Pregnancy is unique for every woman. Some women have morning sickness right off the bat; within days of pregnancy, they start having morning sickness. And in rare cases, it can come back late in pregnancy. Many pregnant women find themselves asking “is it normal to get morning sickness in the second trimester or later?”
It is normal for morning sickness to first be an issue after the first trimester, or to come back again later in pregnancy.
This article will provide information on morning sickness in later pregnancy.
- What is Morning Sickness?
- Why does it occur?
- Morning sickness in the first trimester.
- Is it normal for morning sickness to come back in the second trimester?
- Hyperemesis Gravidarum
- Morning Sickness in the third trimester.
- Preeclampsia Symptoms
- Morning Sickness complications
- How to deal with Morning sickness?
- Tests for Morning sickness
- Home Remedies
What is Morning Sickness?
Morning sickness refers to nausea and vomiting during pregnancy. Although the name is morning sickness, you may have it at any time of the day; you might find it creeps up on you in the afternoon or evening.
It can be one of the first signs of pregnancy. Though it might be unpleasant to experience morning sickness, there are some ways to alleviate nausea and vomiting symptoms, and reduce the risk of complications.
About 70% of women experience morning sickness during pregnancy. Generally, it lasts up to 12 weeks of pregnancy. But for some women, morning sickness may keep coming and going throughout the whole pregnancy.
Why Does Morning Sickness Occur?
The exact reason why morning sickness occurs is still up for debate, but it\’s generally accepted that morning sickness occurs as a result of sudden hormonal changes during pregnancy. A hormone called progesterone supports pregnancy and is considered a major factor, as well as Human Chorionic Gonadotropin or HcG hormone.
Progesterone slows things down as well as the intestines and as a result, food can\’t be digested as well as before pregnancy. (We\’ve got more on safe eating during pregnancy here) This can lead to nausea and vomiting, and feel a lot like motion sickness.
Morning sickness can be more likely to occur if there are some medical issues or complications other than pregnancy. For example, if you have thyroid or liver diseases etc you may have morning sickness more often. (More on this later!)
Morning Sickness in the First Trimester
Almost 80% of women experience morning sickness in the first trimester. That is from the very beginning of the pregnancy or from 6 weeks to 12 or 13 weeks.
The reason why morning sickness occurs frequently in the first trimester is the rise of HcG. (which is what pregnancy tests detect) Many experts believe that morning sickness is the body’s reaction to this hormone.
About 60% of women experience vomiting in this period. Some women don’t have morning sickness during the first trimester, which is actually completely safe if that\’s the case for you.
As pregnancy is different for every woman, morning sickness is too. For some, it might also come with other quirks like dizziness, mood swings, etc.
Is it Normal For Morning Sickness to Come Back in the Second Trimester?
As mentioned earlier, it is normal and safe to experience morning sickness in the second trimester as well. Morning sickness usually goes away after the first trimester but some women experience it in the second trimester too.
The second trimester of pregnancy starts from 13 weeks and lasts up to 28 weeks. During this phase, the body goes through some physical changes which are the main highlight of the second trimester. Although it is less in number, some women experience first trimester symptoms too.
The only reason you need to worry if you experience severe morning sickness. Too much nausea, constant vomiting, etc. may be due to a sickness called hyperemesis gravidarum. We will discuss it later on in detail but in short, it’s severe nausea.
A study in Sweden shows that women having the sickness in the second trimester are vulnerable to experience placental abruption, have an increased risk of developing preeclampsia which can damage vital organs, and if left untreated can even cause maternal death.
If you have hyperemesis gravidarum that warrants hospitalization, your doctor will be able explain your specific risks and things to be aware of.
What is Hyperemesis Gravidarum?
Hyperemesis Gravidarum is a pregnancy complication. Severe nausea, vomiting, faint, etc are its primary symptoms. Hyperemesis is considered more dangerous than usual morning sickness. It may cause serious health issues.
Visit your gynecologist if you
- Have very dark-colored urine
- Do not pass urine for over 8 hours
- Have severe dizziness
- Have intense abdominal pain
- Vomit blood
- Have a fever above 100.4 degrees Fahrenheit.
Generally, hyperemesis gravidarum can be treated by some medications and fluids. Only 0.1% of women will end up being hospitalized due to hyperemesis gravidarum.
Morning Sickness in the Third Trimester
Morning sickness can come back in the third trimester. There may be a number of things why it is occurring at this period; indigestion, hormonal changes are usually responsible for this.
For many women, morning sickness becomes a recurring event in the third trimester. It mostly happens due to the weight the growing baby puts in the abdomen. As the baby grows gradually it puts increasing pressure on the uterus and other organs, including those in the digestive system. Thus, it is quite normal to experience morning sickness in the third trimester.
However, it may also indicate a dangerous pregnancy complication called preeclampsia. If you experience significant morning sickness in the third trimester, consider reaching out to your GP, midwife or obstetrician.
