Morning sickness is a common experience for many pregnant women, especially during the first trimester. While the term "morning sickness" suggests symptoms occur in the morning, nausea and vomiting can happen at any time of day. In fact, studies show that up to 70% of pregnant women experience some form of morning sickness. 

Thankfully, there is a light at the end of the tunnel, says Rashmi Bolinjkar, M.D., an OB/GYN on the medical staff at Texas Health Allen.

We spoke with her to understand what morning sickness is and why it happens, plus her tips for pushing past it until it subsides.

Why Morning Sickness Happens 

You may start feeling nauseous around the sixth week of your pregnancy, or typically two weeks after your first missed period. Key symptoms of morning sickness are vomiting and nausea during pregnancy, especially during the first trimester. But despite its name, morning sickness doesn’t mean you will only feel sick in the morning.

Pregnant women can have morning sickness at any time of day,” Bolinjkar explains. “Nausea during pregnancy is most likely caused by the sudden increase of hormones in your body. Morning sickness symptoms can also be triggered by or cause strong aversions to certain smells and foods, heat, or excess salivation. It can also mimic the feeling of being seasick or nauseated after eating which can lead to vomiting.”

Morning sickness typically occurs within the first nine weeks of pregnancy but tends to peak around 10 weeks and usually subsides by 14 to 16 weeks, she adds. But some women, like Catherine, Princess of Wales,and actress Amy Schumer, have such severe forms that they need to be hospitalized, and some women even die from it.

“Hyperemesis gravidarum happens when severe nausea and vomiting lead to dehydration or cause the woman to lose more than 5 percent of her pregnancy body weight,” Bolinjkar explains. “Because of this, sometimes she may not get enough nutrients, leading to malnourishment. If this is the case, she may have to stay in the hospital to get fluids, medication, and rarely, a feeding tube.”

If you’re feeling a pang of fear (and nausea) after reading that, it’s good to add that hyperemesis gravidarum typically occurs in only .3 to 3 percent of pregnancies.

Practical Tips to Manage Morning Sickness

If you're struggling with nausea or vomiting during pregnancy, try these evidence-based tips:

• Eat Small, Frequent Meals: Large meals can overwhelm your digestive system, so aim for smaller portions throughout the day. Foods like crackers, toast, or plain rice can be easier on your stomach. “Remember, an empty stomach may make nausea worse, so snack often and eat small portions throughout the day rather than eating three larger meals,” Bolinjkar adds.
• Stay Hydrated: Dehydration can worsen nausea. Sip on water throughout the day or try clear broths and electrolyte drinks if plain water is unappealing. Make sure you’re drinking plenty of fluids — ideally six to eight cups of noncaffeinated fluids every day.
• Snack on Ginger: Ginger has been shown to help reduce nausea in pregnant women. You can try ginger tea, ginger candies, or even fresh ginger added to meals.
• Avoid Trigger Foods and Smells: Strong odors or spicy foods may worsen nausea. Identify your triggers and avoid them when possible.
• Keep Crackers by Your Bed: Eating a small snack like crackers before getting out of bed in the morning may help settle your stomach.
• Wear Acupressure Wristbands: Acupressure wristbands, commonly used for motion sickness, may provide relief by targeting pressure points associated with nausea.

If those don’t do the trick, you can turn to over-the-counter medications, but it’s always best to consult with your doctor or midwife beforehand to make sure it’s safe for you and your unique health factors.

If you’re having trouble sleeping because of nausea or find yourself waking up in the middle of the night because you’re queasy, the American College of Obstetricians and Gynecologists recommend using a combination of Unisom SleepTabs (Doxylamine succinate) along with vitamin B-6 during your first trimester. Take 10 to 25 mg of vitamin B-6 three times a day, every six to eight hours, then take 25 mg of Unisom SleepTabs once before bed.

If combining OTC medications makes you feel a bit uneasy, your doctor or midwife can prescribe you Diclegis®, an FDA-approved prescription medication that contains both doxylamine succinate and a form of vitamin B6.

Trials have shown it reduces nausea and vomiting in up to 70 percent of cases,” Bolinjkar adds. “But side effects include drowsiness, dry mouth, headache, nervousness, and stomach pain. That being said, there are other medications that we can prescribe as well, and your doctor or midwife can discuss side effects with you.”

Be Mindful of Alternative Remedies

As with almost anything these days, you can hop on the internet and find forums, blogs, and webpages recommending alternative remedies to conventional medicine, which you should proceed with caution when considering. Just because something is “all-natural” doesn’t necessarily mean it is safer, more effective, or even appropriate for pregnant women.

There is a myth around marijuana, claiming that it calms you down and helps with morning sickness,” says Bolinjkar. “Beyond the fact that it is not legal in the state of Texas, there are not many studies evaluating the impact of marijuana on pregnant women. Some of the studies I’ve seen show that if you use marijuana during pregnancy, your child could have trouble with learning, memory, attention, and behavior later in life. Additionally, smoking marijuana during pregnancy can cause premature birth. So, it’s best not to use it.”

While herbal remedies might seem like a better option than medicines because they come from plants, oftentimes herbal remedies have side effects and may not be safe for you or your baby when consumed in large amounts.

Debunking Myths

Now that we know a bit more about morning sickness, we wanted to ask about some frequently talked about myths surrounding morning sickness, such as if it can predict the gender of your baby or if the absence of it means something is wrong with you or your pregnancy.

While it is correct that fading pregnancy symptoms, such as morning sickness, can occur with a miscarriage, just because symptoms have disappeared, doesn’t mean you have had a miscarriage,” Bolinjkar explains. “Some women never feel nauseated during their pregnancy, while it is usually mild and will go away halfway through pregnancy for many women. That being said, 20 to 30 percent of pregnant women never experience any morning sickness but give birth to perfectly healthy babies.”

And no, there is no truth to morning sickness predicting if you will have a boy or a girl, she adds.

The Takeaway

Most morning sickness is natural and shouldn’t be a matter of concern. It shouldn’t affect your health or your baby’s. However, extreme morning sickness, especially if you have trouble eating or drinking fluids, can affect your weight and subsequently your baby’s weight at birth.

Contact your doctor or midwife immediately if you have a fever of 100.4 F or above, have persistent vomiting and are not able to keep any food or drink down for 24 hours, have very dark-colored urine or do not pass urine for more than eight hours, feel severely weak, dizzy or faint when standing up, have tummy pain, or vomit blood.

You should also reach out to your doctor or midwife if morning sickness is affecting your quality of life and ask them about treatment options. Oftentimes, they can work with you to find the perfect remedy until it subsides, typically around your second trimester.

Finding support and guidance you can trust throughout your pregnancy can help relieve anxiety or stress and make sure you’re staying healthy and safe. Texas Health is here for you every step of the way. For more information for moms-to-be, visit TexasHealth.org/Moms.