Prescribing_Information.pdf. Accessed July 10, 2014.
- FDA approves Diclegis for pregnant women experiencing nausea and vomiting. U.S. Food and Drug Administration. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm347087.htm. Accessed July 10, 2014.
- Murry MM (expert opinion). Mayo Clinic, Rochester, Minn. July 27, 2014.
- Parisa Y, et al. The effect of lemon inhalation aromatherapy on nausea and vomiting of pregnancy: A double-blinded, randomized, controlled clinical trial. Iranian Red Crescent Medical Journal. 2014;16:e14360.
- Pasha H, et al. Study of the effect of mint oil on nausea and vomiting during pregnancy. Iranian Red Crescent Medical Journal. 2012;14:727.