When Does Morning Sickness Start? A Timeline for Expectant Mothers

Thankfully, for most women, morning sickness tails off after 12 or 13 weeks of pregnancy and doesn’t cause too much disruption or suffering, with the woman able to manage her symptoms pretty well.

Although we call it morning sickness, nausea and vomiting in pregnancy (NVP) can happen at any time of day. It can be more common in the morning due to hormonal fluctuations and possibly low blood sugar before breakfast.

If you’re experiencing morning sickness, here’s what you need to know

• Morning sickness is a normal feature of pregnancy, with around 80%, or four out of five, women experiencing some degree of nausea and/or vomiting

• NVP is probably due to an increase of human chorionic gonadotropin (hCG), the pregnancy hormone, although no one really knows for certain

• You can feel very hungry in early pregnancy as your body is working very hard and this can make your nausea worse
• Mild morning sickness will not harm your baby in any way, so even if you’re feeling awful and being sick a a few times a day, your baby will still get everything they need from you

•  If your morning sickness is mild to moderate then you can help yourself with things like resting, drinking ginger or peppermint tea and making sure you eat little and often to stabilise your blood sugar

More on the causes of morning sickness

Those pesky hormones! Pregnancy is a hormonal rollercoaster, and your hCG levels can double every two or three days, causing quite a bit of chemical chaos.

In very early pregnancy, the collection of cells which will form your placenta produce hCG in large quantities to “tell” your womb lining to thicken and your placenta to grow so they can support your baby.

By the time you’re 11 or 12 weeks pregnant, your placenta and womb lining are pretty much fully formed and are doing their jobs nicely so your hCG starts to decline and it’s around this time that most women start to feel better.

It’s not just hCG behind morning sickness

We can’t blame hCG alone for making you feel sick, as oestrogen may also have a part to play, as well as progesterone. The levels of these two hormones also rise rapidly and this is thought to contribute to feelings of nausea.

NVP can also be compounded by low blood sugar. Growing a placenta takes a lot of energy and this can cause big fluctuations in your blood sugar levels. Low levels can often make you feel sick and, combined with your pregnancy hormones, low blood sugar is a recipe for NVP.

How to cope with morning sickness

For most pregnant women, morning sickness can be managed and so with a few adjustments and tricks you can carry on with your life pretty much as normal. Here are our best tips for dealing with pregnancy sickness.

Rest as much as possible

You’re doing something amazing, so allow yourself to rest up whenever you can. Tiredness can increase your feelings of sickness and cause you to vomit more, so head to bed early and try to nap or at least chill during the day.

Eat little and often to stabilise your blood sugar

Aim to eat six or so times every day so that you’re not going too long between meals and also so that you’re not eating a great deal in one go as large meals can often - ahem - reappear. Complex carbs and not-too-fatty sources of protein are your best friends here.

Stay well hydrated

Dehydration due to vomiting can make your feel even worse, so aim to drink 1.5 litres of water every day. You don’t have to chug down a pint in one go; sipping tiny amounts regularly is the way to do it, but do monitor your intake. Eating fresh fruit and vegetables is also a good way to keep up your water levels. 

Try ginger sweets, biscuits and tea

Ginger can help to reduce feelings of nausea, as can peppermint, so suck on ginger-flavoured sweets or mints and drink some mint or ginger tea. This won’t cure your morning sickness, but it can reduce it for a while to help you to go about your day. 

Build your pregnancy nausea into your day

If there’s a particular time of day you feel very sick or vomit then schedule your routine around it so it doesn’t interfere too much. For example, if you’re very nauseated at the time you usually commute into work, ask HR if you can come in slightly later.

Avoid your nausea triggers

You’ll know what they are with absolute certainty! They could be various cooking smells, eating particular foods or travelling in a car. Do your best to eliminate your triggers and if you do have to get into a car, try sipping fizzy water to quell the nausea. 

When should you get help for your pregnancy sickness?

For some women, morning sickness can become serious. Hyperemesis gravidarum(HG), or excessive vomiting in pregnancy, is a severe form of NVP which can lead to dehydration and even malnutrition.

No one is sure of the exact figure, but it’s thought that between 1% and 3% of pregnant women suffer from HG. Hyperemesis tends to last longer than “regular” morning sickness, too, often persisting beyond 20 weeks and sometimes right for the entire pregnancy, although it does often reduce in severity.

You’re also more likely to develop HG if you’re expecting twins(or more), if you have a history of motion sickness and migraines and if you’ve had HG in a previous pregnancy.

The cause of HG is still something of a mystery, but some researchers believe it’s linked to the way individual hormones behave and interact. It’s still unlikely that this severe form of morning sickness will hurt your baby, especially if you get treatment.

