When can nausea start with pregnancy

In general, morning sickness starts around week 5 and peaks by week 9 or 10, when levels of the pregnancy hormone human chorionic gonadotropin (hCG) are highest. For most women, morning sickness fades between 14 and 20 weeks.

When does morning sickness start?

Morning sickness – also called nausea and vomiting of pregnancy – affects different expecting moms at different times (and some not at all). But it usually starts around week 5 or 6 of pregnancy. For some women, that telltale queasy feeling is one of the first giveaways that they're pregnant.

Unfortunately, morning sickness is very common. In fact, around 70 percent of pregnant women experience morning sickness in early pregnancy. In addition to nausea and vomiting, other symptoms of morning sickness include retching (dry heaving) and excessive salivation.

"Morning sickness" is a misleading term because the condition often starts in the morning and lasts all day. Some women feel better as the day wears on, but others find their symptoms get worse in the evening.

This unpleasant part of pregnancy is thought to be linked to the pregnancy hormone human chorionic gonadotropin (hCG) and estrogen. Both hormones rise rapidly in early pregnancy, and women with higher hCG levels (like moms of multiples) often have more severe morning sickness.

For some expecting moms dealing with morning sickness, it's reassuring to keep in mind that in this case, feeling crappy means that your body is doing what it's supposed to – producing hormones that support your baby's development. But plenty of women with healthy pregnancies never have morning sickness, so if you don't experience it, don't be alarmed.

Morning sickness usually isn't harmful to your health or to your growing baby, but it makes it hard to get through the day. A "mild" case can mean feeling nauseated for a short time every day and vomiting once or twice. Many women describe it as feeling "blech" all the time. Many also have specific and significant food aversions. In more serious cases, nausea lasts for several hours and vomiting happens frequently.

And in the worst cases, some women experience hyperemesis gravidarum (HG), a severe form of morning sickness that can result in weight loss, dehydration, and other complications. Women with HG throw up so often that they can't keep down enough food and fluid, and may need to be treated in the hospital with IV fluids, vitamins, and medication. (If you aren't able to keep liquids down for more than 12 hours, or solid foods down for 24 hours, call your healthcare provider.)

Because morning sickness is common in pregnancy, some providers may minimize it. And some expecting moms are reluctant to seek help, in part because they're worried about taking medications that could affect their baby. But there are safe ways to get relief from morning sickness, including changes to your diet and lifestyle, natural remedies, and medication prescribed by your provider. And many experts say that getting early help for morning sickness is important to prevent it from getting more severe. So be sure to talk to your provider if you're suffering.

When does morning sickness peak?

It varies from woman to woman, but symptoms tend to be the worst at around 9 or 10 weeks, when levels of hCG are at their highest. At 11 weeks, hCG levels start to fall, and by 15 weeks they've dropped about 50 percent from their peak.

Scientists believe that morning sickness may be the body's way of protecting your baby in early pregnancy from toxins and potentially dangerous foods. This theory makes sense because the first trimester – when most women have the strongest morning sickness – is the crucial period of development when all of your baby's organs and physical structures form.

How long does morning sickness last?

Most women get relief from morning sickness by the second trimester, between 14 and 20 weeks. But some women with morning sickness continue to have symptoms beyond that, and a few women will experience it throughout their entire pregnancy.

If your morning sickness lasts beyond 20 weeks of pregnancy, occurs for the first time after 9 weeks of pregnancy, or lessens and then returns, play it safe and let your healthcare provider know. Persistent nausea and vomiting can sometimes indicate another medical problem – or just make you miserable – so it's important to be seen and possibly treated.

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 heartbeat 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 the root of a plant that is 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 with 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 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 with 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