Morning sickness affects up to 70% of pregnant women, bringing nausea and vomiting that can strike at any time of day. While the exact cause remains unclear, researchers have made progress understanding how hormones and individual sensitivity play a role. Most women find relief through dietary changes and lifestyle adjustments, though some require medical treatment to manage severe symptoms that can affect their quality of life and daily functioning.

What You Need to Know About Managing Pregnancy Nausea

The journey through pregnancy brings many changes to a woman’s body, and for the majority of expectant mothers, nausea and vomiting become unwelcome companions during the first trimester. Despite its misleading name, morning sickness can occur at any hour of the day or night, and for some women, the queasiness persists from sunrise to sunset. The primary goal of treatment is to help women maintain adequate nutrition and hydration while reducing discomfort enough to preserve their ability to work, care for their families, and enjoy this special time in their lives.^[1][2]

Treatment approaches vary depending on the severity of symptoms and how they impact each individual woman. Some experience only mild nausea that responds well to simple dietary adjustments, while others face debilitating symptoms requiring medical intervention. The condition typically begins around the sixth week of pregnancy and peaks between eight and ten weeks, with most women finding relief by the end of the first trimester around week 14. However, about one in five women continues to experience symptoms into the second trimester, and in rare cases, nausea persists throughout the entire pregnancy.^[2][5]

Healthcare providers now recognize that morning sickness is not a psychological condition, as was once mistakenly believed, but rather a physical response to the dramatic changes occurring in the body during early pregnancy. Standard treatments approved by medical societies include dietary modifications, lifestyle changes, vitamin supplementation, and various medications that have been studied for safety during pregnancy. At the same time, researchers continue investigating new therapies and exploring the underlying mechanisms that cause some women to suffer more severely than others.^[3][4]

Understanding the Condition and Its Causes

Morning sickness, medically known as nausea and vomiting of pregnancy, represents one of the most common medical conditions affecting pregnant women. Approximately 70 to 80% of women experience some degree of nausea during pregnancy, though the severity varies considerably from one person to another. For most women, symptoms begin before nine weeks of pregnancy and improve significantly by weeks 12 to 14. The name “morning sickness” is actually a misnomer because symptoms can strike at any time during the day or night, and some women feel nauseated continuously throughout the day.^[2][5]

The exact cause of morning sickness remains incompletely understood, but researchers believe it results from a combination of physical and chemical changes occurring in the pregnant body. The most likely culprits include increases in pregnancy hormones, particularly human chorionic gonadotropin (HCG) and estrogen, which rise dramatically during early pregnancy. Blood sugar levels may drop, blood pressure can fluctuate (particularly lowered blood pressure), and the body undergoes significant changes in how it metabolizes carbohydrates. All these factors together create the perfect storm for nausea and vomiting.^[2][3]

Recent research published in the journal Nature has identified a specific hormone called GDF15 as a key player in pregnancy sickness. This hormone is produced by the placenta and increases substantially during pregnancy. Scientists discovered that women exposed to lower levels of GDF15 before pregnancy tend to experience more severe symptoms when they become pregnant and are suddenly exposed to higher levels. Essentially, a woman’s sensitivity to this hormone determines how sick she will feel. The receptors for GDF15 are located in the part of the brain that controls nausea and vomiting, which explains the direct connection between hormone levels and symptoms.^[4]

Certain factors can make morning sickness worse or trigger nausea episodes. These include stress and anxiety, being overtired or exhausted, eating or smelling certain foods that the pregnant woman finds offensive, experiencing motion sickness (such as being in a car), and exposure to heat or warm weather. Many pregnant women develop a heightened sense of smell during early pregnancy, which can make previously tolerable odors suddenly unbearable and nausea-inducing. Some women notice that their symptoms follow patterns, with certain times of day or specific situations consistently triggering worse nausea.^[2][19]

Several risk factors increase the likelihood of experiencing morning sickness. Women carrying twins or other multiples often have more severe symptoms, possibly because they have a larger placenta producing more pregnancy hormones. Having experienced morning sickness in a previous pregnancy makes it more likely to occur again, and if your mother or sister had severe morning sickness, your chances increase. First-time pregnancies, a history of motion sickness or migraine headaches, being overweight with a body mass index of 30 or more, and even being pregnant with a female fetus all increase the risk of developing morning sickness.^[5][7]

Standard Treatment Approaches

The foundation of managing mild to moderate morning sickness rests on dietary and lifestyle modifications that women can implement at home without medication. Healthcare providers typically recommend trying these approaches first, as they prove effective for many women and carry no risk of side effects. The strategy involves making small but meaningful changes to eating patterns, food choices, and daily routines that can significantly reduce nausea and improve comfort during pregnancy.^[6][7]