Preeclampsia is very common after 20 weeks of pregnancy and it can be managed. Preeclampsia is characterized by high blood pressure. While it is true that preeclampsia can be dangerous, with proper timely treatment it can be overcome.
What Causes Preeclampsia?
The exact cause of preeclampsia is unknown. But doctors and researchers believe that it is related to the placenta, the most important organ of pregnancy. On the other hand, some doctors think it is related to food or nutrition, or genetics. So, there is unfortunately no exact reason known.
What Are The Symptoms of Preeclampsia
The common preeclampsia symptoms are:
- Upper abdominal pain: This is where the upper belly part, especially under your ribs on the right side, is uncomfortable.
- Decreased urination: You have a problem urinating. Decreased urine output is a primary symptom of preeclampsia.
- Severe heartburn: If heartburn is a symptom you\’ve not had before, or your symptoms are worsening without relief, it could be a symptom.
- Vertigo: Blurred vision, having light sensitivity or difficulty seeing in light, and general vertigo. Sometimes there is temporary vision loss too.
- Shortness of breath: If you feel an extreme tightening in the chest, difficulty in breathing, or feel like you\’re suffocating, it may be a symptom of preeclampsia. It may be due to fluid in your lungs.
- Sudden weight gain: Swelling and weight gain is normal in pregnancy, but if suddenly you have significant swelling/weight gain when you didn\’t yesterday, it may be a symptom. It\’s most common on the face and legs.
Morning Sickness Complications
Morning sickness can be a pain. It is unpleasant and hard to deal with. It makes pregnancy hard and tough. The below complications are connected with pregnancy, and are all things to look out for.
- The inability to keep food down: Vomiting frequently, especially when you\’re eating or taking medications.
- Fever: Intense fever and severe weakness along with dizziness.
- Fast heartbeat: An intense heart rate that can\’t be slowed through rest.
- Dark-colored urine: Dark-colored urine is connected with dehydration, which could be due to vomiting or an inability to keep fluids down.
- Vomiting blood: While vomiting due to nausea is normal, blood in your vomit is not.
You may not experience all of these at once but it is better to know and stay alert. If you can, take notes or keep a journal of your symptoms, so that you can keep your medical team better informed at your checkups. That said, if you are experiencing extreme symptoms (especially an increased heart rate and blood in your vomit) contact your doctor immediately.
Tests for Morning Sickness / Hyperemesis Gravidarum
If you\’ve talked with your doctor about your symptoms, (that hopefully you\’ve kept a log of) based on the complications and symptoms you are facing, your doctor may suggest you take some tests. This will help to specify the reason why it is happening, whether they\’re putting your health at risk, etc.
Some of these tests include:
- Urine Test: There are quite a number of urine tests, which primarily deal with testing for dehydration or infection. This test is common in pregnancy as it can help to detect if you have diabetes, preeclampsia, or urinary tract infection. You may find that your doctor does these tests routinely during your pregnancy, even if you don\’t have strong symptoms of morning sickness / hyperemesis gravidarum.
- Blood Chemical Tests: Predominantly these tests are taken to determine if you’re malnourished, lacking in any vitamin or nutrition, if you\’re dehydrated, and whether you have anemia or not. Typically, three tests are given:
- CBC (Complete Blood Count) / FBC (Full Blood Count) / FBE (Full Blood Examination): This test determines the levels of different types of cells within your blood. In the case of pregnancy, it is usually taken to evaluate symptoms like tiredness, weakness or swelling, etc.
- Comprehensive Metabolic Panel: This test is taken to diagnose, monitor, or screen electrolyte levels, blood sugar, and organ functionality. (Predominantly kidney and liver function) Within this is a Chem 20 Panel, which focuses on electrolyte and blood sugar levels.
- Ultrasound: Usually, ultrasonography is done to monitor the baby\’s development. It may be used as support for diagnosing mom\’s heath concerns too.
How to Deal With Morning Sickness
Morning sickness can be very unpleasant. There is no particular way to stop this since it is a natural occurrence. But fortunately, researchers suggest some diet and lifestyle modifications that can improve your condition.
You can overcome morning sickness by following the below steps.
- Get Rest: It is recommended to get plenty of rest in pregnancy. It turns out that being tired can actually make nausea feel worse!
- Do Light Exercise: Light exercise keeps you healthy during pregnancy, but it can also reduce the impacts of morning sickness. Any exercise that takes the blood flow coming to the stomach area away will help. Don\’t overdo it – light activity is perfect.
- Get Up Slowly: If you feel nauseous the first thing in the morning, try to get up slowly. If possible, eat a dry biscuit or toast before you fully wake up.
- Small Frequent Meals: Carbohydrates will make a big difference in making you feel better, but small portions are the go here. Try 5 small meals instead of 3 big meals over the day.
- Avoid Very Sweet and Very Spicy Food: Pregnancy cravings can be wild and intense! Try to hold back from eating any very sweet or very spicy foods you crave, even if that\’s only to test how they can affect your nausea.
