Should You Worry About Morning Sickness? One OBGYN Weighs In

Find out why you feel so sick and some ways to calm your stomach.

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Morning sickness, or nausea and vomiting that occurs due to pregnancy, is one of the most common symptoms that expectant moms will experience, especially in their first trimester. In fact, between 50 and 90 percent of pregnant women who have normal pregnancies will deal with some type of nausea along the way. Despite how common it is, the cause is still not completely understood.

Luckily, morning sickness symptoms usually subside by the time the second and third trimesters roll around, but until then, you may be thinking about how you’re going to handle the discomfort.

So, is the old saying, that morning sickness means you have a healthy baby, true? We talked with OBGYN Lisa Beard, MD, of The Woman’s Hospital of Texas in Houston to learn the answer to that question, as well as what risk factors pregnant women might face and what morning sickness means for your health.

Medically reviewed in May 2018.

Some factors may increase your risk

2 / 5 Some factors may increase your risk

Although morning sickness is very common, the cause of the nausea is not well understood. Hormonal changes are at least partially responsible, says Dr. Beard, specifically high levels of estrogen and the pregnancy hormone human chorionic gonadotropin (hCG).

But the American College of Obstetricians and Gynecologists (ACOG) says there are some other factors that may up your risk for severe nausea and vomiting, such as:

  • Past history of morning sickness in pregnancy
  • Being pregnant with more than one baby
  • A mother or sister with a history of morning sickness
  • Being pregnant with a female fetus
  • Prior history of motion sickness or migraines

Remember that just because you are at an increased risk doesn’t necessarily mean you will experience morning sickness.

Sometimes nausea and vomiting during pregnancy could be caused by a completely separate medical issue:

  • Thyroid disease
  • Gallbladder disease
  • Stomach ulcers
  • Foodborne illnesses

It's important to talk to your doctor if you experience any symptoms of morning sickness during your pregnancy. Continue to discuss with your doctor if symptoms worsen or interfere with daily activities or if you are losing weight or having trouble gaining the expected pregnancy weight.

There is a small chance you’ll have extreme morning sickness

3 / 5 There is a small chance you’ll have extreme morning sickness

You’ve may have heard of hyperemesis gravidarum, or severe morning sickness, because Catherine, Duchess of Cambridge, experienced it during all three of her pregnancies, but the condition extends beyond royalty.

Just about three percent of pregnant women will have hyperemesis gravidarum, a condition that while rare, usually causes a woman to lose more than five percent of her pre-pregnancy weight and experience dehydration.

“Hyperemesis gravidarum can impact daily function, impair a woman’s ability to work, cause anxiety and if left untreated, cause rare complications like fetal growth restriction, malnutrition and esophageal tears, among other things,” says Beard. 

If you're vomiting three or more times per day, or experiencing dizziness, dehydration symptoms such as dark urine, constipation or weight loss, your doctor may order lab testing to screen for underlying causes of vomiting unrelated to pregnancy or assess for complications of severe vomiting. These tests, which include blood counts, electrolytes and urine ketones measurements, can help doctors determine whether or not you have hyperemesis gravidarum. In some cases, an ultrasound is suggested to check for multiples.

The good news is that there are successful treatment options for hyperemesis gravidarum.

Intravenous fluids (IVs) can keep you hydrated, anti-nausea medications can help relieve some of the vomiting and for women with very severe cases, nutrients through IVs may be needed.

Morning sickness may increase the risk of other health conditions

4 / 5 Morning sickness may increase the risk of other health conditions

Usually, morning sickness is no cause for concern—most morning sickness is natural and shouldn’t affect your health or your baby’s. But, extreme morning sickness, especially if have trouble eating or drinking fluids, can affect your weight and subsequently your baby’s weight at birth. Elevated hormone levels associated with morning sickness or extreme morning sickness can cause thyroid, liver and fluid balance issues, and very rarely, bleeding in the esophagus if there is constant vomiting.

Morning sickness symptoms usually arise sometime in the first 9 weeks of pregnancy, and for most women, subside by the second trimester (14 weeks). However, every woman is different, and it’s possible that these symptoms last just a few days or for the entire length of the pregnancy.

Call your OBGYN if you’re unable to keep fluids down, feel dizzy or lightheaded, notice blood when you vomit, have abdominal pain or notice you’ve lost over five pounds.

There are treatments that actually work

5 / 5 There are treatments that actually work

Nausea and vomiting during pregnancy can be treated in a number of ways, says Beard. She says avoiding triggers that make you feel bad, such as certain foods, smells, bright lights and car rides, can minimize symptoms. Staying hydrated is very important, as well—it’s recommended that pregnant women drink 8 to 12 glasses of water per day, although you should talk to your doctor about the amount that’s right for you.

Eating small, more frequent meals and sticking to bland foods like rice, crackers, potatoes or toast might help prevent some of the nausea, too. You can also try bananas, rice, applesauce or toast. Supplements, candies and sodas made with real ginger have long been used for lessening the symptoms of morning sickness, too.

Your OBGYN may suggest that you try over-the-counter treatments, like Vitamin B6 or doxylamine (one or both), an over-the-counter sleep aid to help reduce nausea and vomiting. Some physicians might recommend you wear a pressure-point wrist band throughout the day, since some believe putting continuous pressure on the wrists can ease nausea.

If these options are not effective, safe antiemetic medications may be prescribed to reduce vomiting. Women who have extreme morning sickness or hyperemesis gravidarum may need to spend some time in the hospital, so doctors can evaluate how well their liver is functioning, monitor any extreme weight loss or nutritional deficiencies, give IV medications or treat any electrolyte imbalances.

Anytime you’re worried about symptoms during pregnancy, call your OBGYN. No matter how minor the symptom is, it’s better to have a discussion with a physician, in case treatment is needed.

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