Dietary changes form the cornerstone of morning sickness management. Women are advised to keep crackers or dry toast at their bedside and eat a few pieces before getting out of bed in the morning, as an empty stomach can trigger or worsen nausea. Instead of eating three large meals, pregnant women should consume five to six small meals throughout the day, preventing the stomach from becoming too empty or too full, as both extremes can increase queasiness. The focus should be on bland, easy-to-digest foods that are high in carbohydrates and low in fat, such as bread, rice, crackers, pasta, bananas, applesauce, and toast. Cold foods often work better than hot meals because they produce less odor, and protein-rich foods like chicken, peanut butter, beans, nuts, cheese, milk, cottage cheese, and yogurt can help calm nausea by increasing a hormone called gastrin that aids digestion.^[6][13]

Staying hydrated is critical, especially for women who are vomiting. Drinking plenty of fluids throughout the day helps prevent dehydration, which occurs when the body doesn’t have enough water and can lead to serious complications. Women should sip fluids slowly rather than drinking large amounts at once, and taking small sips frequently throughout the day may help prevent vomiting. Some women find that certain beverages work better than others—for example, ginger ale, seltzer water, or other carbonated drinks may be easier to tolerate. Ice cubes, ice lollies made from juice or water, and cold beverages are often better tolerated than room-temperature or warm drinks. It’s helpful to drink fluids between meals rather than with meals to avoid making the stomach too full.^[2][20]

Foods and drinks containing ginger have shown some evidence of helping reduce nausea and vomiting during pregnancy. Women can try ginger tea, ginger candy, ginger ale (checking that it contains actual ginger rather than just ginger flavoring), or ginger supplements. However, pregnant women should check with their pharmacist before taking ginger supplements to ensure they are using appropriate products and doses. Vitamin B6-rich foods, including whole grains, nuts, seeds, peas, beans, salmon, and avocados, may also help with symptoms.^[7][13]

Lifestyle adjustments complement dietary changes and can make a substantial difference in symptom management. Getting plenty of rest is essential, as tiredness makes nausea worse. Women should avoid rushing in the morning and give themselves time to wake up slowly and calmly. Identifying and avoiding specific triggers—whether certain smells, foods, or situations—can prevent nausea episodes. Keeping rooms well-ventilated helps reduce odors that might trigger nausea. Wearing loose, comfortable clothing made of breathable fabrics prevents the feeling of restriction that can worsen queasiness. Taking prenatal vitamins at night rather than in the morning may help if the iron they contain irritates the stomach, and taking them with a small amount of food rather than on an empty stomach can also reduce nausea. Some women find they need to try several different brands of prenatal vitamins to find one they can tolerate, or they may need to temporarily take just folic acid for a few weeks.^[14][15]

Some non-medical therapies have shown promise in helping women manage morning sickness. Acupressure involves applying pressure to specific points on the wrist, either by pressing with fingers or using special wristbands or bracelets designed for this purpose. These bands, often marketed for motion sickness, are available at drugstores, health food stores, and travel stores. Some evidence suggests they may help relieve symptoms. Acupuncture, a traditional Chinese medicine practice involving the insertion of thin needles at specific points on the body, has also been used with varying degrees of effectiveness. Women interested in acupuncture should talk with their healthcare provider and seek an acupuncturist trained to work with pregnant women.^[6][12]

When lifestyle and dietary changes prove insufficient, medical treatment becomes necessary. The first line of pharmaceutical treatment typically involves vitamin B6 supplements, also called pyridoxine. Studies have shown that vitamin B6 at doses of 100 mg or less daily can ease symptoms of morning sickness, and many healthcare providers recommend trying this before other medications. It is considered safe for use during pregnancy.^[8][14]

If vitamin B6 alone doesn’t provide adequate relief, doctors may recommend combining it with doxylamine, an antihistamine typically used to treat allergies but which also works as an anti-sickness medicine. In some countries, a prescription medication combining doxylamine succinate and pyridoxine hydrochloride is specifically approved for treating morning sickness. This combination has been extensively studied and is considered safe during pregnancy.^[8][12]

Other medications that may be prescribed include various types of antihistamines, which are usually given as tablets to swallow. These work both to treat allergies and to prevent nausea and vomiting. Additional options with relatively good safety profiles include ondansetron, a medication commonly used to prevent nausea and vomiting from other causes; phenothiazines, a class of drugs with anti-nausea properties; and metoclopramide, which helps the stomach empty and reduces nausea. For severe cases, doctors may prescribe corticosteroids, though these are typically reserved for women with the most severe symptoms.^[12]

