When does throwing up start during pregnancy

Morning sickness can start very early for some women. About one in five women get nausea soon after they conceive, while about one in 30 start vomiting too.

But it's more usual to first experience nausea when you're five weeks or six weeks pregnant. If you don’t feel queasy in the early weeks, you may miss morning sickness altogether.

You may start to feel sick as soon as you wake up. But although it's called morning sickness, nausea can strike at any time of the day or night.

Certain smells may set off your nausea. Tiredness can also leave you feeling sick, so you may feel worse later in the day. Things that made you feel sick before you became pregnant may feel more nauseating now.

The sickness you feel is thought to be connected to the hormones human chorionic gonadotrophin (hCG) and oestrogen. These hormones are produced by your body in large quantities until the placenta has grown enough to take over nourishing your baby.

Pregnancy hormones are likely to be higher, and sickness worse as a result, if you're expecting a girl, or twins or triplets

If your morning sickness is severe, you may feel very sick and be vomiting often. The most severe form of morning sickness is hyperemesis gravidarum (HG), which means excessive vomiting during pregnancy.

If you can't eat or drink anything without being sick, and are vomiting many times a day, you may have HG. HG can cause dehydration and weight loss, so ask for help from your doctor as soon as possible.

Coping with morning sickness can be hard. It can make it difficult for you to work, do shopping, or look after your family. It can also be upsetting to be so unwell when you feel you should be happy.

Although morning sickness can make you feel miserable, it is a good sign. It means that the levels of hormones in your body are high, protecting your pregnancy. Rest assured that you should be through the worst by week 16.

Try not to worry if you don't feel sick at all – that's fine too, and it just means you've escaped an unpleasant pregnancy side-effect!

Take a look at these tips to help you keep nausea at bay.

Jenny Leach is an editor and writer specialising in evidence-based health content.

What is morning sickness?

Morning sickness (also called nausea and vomiting of pregnancy, or NVP) 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. This is a record of any health conditions and treatments that you or your family members have had.
• 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 heart beat 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 an herb (plant) 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 to 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 sleep aids (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 to 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

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