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About 70% of pregnant women get morning sickness. In about 3%, nausea and vomiting can be severe. Learn more about when it usually starts, how it's treated, what you can do to feel better, and when to call your doctor.
Morning sickness, also called nausea and vomiting of pregnancy, is a common condition. It occurs in about 70% of pregnancies and usually starts around 6 weeks of pregnancy and lasts for weeks or months. Symptoms usually improve during the second trimester (weeks 13 to 27; the middle 3 months of pregnancy). In a few women, however, morning sickness occurs throughout their pregnancy. Despite its name, “morning” sickness can happen at any time of the day. Can morning sickness become severe?Yes. Most women who experience morning sickness usually feel nauseous for a short time each day and may vomit once or twice. In more severe cases of morning sickness, nausea can last several hours each day and vomiting occurs more frequently. This most severe type of nausea and vomiting, which occurs in up to 3% of pregnant women, is called hyperemesis gravidarum.
The cause of morning sickness is not totally known. It may be caused by low blood sugar or the rise in pregnancy hormones, such as human chorionic gonadotropin (HCG) or estrogen. Morning sickness may be worsened by stress, being overtired, eating certain foods, or having sensitivity to motion (motion sickness). What are the symptoms of severe morning sickness (hyperemesis gravidarum)?Symptoms of hyperemesis gravidarum include:
Women with severe morning sickness may need to be admitted to the hospital to receive IV fluids to restore hydration and medications to relieve nausea.
There are a few things you can do to feel better. These include:
Other methods may help reduce nausea. Talk with your healthcare provider before trying these:
Do not use marijuana to treat morning sickness! It has not been shown to be safe for your baby during pregnancy. What medications are available to treat morning sickness?Your healthcare provider may recommend taking vitamin B6 (also called pyridoxine) and doxylamine. Doxylamine is also used as a sleep aid and to treat hay fever or other allergies. Both products are available over-the-counter and don’t need a prescription. However, there is a pill that contains the combination of these 2 products. It is available by prescription only and is known by the trade name Diclegis®. Unlike the separate over-the-counter products, Diclegis® is a slow-release single pill. This may be more convenient or helpful for women who have trouble (for example, have a gag reflex) taking many pills per day. Medications to prevent nausea (also called antiemetics) can also be prescribed. If these drugs don’t help, other drug classes can be tried including antihistamines and anticholinergics. You and your healthcare provider will decide which medications work best for you. Does morning sickness harm my baby?Mild to moderate nausea and vomiting of pregnancy usually is not harmful to you or your baby. However, it can become a problem if you can’t keep food or liquid down, become dehydrated, and lose weight. Unmanaged severe nausea and vomiting can prevent you from getting the nutrition you need and affect the weight of your baby at birth.
Yes. The risk for severe morning sickness is increased if a woman:
Do not wait until vomiting becomes severe to call your doctor. Seeking care for morning sickness early in pregnancy can help prevent it from becoming more severe. Severe vomiting is not a normal aspect of pregnancy and requires medical care or even hospitalization. Another reason to investigate severe nausea and vomiting is that it may be a symptom of other medical conditions including ulcers, reflux (heartburn), food-related illnesses, thyroid disease, gallbladder disease, or inflammation of the appendix, stomach, pancreas, or liver. Call your doctor right away if you:
Last reviewed by a Cleveland Clinic medical professional on 06/29/2017. References
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During the first trimester of pregnancy, many women have the bouts of nausea and vomiting known as morning sickness. Despite its name, morning sickness can happen day or night. It usually starts around the 6th week of pregnancy, is at its worst around week 9, and stops by weeks 16 to 18. Although unpleasant, morning sickness is considered a normal part of a healthy pregnancy. What’s Severe Morning Sickness?Severe morning sickness is when nausea and vomiting get so serious that a pregnant woman vomits several times a day, loses weight, and gets dehydrated or is at risk for dehydration. If this rare pregnancy-related condition isn’t treated, it can affect a woman's health and her baby's ability to thrive. The medical term for severe morning sickness is "hyperemesis gravidarum" (hi-per-EM-eh-sis grav-ih-DARE-um), which means "excessive vomiting during pregnancy." It usually follows a similar timeline to normal morning sickness. But it can go longer, sometimes lasting for the whole pregnancy. Often, the symptoms get less severe as the pregnancy continues. Most cases of hyperemesis gravidarum affect a woman's first pregnancy. But women who have it in one pregnancy are more likely to have it in future pregnancies. What Causes Severe Morning Sickness?The cause of severe morning sickness isn’t known. But it might be related to the hormone changes of pregnancy. A hormone called human chorionic gonadotropin, or HCG, might be to blame because severe morning sickness most often happens when HCG levels are at their highest in a pregnant woman's body. Severe morning sickness also might run in families. It’s more common in women whose close family members (such as mothers and sisters) have had it. Other things that can increase a woman's chances of having severe morning sickness include:
What Problems Can Happen?The nausea and vomiting that happen in severe morning sickness are so extreme that they can harm the mother and the baby. Not being able to keep down food makes it hard for the mom to meet her nutritional needs. So she might lose weight. And a loss of fluids, combined with the loss of stomach acid from vomiting, can cause dehydration and electrolyte imbalances. If severe morning sickness isn’t treated, it can cause many problems, including organ failure and the early birth of her baby. When Should I Call the Doctor?Call the doctor right away if you’re pregnant and have any of these symptoms:
How Is Severe Morning Sickness Treated?Treatments used for morning sickness, such as eating dry crackers in the morning or a bland diet, may be recommended for women with extreme morning sickness. But these might not help with severe symptoms. Medical treatment can include:
Some women might get medicine to stop the vomiting, either by mouth or through an IV. The doctor might recommend eating foods with ginger or taking vitamin B6 supplements to help ease nausea. It can also help to:
If a woman feels anxious or depressed about her condition, talking to a therapist or counselor might help her cope with her feelings. What Else Should I Know?With treatment, women with severe morning sickness can feel better and get the nourishment they need so they and their babies thrive. And lifestyle changes can help ease nausea and vomiting and make the pregnancy more enjoyable. With time, symptoms usually do improve. And, of course, they stop by the time a woman's next journey starts: parenthood. |