Is having morning sickness a good sign

Morning sickness is one of the most feared side effects that comes with being pregnant. The feeling of nausea and vomiting can be miserable, but you aren’t alone. Morning sickness is very common and affects the majority of pregnant women, especially in their first trimester. Approximately 50 to 80 percent of pregnant women will experience nausea, and about 50 percent will experience vomiting with their pregnancy.

Why does morning sickness happen?

There is no exact reason as to why women experience morning sickness. It’s most likely due to the rise in two hormones during pregnancy: human chorionic gonadotropin (hCG) and estrogen. Human chorionic gonadotropin is secreted by the placenta, which nourishes the egg after it’s been fertilized. This secretion peaks in early pregnancy when symptoms are typically at their worst. Estrogen levels increase throughout pregnancy, but the largest jump in levels can be seen in the first trimester. It plays a key role in helping the fetus grow and mature.

Is morning sickness a good or bad thing?

Having morning sickness, or not, doesn’t specifically mean anything good or bad about a pregnancy. Studies have shown a lower rate of miscarriage in women with mild or moderate morning sickness. This likely reflects healthy hCG production.

If you’re not experiencing morning sickness, this doesn’t mean you have an unhealthy pregnancy. If you have questions or concerns regarding your morning sickness, you should contact your doctor.

Is it bad to still be experiencing morning sickness beyond the first trimester?

Morning sickness typically resolves after the first trimester, as this is when hCG peaks. Some women may still experience nausea and vomiting after the first trimester. In this case, I recommend speaking with your doctor, as other conditions may be playing a role in your symptoms, such as gastroesophageal reflux disease (GERD), which is common in the second and third trimesters due to increased pressure on your stomach. This may require medication for symptom management.

Does having hyperemesis gravidarum mean anything about the health of your baby?

Hyperemesis gravidarum is a severe form of morning sickness that often requires hospital evaluation and administration of IV fluids to maintain hydration during pregnancy. This is more common in certain pregnancies, including twin pregnancies. While some studies have shown higher rates of low birth weight and premature infants in pregnancies affected by hyperemesis gravidarum, this illness doesn’t typically affect the health of your baby, as pregnancies are very resilient.

Megan Quimper is an OB-GYN at The Ohio State University Wexner Medical Center.

What is morning sickness?

Morning sickness (also called nausea and vomiting of pregnancy, or NVP) is nausea (feeling sick to your stomach) and vomiting that happens in the first few months of pregnancy. Even though it's called morning sickness, it can last all day and happen any time of day.

At least 7 in 10 pregnant women have morning sickness in the first trimester (first 3 months) of pregnancy. It usually starts at about 6 weeks of pregnancy and is at its worst at about 9 weeks. Most women feel better in their second trimester, but some have morning sickness throughout pregnancy. If you have morning sickness, tell your health care provider.

Mild morning sickness doesn’t harm you or your baby. But if nausea and vomiting becomes severe (called hyperemesis gravidarum), it can cause serious problems during pregnancy. You may need to stay in the hospital for treatment.

What is hyperemesis gravidarum?

About 3 in 100 women may have hyperemesis gravidarum. This is extreme, excessive nausea and vomiting during pregnancy. It can cause you to lose weight and become dehydrated (not have enough water in your body). It can start early in pregnancy and last the entire pregnancy. If you have hyperemesis gravidarum, you need treatment to help keep you and your baby safe.

You may be at risk for hyperemesis gravidarum if you:

• Are pregnant for the first time.
• Are pregnant with a girl.
• Are pregnant with multiples (twins, triplets or more). Being pregnant with more than one baby may increase your risk for severe morning sickness because you may have a large placenta and increased pregnancy hormones. The placenta grows in your uterus (womb) and supplies your babies with food and oxygen through the umbilical cord.  
• Had mild or severe morning sickness in a previous pregnancy, or your mother or sister had severe morning sickness during pregnancy. Take your family health history to help you find out about health conditions that run in your family. This is a record of any health conditions and treatments that you or your family members have had.
• Have motion sickness or migraines.  A migraine is a severe headache that may make you sensitive to bright lights and sound.
• Are overweight.
• Have trophoblastic disease, a condition that leads to abnormal cell growth in the uterus (womb).