The duration of medication treatment varies depending on symptom severity and how well a woman responds to therapy. Some women need medication only during the first trimester, while others require treatment for longer periods. Healthcare providers carefully monitor pregnant women taking medications, adjusting doses and types as needed to find the most effective treatment with the fewest side effects. Women should never start or stop any medication during pregnancy without consulting their healthcare provider, as even over-the-counter medications and herbal supplements need to be evaluated for safety.^[8]

Managing Severe Morning Sickness: Hyperemesis Gravidarum

Hyperemesis gravidarum represents the most severe form of pregnancy-related nausea and vomiting, affecting approximately 2 to 3% of pregnant women. This condition goes far beyond typical morning sickness and can cause serious complications if left untreated. Women with hyperemesis gravidarum experience extreme, excessive nausea and vomiting that persists throughout the day and night, often preventing them from keeping down any food or liquids. The condition is diagnosed when a woman loses 5% or more of her pre-pregnancy body weight and shows signs of dehydration or electrolyte imbalances.^[5][9]

The symptoms of hyperemesis gravidarum are much more severe than typical morning sickness. Women vomit more than three to four times per day, become severely dehydrated (indicated by producing very little urine that is dark in color, or no urine at all), feel dizzy or faint when standing up, and may lose 10 pounds or more. The constant vomiting can lead to imbalances in important minerals in the body called electrolytes, such as sodium and potassium, which are essential for proper body function. Women may also experience rapid or pounding heartbeat, extreme weakness, and inability to perform daily activities.^[9][10]

Treatment for hyperemesis gravidarum often requires hospitalization to restore fluids and stop the vomiting. In the hospital, women receive fluids through a vein (intravenously) to correct dehydration and restore electrolyte balance. Anti-nausea medications are also administered, either through an intravenous line, as injections, or as suppositories inserted into the rectum. These methods deliver medication directly into the bloodstream, bypassing the stomach and allowing them to work even when a woman cannot keep anything down by mouth. Most women begin to feel better after receiving intravenous fluids and medications, though some require repeated hospital stays if symptoms return.^[8][9]

In rare cases where a woman continues to lose weight despite treatment, doctors may need to place a feeding tube to ensure she receives adequate nutrition. This is uncommon but may be necessary to protect both the mother and the developing baby. Women with hyperemesis gravidarum may need ongoing monitoring throughout their pregnancy, with frequent check-ups to assess hydration status, weight, and overall health.^[8]

The psychological impact of severe morning sickness cannot be underestimated. Hyperemesis gravidarum can profoundly affect a woman’s quality of life, preventing her from working, socializing, caring for other children, or performing basic daily tasks. Women with this condition report higher levels of psychological stress, anxiety, and depression. Some women feel isolated and misunderstood, especially if others minimize their symptoms or suggest they are exaggerating. In extreme cases, women have chosen to terminate wanted pregnancies rather than continue suffering from severe symptoms. Healthcare providers now recognize the importance of providing both physical treatment and emotional support for women dealing with hyperemesis gravidarum.^[3][5]

Research Into New Treatments

Scientists continue working to better understand the mechanisms behind morning sickness and hyperemesis gravidarum, with the ultimate goal of developing more effective treatments and potentially preventing the condition altogether. The recent discovery of GDF15’s role in pregnancy sickness represents a major breakthrough that could lead to new therapeutic approaches in the coming years.^[4]

Research conducted by teams from the United States, United Kingdom, and Sri Lanka collected extensive evidence showing that GDF15 is a key cause of pregnancy sickness. The hormone is produced by the fetus in the placenta and increases substantially during pregnancy. The groundbreaking study, published in the journal Nature, revealed that both the amount of GDF15 a woman is exposed to and her sensitivity to the hormone determine the severity of her symptoms. Women who had lower exposure to GDF15 before pregnancy are not accustomed to the hormone, so when they become pregnant and levels rise dramatically, they experience more severe nausea and vomiting.^[4]

The research team used multiple approaches to establish the link between GDF15 and pregnancy sickness, including analyzing patient genetics and blood samples, conducting studies with human cells, and performing experiments with mice. One important finding involved a rare genetic mutation in the gene that codes for GDF15. Women with this mutation have abnormally low levels of the hormone throughout their lives before pregnancy. When they become pregnant and are suddenly exposed to higher levels of GDF15 from the placenta, they are at much greater risk of developing hyperemesis gravidarum. However, if the fetus also inherits the low-GDF15 mutation, the mother may be less likely to develop severe symptoms because the placenta produces less of the hormone.^[4]

