Pregnancy
Morning Sickness: When Does It Start, When Does It End, and What Helps?
Morning sickness usually starts around 6 weeks of pregnancy and eases by about 12 to 14 weeks for most people. Despite the name, it can hit any time of day, and for some people it lasts all day. It's very common, it usually doesn't harm the baby, and there are safe treatments, so you don't have to white-knuckle it.
Plenty of people are still hiding their pregnancy at work during exactly the weeks nausea peaks. If you're nibbling crackers under your desk and inventing excuses for skipping lunch meetings, you have a lot of company.
Week by week: what's typical
| Weeks | What's typical |
|---|---|
| 4–6 | Nausea may begin, often around 6 weeks |
| 8–11 | Usually the worst stretch |
| 12–14 | Most people start to feel better |
| After 16–20 | A smaller group still has symptoms; some have them all pregnancy |
Weeks are counted from the first day of your last period. If nausea starts for the first time after 9 weeks, tell your provider, since new nausea later on can have other causes.
Why it happens
The exact cause isn't fully understood, but rising pregnancy hormones, especially hCG, are thought to play a big role. ACOG estimates that a large majority of pregnant people have some degree of nausea.
Stronger nausea is more likely if you:
- Are pregnant with twins or more
- Had bad nausea in a previous pregnancy
- Get motion sickness or migraines
- Have a family history of severe pregnancy nausea
What actually helps
Food and drink
- Never let your stomach go empty. An empty stomach usually makes nausea worse. Eat something small every one to two hours.
- Crackers on the nightstand. Eat a few before you even sit up in the morning.
- Bland, dry or salty foods: toast, rice, pretzels, potatoes. Protein snacks help some people.
- Skip your triggers: greasy, spicy or strong-smelling food. The halal cart smell you loved last month may be your enemy now.
- Drink between meals, not with them. Cold, tart or fizzy drinks often go down easier. Many people swear by seltzer with lemon.
- Ginger: tea, candies or capsules. It has some evidence behind it.
Other tricks
- Rethink your prenatal vitamin. The iron can make nausea worse. Ask about taking it at night with a snack, switching brands, or temporarily taking folic acid alone.
- Acupressure wristbands on the P6 point help some people, though studies are mixed.
- Rest. Being tired makes nausea worse.
- Fresh air. Hot, stuffy rooms (and packed rush-hour trains) can tip you over. If you can, ride in a less crowded car or stand near the doors.
A commuter's survival kit
Keep in your bag: a sleeve of crackers, a water bottle, mints or ginger candies, a small plastic bag, wipes, and a spare hair tie. Know where the bathrooms are on your route. It sounds dramatic until the day you need it.
Is morning sickness medicine safe in pregnancy?
Yes, several options are considered safe. ACOG recommends a stepwise approach:
- Vitamin B6 (pyridoxine), alone or combined with doxylamine, is first-line. The combination comes as separate over-the-counter products and as a prescription pill made for pregnancy nausea. Doxylamine can make you drowsy, so many people take it at bedtime.
- If that isn't enough, your provider may add other prescription anti-nausea medicines, such as ondansetron, metoclopramide or promethazine.
- For severe cases, IV fluids and medicines may be needed.
Your provider will tell you which medicine and dose to use. Don't start, stop or combine medicines without asking, even over-the-counter ones. See safe medications during pregnancy.
Does morning sickness hurt the baby?
Mild to moderate nausea and vomiting usually doesn't affect the baby, even if you eat poorly for a few weeks; your baby draws on your body's stores. The real concern is dehydration and not keeping anything down, which needs medical care.
Morning sickness or hyperemesis gravidarum?
A small percentage of people develop hyperemesis gravidarum (HG), a severe form with ongoing vomiting, dehydration and weight loss.
| Morning sickness | Hyperemesis gravidarum | |
|---|---|---|
| Vomiting | Occasional, some days | Frequent, often many times a day |
| Eating and drinking | Can keep some food and fluids down | Often can't keep fluids down |
| Weight | Usually stable | Weight loss, often 5% or more of pre-pregnancy weight |
| Daily life | Uncomfortable but manageable | Hard to work or care for yourself |
| Treatment | Home measures, B6 with doxylamine | Prescription medicine, often IV fluids, sometimes hospital care |
More in our hyperemesis gravidarum guide.
Can you prevent it?
There's no guaranteed way. ACOG notes that taking a multivitamin before and around conception may lower the chance of severe nausea. If you had bad nausea last time, talk with your provider before or early in your next pregnancy about starting treatment early.
"My nausea suddenly stopped. Should I worry?"
Everyone asks this. Many healthy pregnancies have little or no nausea, and symptoms come and go from day to day and pregnancy to pregnancy. A sudden easing in the first trimester is usually normal fluctuation. Call your provider if it worries you, especially if you also have bleeding or cramping.
Twins and morning sickness
Carrying twins or more often means stronger, longer nausea, likely from higher hormone levels. Same treatments, but you may need medicine sooner. See twin pregnancy.
Can nausea come back later?
Some people feel queasy again in the third trimester, often from heartburn or the baby pressing on the stomach. That's usually harmless. But new nausea and vomiting in the second half of pregnancy, especially with a headache, upper belly pain or vision changes, can signal preeclampsia or a liver problem and needs a same-day call.
Getting help in New York
Nausea is one of the most common reasons for early prenatal calls, and many practices have nurse lines for exactly this. No provider yet? Search the directory for OB/GYNs, midwives and nurse practitioners, or browse certified nurse midwives in Manhattan. If you're uninsured, NY Medicaid's presumptive eligibility can cover early prenatal care while your application is processed.
When to call your provider
Call your OB/GYN or midwife if:
- You can't keep down any food or fluids for 24 hours
- You're peeing very little or your urine is dark
- You feel dizzy or faint when you stand
- You're losing weight
- You vomit blood or something that looks like coffee grounds
- You have belly pain, fever or a headache along with vomiting
- Nausea starts for the first time after 9 weeks
- Nausea is affecting your mood, work or ability to take care of yourself
Go to the emergency room if you can't keep fluids down and feel very weak, confused or faint.
Frequently asked questions
When does morning sickness start?
Morning sickness usually starts around 6 weeks of pregnancy, counted from the first day of your last period. Some people notice nausea a little earlier, around 4 to 5 weeks.
When does morning sickness end?
For most people it eases by about 12 to 14 weeks, early in the second trimester. A smaller number have nausea that lasts longer, and some have it throughout pregnancy.
Is it bad if I don't have morning sickness?
No. Many people with healthy pregnancies have little or no nausea. Not having morning sickness isn't, on its own, a sign of a problem.
What medicine is safe for morning sickness?
ACOG recommends vitamin B6, alone or combined with doxylamine, as a first-line treatment. Other prescription anti-nausea medicines are available if those don't help. Ask your provider which option and dose is right for you.
Sources
- ACOG — Nausea and Vomiting of Pregnancy (Practice Bulletin 189)
- ACOG — Morning Sickness: Nausea and Vomiting of Pregnancy FAQ
- MedlinePlus — Morning Sickness
- NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development — Pregnancy
This article is for general education and is not medical advice. It does not replace an evaluation by a licensed clinician who knows your history. If you think you have a medical emergency, call 911.