Morning Sickness Survival Guide

Medical Expert: Phabilla Afflack, MD

It was my sudden repulsion to fried chicken that made me suspect I was pregnant. Sure enough, my at-home test was positive, and as the weeks progressed, so did my nausea. The smell of garlic was vomit-inducing, simply looking at scrambled eggs made me lose what little appetite I had left, and even water wouldn’t sit right. It was awful, but also par for the course. 

Morning sickness, which can occur at any point in the day, affects about 80% of pregnant people, according to Phabilla Afflack, MD, an OB-GYN practicing in Calabasas, California, and a member of the practitioner collective for the perinatal nutrition brand Needed. But unlike a typical stomach bug, this nausea doesn’t go away in 24 to 48 hours, it lasts for weeks. And sometimes, thanks to pregnancy aversions, the same go-to foods you would normally use to ease wooziness could make the situation even worse. 

This part of pregnancy is pretty rough, but the good news is that for most expecting parents, it eases up by the end of the first trimester. 

What is Morning Sickness? 

Morning sickness is a condition unique to pregnancy where the parent-to-be experiences nausea and sometimes vomiting. It’s called “morning sickness” because symptoms are more likely to be felt earlier in the day, but really, a pregnant person can experience them morning, noon, night, or around the clock. This queasiness can be triggered by certain foods or smells, or it can be present for no reason other than pregnancy. It’s incredibly unpleasant for the expecting parent, but rest assured it doesn’t harm the fetus, according to the American Academy of Obstetrics and Gynecology (ACOG).

Aside from nausea and vomiting, someone suffering from morning sickness may also experience gagging, food aversions, fatigue, and loss of appetite. The ACOG notes that morning sickness typically starts before week 9 of pregnancy and fades by week 14 for most people.  

What Causes Morning Sickness? 

So what causes this unfortunate side effect of pregnancy? Dr. Afflack explains, “Since numerous physiological adaptations are happening during pregnancy, especially in the first trimester, it’s hard to nail down an exact cause [of morning sickness].” However, there are some theories. 

“One well-known cause is a pregnant person’s enhanced sense of smell, known as hyperosmia, which can lead to aversion and nausea,” says Dr. Afflack. The cause of this pregnancy side effect isn’t entirely known, but increased levels of estrogen are the suspected culprit.

Some other proposed theories include increased hormone levels, [such as estrogen, progesterone, and human chorionic gonadotropin (hCG)], hypoglycemia, and thyroid dysfunction.” Additionally, she says genetics may play a part in the severity of morning sickness, particularly for cases of hyperemesis gravidarum (more on that later). Dr. Afflack continues, “There are also theories related to gut health that can impact nausea and vomiting including delayed gastric emptying, constipation, and Helicobacter pylori (H. pylori) infection.” 

No matter the reason behind your persistent nausea and vomiting, you’ll need coping strategies to get through it. 

How to Relieve Morning Sickness Symptoms

Most parents-to-be will know going into a pregnancy that there’s a high chance they’ll experience morning sickness, but there’s only so much you can do to prepare yourself for the reality of symptoms. Once you’re in it, you quickly realize how much it can affect your daily life, and since you can’t ask the world to press pause until you’re over this stage of pregnancy, you’re going to have to find ways to cope. 

Dr. Afflack explains that morning sickness treatment will depend on the severity of symptoms. Most of the time, though, she says symptoms can be treated at home. Some of her suggestions include eating smaller, more frequent meals, getting outside for fresh air, moving slowly (particularly when you’re getting out of bed or standing up), opting for cold foods (as the smell of hot food may trigger nausea), acupuncture or acupressure, slowly sipping water throughout the day, and resting as much as possible. 

She also notes that what you put into your body during this time is incredibly important, and the right foods and supplements have the potential to ease your queasiness. She advises trying to get enough protein as a way to ward off nausea. “Large swings in blood sugar levels can trigger nausea or make it worse. Protein powders such as collagen peptides can support protein intake in pregnant people with aversions or nausea,” she says. Additionally, she recommends keeping protein or fat-rich snacks nearby overnight, so that you have something to quickly grab if you wake up feeling sick. 

Finally, she says nutritional supplementation may also help ease morning sickness symptoms. “Certain nutritional supplements, like B6 and ginger, are effective at controlling nausea. In fact, vitamin B6 is often used alongside the medication doxylamine (Diclectin) for moderate to severe symptoms.” Many prenatal vitamins include B6 in their formula, so if you want to give this supplement a try, make sure you’re not getting more than your suggested daily amount, which is 25 milligrams three times a day (75 milligrams total per day).

As a reminder, you should never start taking supplements during pregnancy without talking to your health care provider first. 

When Should You Worry?

Between 1% to 3% of pregnant people will suffer from hyperemesis gravidarum, which is extreme nausea and vomiting during pregnancy. Someone experiencing this severe form of morning sickness will feel significantly (if not debilitatingly) sick all day long, and nausea and vomiting could last throughout the whole pregnancy. While certainly awful for the parent-to-be, it’s important to note that this is not a sign that anything is wrong with baby, but your OB should be involved in your care and treatment, as they’ll want to make sure you’re keeping down enough calories and fluid to maintain your own health and allow your baby to grow properly. 

Regardless of whether you have hyperemesis gravidarum or just standard morning sickness, Dr. Afflack notes that it’s important to monitor your vomiting. “If morning sickness progresses to severe and persistent vomiting or the inability to keep down fluid or solids for 24 hours, it’s important to seek medical help,” she says. “This [degree of vomiting] can result in dehydration, acid-base imbalance, nutritional deficiencies, and substantial weight loss.” Additionally, she notes that if a pregnant person has “dark-colored urine or feels weak or dizzy, they should seek medical care as soon as possible.” 

In the event you are experiencing extreme sickness, you may be sent to the hospital so that you can be treated and baby can be monitored. “Severe and persistent vomiting or the inability to keep down fluid and solids requires medical help in the form of intravenous fluids, motility medications, antiemetics, and other therapies that ease symptoms and support the consumption of more fluids and solids,” explains Dr. Afflack. 

Unfortunately, there’s nothing you can do to speed up or bypass the morning sickness phase of pregnancy—it’s just something you have to ride out. So, until you reach that magical 12- to 14-week mark, stock up on the foods and drinks you can stomach, clear the pantry and fridge of anything that makes your belly churn, and try to hang in there the best you can.