- Drink Plenty of Water: Vomiting takes that all-important water out of your body. You become dehydrated. Even if you aren\’t vomiting a lot, try and drink frequently over the day. Sip small amounts, but frequently – this way you\’ll not get that bloated feeling. If you need help drinking water, you could try experimenting with low/no sugar sports and electrolyte drinks.
- Avoid Triggering Smells: Strong smells can make you feel nauseous! During pregnancy you may have a more sensitive sense of smell, and as a result, you may get triggered easily.
- Lemon Scents, or Lemon in Water: Just the smell of lemon can soothe your morning sickness. It can also gently flavor water to help encourage you to drink it.
- Distract Yourself: Try to avoid doing activities that require intense concentration. Activities like meditation, light yoga, or even simply talking with your close friends and family may help you manage your nausea.
- Wear Comfortable Clothing: Wear clothes that are comfortable and easy to walk in and wear. Clothing that is restrictive or constrictive puts pressure on your torso, which makes nausea much more likely.
- Avoid Caffeine: Caffeinated beverages can be a big no-no to avoid morning sickness. Tea or coffee and other caffeinated drinks may make your nausea worse.
- Don\’t Go to Bed Immediately After Eating: It is recommended to at least have dinner 2 to 3 hours before going to bed. As sleeping on a full stomach could lead to heartburn resulting in nausea.
- Ventilate Your Space: Fresh air makes everyone feel better! We undo the car windows if we\’re getting car sickness, so it makes sense that fresh air in your home and office could support you, too.
Treatment for Morning Sickness
Your doctor may prescribe you some medications in order to reduce morning sickness. While the medications are common, you should never take them without medical advice.
The most helpful and common medications are as follows:
- Phenothiazine: This drug affectsthe dopamine D2-receptor in your brain with the aim of calming intense nausea and vomiting.
- Antacids: Antacids helps in absorbing stomach acids and relieve heartburn. Acidity occurs when the valve between the esophagus and stomach fails to prevent stomach acid from coming back up.
- Antihistamines: Typically for hayfever symptoms, it can also help with your morning sickness.
- Metoclopramide: This drug is used mainly for GRED. (Gastroesophageal reflux disease) When your food doesn\’t progress from your stomach to the rest of your digestive system efficiently, it can cause nausea and bloat.
Home Remedies for Morning Sickness
The anti-nausea medications can have some side effects, even severe ones. As a result, many people prefer natural ways that can be easily done in the home to reduce morning sickness and feel better.
- Eat Ginger: Ginger is considered as a safe and effective morning sickness remedy. It is popular for its anti-nausea magic. Adding a touch of ginger to your meal, or having a ginger tea may help your symptoms.
- Vitamin B6 supplements: Taking up to 200 mg vitamin B6 also known as pyridoxine a day is considered safe in pregnancy. Just like ginger, this is another alternative method to avoid anti nausea medications. For this reason, several reports show how useful it works against morning sickness.
- Try Peppermint Aromatherapy: A study shows that this aromatherapy was successful against nausea in 57% of cases. Another study shows those who were given this smell rated their level of nausea less than the ones who were just given medications. Moreover, many recommend sipping peppermint tea to reduce nausea, or using peppermint oil.
- Breathing Technique: Studies show that specific breathing techniques can help reduce nausea symptoms. The breathing technique worked for 62% of women in reducing nausea. This particular breathing technique is to inhale on a count of three and then exhale on a count of three slowly. The controlled breathing pattern is known to relieve stress as well – no wonder women in labor are told to breathe!
- Relaxing your Muscles: Relaxing your muscles in a specific way can help with nausea, studies show. help to achieve both physical and mental relaxation. There is a technique that is quite well known for this. It’s called PMR or progressive muscle relaxation. There are guided videos on YouTube that you could start with to see if this is effective for you.
- Acupuncture and Acupressure: These are ancient Chinese techniques to reduce nausea. Even to this day, they are used and are as effective as medications with no seen side effects. Studies have shown acupuncture as effective in managing nausea.
Pregnancy is always a delicate time, but it can be especially difficult if nausea and vomiting persists throughout pregnancy. We\’ve listed some common questions below, but as always – consult your doctor if you are unsure if what you are experiencing is normal.
Can I take medications for morning sickness in pregnancy?
You can take medication for morning sickness during pregnancy, but only as a result of direct advice from your doctor. Do not take someone else\’s medication, or expired medication, even if it is to treat the same symptoms.
Is nausea a good sign pregnancy is progressing?
Morning sickness or nausea has been associated with a reduced risk of miscarriage.
Is it normal to get morning sickness in the second trimester or later? It\’s completely normal for nausea to make a comeback, or appear at all, later in pregnancy. If the symptoms are becoming more severe, or are impacting your life to the point it is challenging your daily tasks, keep a journal of your symptoms and make an appointment with your doctor.