You should call your doctor if:

• You’ve been unable to keep food or fluids down for more than 24 hours

• You're experiencing weight loss - losing 5% or more of your bodyweight due to NVP is deemed to be a serious case of HG

• You’re peeing less than usual and your pee is very dark

• You’re feeling dizzy and very tired

• You have a headache

• You’re unable to do some or most of your usual activities

There are safe treatments for hyperemesis gravidarum

Modern-day treatments for excessive NVP include antiemetic medications. These medicines have helped a lot of women with HG for several decades now and there’s no evidence to show they harm the baby.

Your doctor might give you the medicine as a tablet that you place between your top lip and gum so that it slowly dissolves, which is useful if you’re having difficulty keeping food and water down.

The meds give you two or three “windows” during the day when you can eat and drink to help you stay hydrated and nourished.

Having severe pregnancy sickness can be an isolating experience, especially if the people around you don’t understand what you’re going through or dismiss it as “normal” morning sickness. If you need to talk to someone, you can contact Pregnancy Sickness Support for help, advice and an understanding ear.

Citations and References

(1) National Health Service (NHS). ‘Vomiting and Morning Sickness.’ 2021. Web. www.nhs.uk/pregnancy/related-conditions/common-symptoms/vomiting-and-morning-sickness

(2) Cleveland Clinic. ‘Morning Sickness.’ 2023. Web. https://my.clevelandclinic.org/health/diseases/16566-morning-sickness-nausea-and-vomiting-of-pregnancy

(3) Pregnancy Sickness Support. ‘Maternal Serum Human Chorionic Gonadotropin (hCG) βhCG And Progesterone Levels in Weeks 5-17 From LMP Associated With Symptoms of Pregnancy Sickness.’ 2023. Web. www.pregnancysicknesssupport.org.uk/resources/causes/maternal-serum-human-chorionic-gonadotrophin-hcg-hcg-and-progesterone--levels-in-weeks-5-17-from-lmp-associated-with-symptoms-of-pregnancy-sickness

(4) National Health Service (NHS). ‘Vomiting and Morning Sickness.’ 2021. Web. www.nhs.uk/pregnancy/related-conditions/common-symptoms/vomiting-and-morning-sickness

(5) National Health Service (NHS). ‘Nausea and Vomiting in Pregnancy. 2023. Web. www.uhsussex.nhs.uk/resources/nausea-and-vomiting-in-pregnancy-2/#what-can-i-do-to-improve-my-symptoms

(6) National Health Service (NHS). Better Health. Start for Life. ‘Week-by-week Guide to Pregnancy.’ 2019. Web. www.nhs.uk/start4life/pregnancy/week-by-week/1st-trimester/week-9

(7) Insider. ‘What you need to know about hCG, the 'pregnancy hormone’.’ 2020. Web. www.insider.com/guides/health/reproductive-health/what-is-hcg

(8) National Library of Medicine. ‘Nausea and Vomiting of Pregnancy.’ 2011. Web. www.ncbi.nlm.nih.gov/pmc/articles/PMC3676933/

(9) National Health Service (NHS). ‘Vomiting and Morning Sickness.’ 2021. Web. www.nhs.uk/pregnancy/related-conditions/common-symptoms/vomiting-and-morning-sickness

(10) University of California San Francisco. ‘Coping With Common Discomforts of Pregnancy.’ 2023. Web. www.ucsfhealth.org/education/coping-with-common-discomforts-of-pregnancy

(11) National Library of Medicine. ‘Taste, smell and food-related nausea and vomiting responses in hyperemesis gravidarum: A case-controlled study.’ 2020. Web. www.ncbi.nlm.nih.gov/pmc/articles/PMC7064589

(12) National Health Service (NHS). ‘Pregnancy Complications: Severe Vomiting in Pregnancy.’ 2023. Web. www.nhs.uk/pregnancy/related-conditions/complications/severe-vomiting

(13) Cleveland Clinic. ‘Hyperemesis Gravidarum.’ 2023. Web. my.clevelandclinic.org/health/diseases/12232-hyperemesis-gravidarum

(14) National Library of Medicine. ‘Hyperemesis Gravidarum.’ 2022. Web. www.ncbi.nlm.nih.gov/books/NBK532917

(15) National Health Service (NHS). ‘Nausea and Vomiting in Pregnancy - Hyperemesis Gravidarum.’ 2023. Web. www.chelwest.nhs.uk/your-visit/patient-leaflets/womens-services/nausea-and-vomiting-in-pregnancy-hyperemesis-gravidarum