Morning sickness: symptoms, when it starts and what helps

In short: Morning sickness is the nausea and vomiting many women feel in early pregnancy, and despite the name it can happen at any time of day or night. It usually starts around 6 weeks of pregnancy and, for most women, eases by around 16 to 20 weeks. Small, frequent meals and avoiding strong smells often help. See a gynaecologist if you cannot keep food or fluids down, feel dizzy, or are losing weight.

If you are feeling queasy all day and wondering whether this is "normal", you are in good company. Morning sickness is one of the most common early pregnancy symptoms. For many women it is the very first sign they are pregnant.

It can be exhausting, especially if you are working, looking after a home or already caring for children. The good news is that in most cases it is a sign of normal pregnancy hormones at work, and it does pass. Here is what to expect, what helps, and when to get help.

What is morning sickness?

Morning sickness (in Hindi, often described as ulti aana or jee machlana in pregnancy) is nausea, with or without vomiting, in pregnancy. It is not harmful to your baby in its usual mild or moderate form.

Common symptoms include:

• Feeling sick or queasy, often on waking or when your stomach is empty
• Vomiting, sometimes once or twice a day
• Gagging at certain smells, like cooking oil, perfume or tea
• Going off foods you normally love
• A metallic or sour taste in the mouth
• More saliva than usual

Many women also notice they are much more sensitive to smells. You can read more in sensitive to smells and sounds in pregnancy.

Why does morning sickness happen?

Doctors are not completely sure of the exact reason, but it is linked to the rise in pregnancy hormones in the first trimester, especially hCG (the hormone a pregnancy test picks up) and oestrogen.

Some things can make it more likely or stronger:

• Carrying twins or more
• Having had morning sickness in an earlier pregnancy
• A history of motion sickness or migraines
• Feeling very tired or stressed
• An empty stomach

Morning sickness does not tell you whether you are having a boy or a girl. That is a popular belief, but it is a myth.

When does morning sickness start and end?

For most women, it begins around 6 weeks of pregnancy, about two weeks after a missed period. Some feel it a little earlier.

It usually peaks around 9 weeks and, for most women, starts to ease by around 16 to 20 weeks. A few women feel sick for longer, and some have it on and off through the whole pregnancy.

Why is it worse at night for some women?

The name "morning sickness" is misleading. Many women feel worst in the evening or at night. This can happen because you are tired at the end of the day, because cooking smells build up in the evening, or because you have gone too long without eating. A small snack before bed and keeping something dry by your bedside can help.

What helps at home

There is no single trick that works for everyone, so try a few and see what suits you.

• Eat little and often: small meals every two to three hours, so your stomach is never completely empty.
• Start the day slowly: keep plain biscuits, toast, khakhra or roasted chana by your bed and nibble before you get up.
• Choose plain, dry foods: rice, poha, idli, roti, plain khichdi or boiled potatoes are often easier than spicy or oily food.
• Try cold foods: cold curd, buttermilk, fruit or chilled water can be easier to keep down than hot food, which smells stronger.
• Ginger: a little ginger in food or ginger tea helps some women.
• Sip fluids between meals: small sips of water, coconut water, lemon water or clear soups through the day, rather than large amounts with food.
• Avoid triggers: step out of the kitchen while others cook, open windows, and keep away from smells that set you off.
• Rest: tiredness makes nausea worse. Lie down when you can and ask family to share the load.
• Fresh air and loose clothes: a short walk or sitting near an open window can settle your stomach.

If you vomit, rinse your mouth with water afterwards rather than brushing straight away, to protect your teeth. For more ideas on pregnancy comfort, see managing common discomforts during pregnancy.

When to see a gynaecologist

Mild nausea that lets you eat and drink a little is usually fine to manage at home. Talk to your gynaecologist at your next visit, or sooner if it is getting you down.

A small number of women get a severe form called hyperemesis gravidarum. It is not just "bad morning sickness". It can make you dehydrated and needs treatment, sometimes in hospital with fluids through a drip. It is not your fault and it is not a sign of weakness.

Go to a doctor the same day if:

• You cannot keep any food or fluids down for a whole day
• You are vomiting many times a day
• Your urine is very dark, or you have not passed urine for many hours
• You feel dizzy, faint or very weak when you stand
• You are losing weight
• You have tummy pain, fever, or vomit blood
• You have vaginal bleeding or one-sided tummy pain
• Nausea starts for the first time after 10 weeks, or comes back suddenly later in pregnancy

How a doctor finds the cause

Your doctor will ask how often you are being sick, what you can eat and drink, and how much urine you are passing. They may:

• Check your weight, pulse and blood pressure
• Test your urine for signs of dehydration
• Do blood tests to check your salts, kidneys and thyroid
• Do an ultrasound to check the pregnancy, and see if there are twins

If it is severe, a doctor can suggest the right treatment safely for pregnancy, so please do not try to put up with it alone.

Questions women ask

Morning sickness kya hai?

Morning sickness pregnancy mein hone wali ulti aur jee machlane ki samasya hai. It is very common in early pregnancy, can happen at any time of day, and usually eases by the middle of the second trimester.

When does morning sickness start?

It usually starts around 6 weeks of pregnancy, roughly two weeks after a missed period. Some women notice it a little earlier, and some never get it at all, which is also normal.

Is it normal to have morning sickness at night?

Yes. Despite the name, many women feel worst in the evening or at night, often because of tiredness, cooking smells or an empty stomach. A small dry snack before bed and sips of water can help.

Is morning sickness a sign of a healthy pregnancy?

It is a sign that pregnancy hormones are rising, and many women with it have healthy pregnancies. But not having morning sickness is not a bad sign either. Every pregnancy is different.

What are the main reasons for morning sickness?

It is linked to rising pregnancy hormones such as hCG and oestrogen. Being tired, stressed, carrying twins, having an empty stomach, or a history of motion sickness can make it worse.