These findings suggest two potential strategies for preventing or treating pregnancy sickness in the future. The first approach would involve lowering GDF15 levels during pregnancy, perhaps through medication that blocks the hormone or reduces its production. The study provides the first human evidence that this approach is likely to be safe. The second strategy involves exposing women to GDF15 before pregnancy to “prime” or prepare their bodies for the elevated hormone levels that occur during pregnancy. By building tolerance to the hormone before conception, women might experience less severe symptoms when they become pregnant. Researchers are now working to develop and test these approaches, though it will likely be several years before any new treatments based on this research become available to patients.^[4]

The identification of GDF15 as a primary cause of morning sickness represents a significant advance in understanding this condition. For decades, researchers struggled to explain why morning sickness occurs and why it affects some women so severely while others have mild symptoms or none at all. This new knowledge provides a clear biological mechanism and opens the door to developing targeted therapies that address the root cause rather than simply treating symptoms. It also validates the experiences of women who suffer from severe morning sickness, confirming that their symptoms have a real biological basis and are not psychological or exaggerated.^[4]

Ongoing clinical research continues to evaluate the safety and effectiveness of various medications already in use for morning sickness. Scientists conduct studies to better understand how different drugs work, determine optimal dosing strategies, and identify which patients might benefit most from specific treatments. This research helps refine treatment guidelines and ensures that healthcare providers have evidence-based recommendations for managing pregnancy-related nausea and vomiting.^[12]

Most common treatment methods

• Dietary modifications
  • Eating small, frequent meals (5-6 times per day) instead of three large meals to prevent the stomach from becoming too empty or too full
  • Consuming bland, easy-to-digest foods high in carbohydrates and low in fat, such as bread, rice, crackers, pasta, bananas, applesauce, and toast
  • Eating protein-rich foods like chicken, peanut butter, beans, nuts, cheese, milk, cottage cheese, and yogurt to help calm nausea
  • Keeping crackers or dry toast at the bedside to eat before getting up in the morning
  • Choosing cold foods over hot meals when the smell of hot food triggers nausea
  • Avoiding foods with strong smells, spicy foods, onions, garlic, and acidic fruits that may worsen symptoms
• Hydration strategies
  • Sipping fluids slowly and frequently throughout the day rather than drinking large amounts at once
  • Trying carbonated beverages like ginger ale, seltzer, or sparkling water
  • Sucking on ice cubes, ice lollies, or popsicles made from juice or water
  • Drinking fluids between meals rather than with meals to avoid overfilling the stomach
• Vitamin B6 (pyridoxine) supplementation
  • Taking vitamin B6 supplements at doses of 100 mg or less daily, which has been shown to ease morning sickness symptoms
  • Eating foods naturally high in vitamin B6, including whole grains, nuts, seeds, peas, beans, salmon, and avocados
• Ginger products
  • Consuming ginger tea, ginger candy, or ginger ale (made with real ginger rather than just flavoring)
  • Taking ginger supplements after consulting with a pharmacist about appropriate products and doses for pregnancy
• Combination medications
  • Using prescription medications that combine doxylamine succinate and pyridoxine hydrochloride (vitamin B6), specifically approved for treating morning sickness
  • Taking the delayed-release combination of doxylamine and vitamin B6, which is the drug of choice for treatment in some countries
• Antihistamine medications
  • Taking antihistamine medications as tablets, which work both to treat allergies and as anti-sickness medicines
  • Using these medications as first-line pharmaceutical treatment when dietary and lifestyle changes prove insufficient
• Other anti-nausea medications
  • Ondansetron for preventing nausea and vomiting
  • Phenothiazines, a class of drugs with anti-nausea properties
  • Metoclopramide, which helps the stomach empty and reduces nausea
  • Corticosteroids for the most severe cases
• Acupressure
  • Applying pressure to specific points on the wrist using special wristbands or bracelets
  • Pressing the acupoint P6 on the forearm with fingers
• Acupuncture
  • Receiving acupuncture treatments from practitioners trained to work with pregnant women
  • Having thin needles inserted at specific points on the body to help relieve nausea
• Hospital treatment for severe cases (hyperemesis gravidarum)
  • Receiving intravenous fluids to correct dehydration and restore electrolyte balance
  • Getting anti-nausea medications through intravenous line, injections, or suppositories
  • In rare cases, placement of a feeding tube to ensure adequate nutrition when weight loss continues despite treatment