Everything You Need to Know About Nausea and Vomiting in Pregnancy

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Welcome. Nausea and vomiting can make life miserable. When they occur during pregnancy, they can feel like they steal the magic and fun out of being pregnant. It probably won’t make you feel any better, but you have lots of company — most women experience some nausea during pregnancy. Although this is sometimes called morning sickness, it can actually occur at any time during the day.

By answering a short series of questions, you can figure out whether your nausea and vomiting are related to your pregnancy or if they might be caused by something else.

Let’s Begin

Repeated episodes of vomiting can deplete you of fluids and electrolytes, no matter what the cause.

Have you been vomiting so much that you feel lightheaded or very weak?

Yes, I have.

No, I am not lightheaded or especially weak.

Okay. Now we need to consider if your symptoms stem from being pregnant or if they might be caused by something else.

How long have you had nausea and vomiting?

My symptoms began within the last five days.

My symptoms have lasted more than five days.

You are likely dehydrated. That can make you feel extra horrible on top of nausea and vomiting. You may not be able to stand up for more than a couple minutes and could possibly faint. Although unlikely, your blood pressure might get so low that blood flow to the placenta might be less than optimal.

Contact your doctor, nurse, or midwife now, or go to urgent care or an emergency department.

Please return to our guide after you have received advice and care.

Click here to return to the guide.

It is important to know whether your nausea and vomiting are brand new, or whether they have been bothering you for a while.

How long have you had your symptoms?

My symptoms began within the last five days.

My symptoms have lasted more than five days.

Let’s be certain you don’t have any other symptoms that could indicate the need for immediate medical evaluation.

Do you have any of the following symptoms?

  • Fever
  • Abdominal or pelvic pain
  • Severe headache
  • New or unusual leg swelling
  • Vomiting blood or black, tar-like stools

Yes.

No.

That’s good. It sounds as if the nausea and vomiting you are experiencing are due to your pregnancy.

About 80% of pregnant women begin to experience nausea and vomiting between the fourth and seventh week after the last menstrual period. For most women, it stops by the 20th week of gestation. In some cases, though, it continues for the duration of the pregnancy.

Are you more than 10 weeks pregnant?

Yes, I am more than 10 weeks pregnant.

No, less than 10 weeks.

What you are experiencing is most likely related to your pregnancy. However, if your vomiting is persistent and severe, you may have a condition called hyperemesis gravidarum.

There is no strict definition that separates severe “morning sickness” from hyperemesis. If you have lost 5 percent of your body weight due to nausea and vomiting, then you have hyperemesis.

Do you have severe and persistent nausea and vomiting and/or have you lost 5 percent or more of your body weight?

Yes.

No.

Some women continue to have nausea and vomiting beyond the 20th week of gestation, which is when it typically goes away.

Did the nausea and vomiting start before you were 10 weeks pregnant?

Yes, it started earlier.

No, it started after 10 weeks

It is unusual for pregnancy-related nausea and vomiting to begin 10 weeks into the pregnancy. If you didn’t have any nausea or vomiting earlier in pregnancy, you need to consider other causes.

A urinary tract infection can cause nausea with or without vomiting.

  • Does it burn when you urinate?
  • Is your urine cloudy or pink?
  • Do you have to urinate more often than usual?

Yes, I have one or more of these symptoms.

No, I do not have urinary symptoms.

What you are experiencing is most likely related to your pregnancy. However, if your vomiting is persistent and severe, you may have a condition called hyperemesis gravidarum.

There is no strict definition that separates severe “morning sickness” from hyperemesis. If you have lost 5 percent of your body weight due to nausea and vomiting, then you have hyperemesis.

Do you have severe and persistent nausea and vomiting and/or have you lost 5 percent or more of your body weight?

Yes.

No.

So far your answers suggest that what you are experiencing is most likely related to your pregnancy.

Just to be sure that there is not another reason for the nausea and vomiting, please continue with the guide.

Click here to continue.

Contact your doctor, nurse, or midwife as soon as possible. If you feel lightheaded and/or very thirsty now, go directly to urgent care or an emergency department. You will likely need intravenous fluids.

Call your doctor, nurse, or midwife immediately, or go to urgent care or an emergency department. These symptoms could indicate something more serious than pregnancy-related nausea and vomiting.

