Morning sickness is the nausea, sometimes paired with vomiting, that often appears in early pregnancy. While most pregnant moms will experience mild symptoms, there is a more severe morning sickness called hyperemesis gravidarum (HG). In today’s post, we’ll learn how to tell the difference between the two. We’ll also discuss what causes morning sickness and — more importantly — what you can do to help it.
How Common Are Morning Sickness and Hyperemesis Gravidarum?
We first discussed morning sickness and hyperemesis gravidarum way back in week six of our weekly pregnancy posts. It’s one of the top signs of pregnancy and is often the first and most difficult symptom of pregnancy.
In fact, around 70 to 85% of women experience morning sickness (1). In about 50% of pregnant women, this includes nausea and vomiting. In (an arguably luckier) 25% of women, it means nausea but without vomiting. And (perhaps the most fortunate) 25% or so don’t experience any nausea or vomiting at all (3). We will soon discuss hyperemesis gravidarum, a more severe form of morning sickness that occurs in only around 2% of pregnancies (1).
You may be more prone to experience morning sickness if you suffer from migraines and/or motion sickness before pregnancy (3). Carrying multiples may also make you more prone to it, or cause you to experience it more severely (1). Still, in a majority of pregnancies, morning sickness is just a fact of pregnancy, even without predisposing factors. The good news is that it usually doesn’t persist for your entire pregnancy, and that it is uncomfortable but far from disabling for almost all women.
What Causes Morning Sickness and HG?
The culprit here is likely the same one that causes so many of the other discomforts of pregnancy: Hormones! At least, that’s what doctors believe causes morning sickness, though no one really knows for sure (1,2). Human chorionic gonadotropin (hCG) is often to blame, as it is produced shortly after fertilized egg attaches to the uterus. Increases in progesterone may also contribute, since the hormone impacts the smooth muscles of your digestive tract.
When Does Morning Sickness Start and When Can I Expect It to Get Better?
Hormone surges happen early in pregnancy, so morning sickness may start as early as the fifth week of pregnancy. (This would be just three weeks from conception.) However, it may appear as late as week nine of pregnancy and will typically resolve by week fourteen, around the end of the first trimester (4). Some women have a little longer to wait, but still find that morning sickness subsides by week twenty. (5) Though not common, there are some women who find that nausea, with or without vomiting, persists throughout pregnancy.
What Can I Do to Feel Better?
There’s no way to make morning sickness go away altogether, but there are some things you can do to try to minimize it.
- Drink plenty of fluids.
- Keep snacks by your bed. While morning sickness isn’t limited to mornings, some women do find they feel worst when they first wake. Getting something simple like crackers or dry toast in your stomach before you start moving around may help.
- Eat smaller, more frequent meals rather than three large meals.
- Eat protein like cheese, eggs, nuts, and lean meats.
- Avoid fatty or greasy meats.
- Avoid spicy foods.
- Try ginger — ginger tea, ginger ale made with real ginger, and ginger candies.
If none of these things help, you can ask your doctor about medication. Just remember that you should never try any meds, herbs, or supplements without talking it through with your healthcare provider first.
What is HG? How is it Different Than Morning Sickness?
In around 2% of pregnancies, women have a more severe form of persistent nausea and vomiting called hyperemesis gravidarum. It’s marked by more extreme symptoms with a higher degree of side effects. HG is diagnosed if a woman loses 5% of her prepregnancy weight and has other problems related to dehydration or loss of body fluids (4). This can result in hospital stays, IV fluids, or IV nutrition.
Some other differences include:
- With morning sickness, mom will feel nausea but may not vomit. With HG, a mom will experience severe vomiting.
- While morning sickness usually goes away after the first trimester, HG may last up to week 20, or throughout the entire pregnancy.
- With morning sickness, you’re unlikely to vomit enough to cause dehydration. HG, on the other hand, can cause severe dehydration and electrolyte imbalances.
What are the Risks?
Neither morning sickness nor HG affect mom or baby’s long-term health in most cases. However, it is important to stay on top of the symptoms. The significant vomiting associated with HG can result in the loss of nutrients and fluid.
When Do I Need to Call My Doctor?
If you can’t keep any food or fluids down for more than a day, or are showing signs of dehydration, call your healthcare provider. Signs of dehydration include (4):
- A small amount of urine or inability to urinate
- Dark-colored urine
- The inability to keep down liquids
- Feeling dizzy or faint when you stand up
- Having a racing heartbeat
Your doctor may have you start with the same suggestions as we discussed above, and if they don’t work, he or she may prescribe meds to help control your nausea and vomiting. In some cases of hyperemesis gravidarum, a woman may need a short hospital stay to receive fluids intravenously (1, 2).
The bottom line is that most women will experience morning sickness during pregnancy. However, it usually lasts only a trimester or so and is uncomfortable but not life-altering for most women. Work to stay hydrated, and communicate with your healthcare provider if you’re significantly uncomfortable or think you may be dehydrated.
If you’d like to learn more about morning sickness or hyperemesis gravidarum, ACOG has a great resource full of information from the experts here.
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1. The American College of Obstetricians and Gynecologists. (2010). Your Pregnancy and Childbirth Month to Month, 5th edition.
2. Simkin, P. (2010). Pregnancy, Childbirth and the Newborn, 4th edition. Meadowbrook Press.
3. Glade, B.C., Schuler, J. (2011). Your Pregnancy Week by Week, 7th edition. First Da Capo Press.
4. Morning Sickness: Nausea and Vomiting of Pregnancy. (n.d.). Retrieved July 10, 2020, from https://www.acog.org/patient-resources/faqs/pregnancy/morning-sickness-nausea-and-vomiting-of-pregnancy.
5. Barratt, J., Cross, C., Steel, S., & Biswas, C. (2016). The pregnancy encyclopedia: All your questions answered. London: Dorling Kindersley Limited.