Nausea is a common symptom during early pregnancy. In fact, up to 80% of people who are pregnant experience nausea, which can range from mild to severe.

Morning Sickness Causes

Why do some people feel a little queasy, while others have frequent waves of vomiting during pregnancy?   

“Morning sickness can be caused by a variety of reasons and can vary from person to person, but the cause is not well understood and is likely related to hormonal changes,” says Dr. Cline.

Some of the factors that may increase your risk of morning sickness include:  

• Differences in hormone sensitivity, especially from the increase in estrogen and progesterone and the body adjusting to the presence of human chorionic gonadotropin (hCG) — the “pregnancy hormone”
• A family history of morning sickness
• Carrying multiples
• A history of motion sickness or migraines

“Progesterone slows down digestion and can lead to acid reflux and constipation, which can contribute to nausea,” says Dr. Cline. “Because of this, you want to make sure you have a little something in your stomach, but you’re not too full. This will help prevent some of the queasy, uneasy feeling.”

Morning Sickness Symptoms

Typical signs and symptoms include:

• Queasiness at any time throughout the day
• Food aversions
• Vomiting (but still staying hydrated and not losing weight)

If symptoms are more severe, morning sickness can progress into a more serious condition called hyperemesis gravidarum, which involves:

• Severe and persistent vomiting
• Not being able to keep any food or liquids down
• Dehydration
• Weight loss or failure to gain weight
• Feeling faint or dizzy
• Dark urine or no urination
• Electrolyte abnormalities

“Hyperemesis gravidarum can be so severe that you lose weight, and this can lead to electrolyte imbalances,” says Dr. Cline.

If you have any of the symptoms of hyperemesis gravidarum, call your physician right away. They can help create a treatment plan that may include:

• Anti‑nausea medications
• Intravenous (IV) fluids
• Nutrition support from a registered dietitian     

How Long Does Morning Sickness Last?

Morning sickness usually starts by the sixth week of pregnancy, peaks by week 10 and improves by week 14. But this isn’t the case for everyone.

“About 90% of patients have relief of their nausea by 20 weeks of pregnancy,” says Dr. Cline.

For some people, morning sickness lasts the full nine months of pregnancy.

How To Manage Morning Sickness

Home remedies

One common tip Dr. Cline shares with patients is to keep crackers at your bedside table or nightstand. “When you wake up, eat a cracker to get ahead of the nausea,” she says.

Other at-home remedies include:

• Eating bland foods, such as dry toast, crackers, rice and bananas
• Eating smaller, frequent and regular meals every couple of hours               
• Focusing on eating more protein
• Eating small amounts of raw ginger (Note: There is no evidence that ginger ale can help.)
• Limiting spicy foods and foods high in fat
• Ventilating your kitchen, and avoiding strong smells and tastes
• Drinking peppermint tea or water with lemon slices if smells trigger nausea
• Resting when you can, and breathing deeply during waves of nausea

You can also talk to your physician about switching prenatal vitamins or taking them at night instead of in the morning if prenatal vitamins upset your stomach. At work or on the go:

• Chew gum or mints.
• Carry snacks and drink water.
• Sit near fresh air and run a fan.
• If commuting makes your nausea worse, offset your travel schedule to avoid crowds and odors.                                                          

If you have frequent vomiting, be sure you stay hydrated. Drink plenty of fluids, take small sips throughout the day, and add ice chips and/or drink broth. Gradually add in food as nausea improves.

Over‑the‑counter treatments

The following options, available at your local pharmacy without a prescription, can help ease morning sickness. Check with your obstetrician before trying them:

• Vitamin B6 (pyridoxine) tablets
• Can help with red blood cell formation and nervous system function
• Often a first-line over-the-counter supplement
• Typical dose: 10 to 25 milligrams (mg) taken three times a day
• Ginger capsules, lozenges and lollipops
• Medications like doxylamine, taken at night to manage morning symptoms

Prescription medications

If at-home and over-the-counter strategies don’t work for you, your doctor may prescribe anti‑nausea medication.

“Some people are hesitant to take medications during pregnancy, but approved medications for nausea have been reviewed by the American College of Obstetricians and Gynecologists, and are considered safe and effective,” says Dr. Cline. “Some patients do better by taking medications sooner.”

Common anti-nausea medications prescribed during pregnancy include:

• Ondansetron
• Often the first anti-nausea medication prescribed before trying others
• Possible side effects: headaches, fatigue and constipation
• Metoclopramide
• Often used when first-line treatments don’t work
• Helps speed up stomach emptying
• Possible side effects: dry mouth, drowsiness, fatigue and restlessness  
• Combination of doxylamine and pyridoxine
• A delayed-release medication taken at bedtime to help relieve morning nausea
• Most common side effect: drowsiness

These medications can be taken as a pill or orally disintegrating tablet. Intramuscular (injection) and IV options are available, too.

How a Partner Can Help With Morning Sickness

A partner, family member or friend can help you manage morning sickness by:

• Helping with meals and dishes to reduce exposure to cooking smells
• Offering small snacks and fluids, and tracking what helps
• Encouraging rest, and assisting with child care or chores

Does Morning Sickness Affect the Baby?

Mild-to-moderate nausea and vomiting in pregnancy does not harm fetal growth. Most people who have morning sickness deliver healthy babies.

Unless you have severe weight loss or dehydration caused by hyperemesis gravidarum, which requires close monitoring, Dr. Cline says there are no significant complications from morning sickness.

“Morning sickness may indicate a healthy pregnancy, but a healthy pregnancy does not always include morning sickness,” says Dr. Cline. “Even if you have nausea and vomiting, and then it stops suddenly, it doesn’t mean something is wrong.”

Other Causes of Nausea During Pregnancy

Although morning sickness is the most common cause of nausea during pregnancy, other medical conditions can cause nausea, including:

• Diabetes
• A cyst on your ovary with torsion
• The cyst can cause your ovary to twist, which can stop blood flow to the ovary. This is a medical emergency. If you suspect an ovarian torsion, go to your nearest emergency department or call 911.
• Kidney infection
• Peptic ulcer disease
• Migraines
• Headaches
• Hyperthyroidism (an overactive thyroid)

Other Tips To Help Morning Sickness

If you’re thinking about getting pregnant, Dr. Cline recommends starting prenatal vitamins at least one month before trying to conceive, which can help lower your risk of nausea. Prenatal vitamins also contain folic acid, which is especially important for baby’s development.

Review a preconception checklist to learn how to prepare for pregnancy.

“If you do have morning sickness, and it gets worse instead of better, talk to your healthcare team who can help find a treatment option that will work for you,” says Dr. Cline. “They can help you feel like your best self again as quickly as possible.”