Some conditions that cause nausea and vomiting also can cause bleeding into the digestive tract. Blood in vomit can appear red or it can look dark and grainy, like coffee grounds, due to chemical changes from stomach acid. Blood in the stool may be black and have a tar-like texture.

Have you vomited blood or “coffee grounds,” or have you noticed black tar-like stools?

Yes.

No.

Although nausea and vomiting are very common during pregnancy, you’re unlikely to have other symptoms if they are simply related to being pregnant.

Do you have any of the following symptoms?

  • Fever
  • Abdominal or pelvic pain
  • Severe headache
  • New and unusual leg swelling

Yes, I have one or more of these symptoms.

No, none of these apply to me.

That’s good. Those symptoms could indicate something more serious than just nausea and vomiting of pregnancy.

About 80% of pregnant women begin to experience nausea and vomiting between the fourth and seventh week after the last menstrual period. For most women, it stops by the 20th week of gestation. In some cases, though, it lasts longer.

Are you more than 10 weeks pregnant?

Yes, more than 10 weeks.

No, less than 10 weeks.

So far, your answers suggest that your nausea and vomiting are related to your pregnancy.

Just to be sure that there is not another reason for the nausea and vomiting, please continue with the guide.

Click here to continue.

A urinary tract infection can cause nausea with or without vomiting.

  • Does it burn when you urinate?
  • Is your urine cloudy or pink?
  • Do you have to urinate more often than usual?

Yes, I have one or more of these symptoms.

No, I do not have urinary symptoms.

Since your nausea and vomiting are just starting now and you are more than 10 weeks pregnant, your symptoms are unlikely to be “morning sickness.” Let’s consider some other possible causes.

A urinary tract infection can cause nausea with or without vomiting.

  • Does it burn when you urinate?
  • Is your urine cloudy or pink?
  • Do you have to urinate more often than usual?

Yes, I have one or more of these symptoms.

No, I do not have urinary symptoms.

Nausea with a yellowing of your eyes or skin and urine that has turned a brownish or cola color can indicate a problem with your liver or blood.

Have you noticed any of these changes?

Yes.

No.

Another reason for nausea and vomiting not specifically related to pregnancy is dizziness from vertigo. This often causes a spinning sensation and problems with balance.

Are you experiencing any dizziness, especially a spinning sensation or feeling off balance?

Yes.

No.

Call your doctor, nurse, or midwife immediately. These symptoms might be caused by an inflammation of your liver or a blocked bile duct. Red blood cells that are breaking apart can also cause similar symptoms.

Your doctor can prescribe an antibiotic that is safe for your baby. The usual treatment lasts 3 to 7 days.

Call your doctor, nurse, or midwife now.

After making the call, please continue to learn about other potential causes of nausea and vomiting.

Click here to learn more.

Another reason for nausea and vomiting not specifically related to pregnancy is dizziness from vertigo. This often causes a spinning sensation and problems with balance.

Are you experiencing any dizziness, especially a spinning sensation or feeling off balance?

Yes.

No.

Okay. Let’s review your answers. You have new nausea and vomiting without fever, headache, or abdominal pain. And you don’t have the spinning sensation or imbalance that occurs with vertigo.

Gastroenteritis, commonly called stomach flu, is another common cause of nausea and vomiting. It is often accompanied by diarrhea.

Gastroenteritis usually gets better without any specific treatment. You need to be sure you drink enough fluids to stay hydrated.

If you develop repeated vomiting or severe diarrhea, call your doctor, nurse, or midwife for advice now, or go to urgent care or an emergency department because you may need intravenous fluids.

Click here to finish.

You likely have vertigo. Most often this is related to a problem within the ear.

There is no specific treatment for vertigo. Keeping your head completely still is a good way to reduce the symptoms enough to allow you to drink and stay hydrated.

If keeping your head still does not stop your nausea and vomiting, call your doctor, nurse, or midwife for advice. You may need to get intravenous fluids to avoid dehydration.

Click here to finish.

We hope this guide was helpful and that you feel better soon.

This is worrisome. You would not have any of these symptoms if this was simply pregnancy-related nausea. It could be a complication of pregnancy, such as preeclampsia, or some potentially serious condition unrelated to your pregnancy.

Call your doctor, nurse, or midwife immediately, or go to urgent care or an emergency department.

The appearance of your vomit or stools suggests that you may have internal bleeding.

Go to urgent care or an emergency department immediately.

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