Signs and symptoms of hyperemesis gravidarum include:

• Vomiting more than 3 to 4 times a day
• Vomiting that makes you dizzy or lightheaded
• Vomiting that makes you dehydrated. Signs and symptoms of dehydration include feeling thirsty, dry mouth, a fast heart beat or making little to no urine.
• Losing more than 10 pounds in pregnancy

If you have hyperemesis gravidarum, your provider may treat you with medicine to help relieve your nausea and vomiting. You may need treatment in a hospital with intravenous (also called IV) fluids. IV fluids go through a needle into your vein. They help you stay hydrated and can give you nutrients that you usually get from food.  If you continue to lose weight, you may need a feeding tube to make sure you’re getting enough nutrients for you and your baby.

What causes morning sickness? 

We don’t know for sure what causes morning sickness. It may be caused by low blood sugar or increased pregnancy hormones. Morning sickness may be worse if you’re stressed or overly tired, if you eat certain foods or if you’re traveling (if you often have motion sickness).

Can you prevent or relieve morning sickness?

Yes. Here’s what you can do to help you feel better and even prevent morning sickness:

• Take a prenatal vitamin before you get pregnant. Talk to your health care provider about which one to take. Sometimes vitamins can upset your stomach, so take it with a snack.
• Keep snacks by your bed. Eat a few crackers before you get up in the morning to help settle your stomach. 
• Eat 5 or 6 small meals each day instead of 3 larger meals. 
• Eat foods that are low in fat and easy to digest, like cereal, rice and bananas. Don’t eat spicy or fatty foods.
• Eat healthy snacks between meals. This can help keep your stomach from being empty and helps prevent nausea. Try snacks that are high in protein, like milk or yogurt.
• Drink plenty of fluids, especially water. 
• Avoid smells that upset your stomach. 

You may have heard about these ways to prevent or relieve morning sickness. Talk to your provider before trying any of these:

• Acupressure and acustimulation (also called electrical nerve stimulation) wristbands. These involve putting pressure on or stimulating certain points of the body (called pressure points) to help prevent nausea.  
• Acupuncture. This is a kind of treatment in which thin needles are put into your skin. If you’re thinking about acupuncture to help with morning sickness, tell your provider and find an acupuncturist who is trained to work with pregnant women.
• Ginger. Ginger is an herb (plant) used in cooking and medicine. Ginger ale, tea or candies may help relieve morning sickness.

Even if it’s legal where you live for either personal or medical use, it’s not safe to use marijuana to treat morning sickness. No amount of marijuana has been proven safe to use during pregnancy. If you’re thinking of using marijuana to help with morning sickness, talk to your provider about other treatments that are safer for your baby. 

Is there medical treatment for morning sickness?

Yes. If you can’t relieve morning sickness on your own or if you have severe nausea and vomiting of pregnancy, your provider may treat you with these medicines:

• Vitamin B6 and doxylamine. Your provider may treat you with these medicines separately or together. You can get vitamin B6 and doxylamine over-the-counter (OTC), which means you don’t need a prescription for them from your provider. Doxylamine is found in some OTC sleep aids (medicines that help you sleep). Or your provider may prescribe you a medicine that combines them.
• Antiemetic drugs. These are drugs that help prevent vomiting. If Vitamin B6 and doxylamine don’t work, your provider may prescribe an antiemetic drug for you. Not all are safe to use during pregnancy, so talk to your provider to make sure the medicine is a good choice for you.

Talk to your provider before you take any medicine during pregnancy, even medicine to help treat morning sickness.

When should you call your health care provider about morning sickness?

For most women, morning sickness is mild and goes away over time. But call your provider if:

• Your morning sickness continues into your 4th month of pregnancy.
• You lose more than 2 pounds.
• Your vomit is brown in color or has blood in it. If so, call your provider right away.
• You vomit more than 3 times a day and can’t keep food or fluids down.
• Your heart beats faster than usual.
• You’re tired or confused.
• You’re making much less urine than usual or no urine at all.

Last reviewed: September, 2020

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