Morning sickness: when it starts, when it ends and what helps

When does morning sickness start?

Pregnancy nausea commonly begins between the fourth and seventh week, sometimes around the time a period is missed. Symptoms often become more noticeable over the following weeks. Not having nausea is also normal and, by itself, does not mean there is a problem.

Hormonal changes in early pregnancy are thought to play an important role. Smells, heat, tiredness, hunger and some foods may make symptoms worse, but triggers differ from person to person.

When does morning sickness end?

For many people symptoms ease between 12 and 20 weeks, and NHS guidance says they usually settle by 16 to 20 weeks. Some continue to have nausea later in pregnancy, and a smaller number experience it until birth.

New vomiting later in pregnancy should not automatically be blamed on morning sickness. Contact your clinician, especially if it comes with severe headache, vision changes, pain under the ribs, fever, diarrhoea or feeling very unwell.

What morning sickness can feel like

• Queasiness with or without vomiting at any time of day
• Food or smell aversions and a metallic or altered taste
• Symptoms that worsen on an empty stomach or when overtired
• Difficulty tolerating usual meals while still keeping some food and fluids down

What can help pregnancy nausea?

• Eat small amounts often; try plain toast, crackers, rice, pasta or potatoes.
• Keep a plain snack by the bed and get up slowly in the morning.
• Sip fluids little and often. Cold drinks, ice chips or a straw may be easier to manage.
• Choose cold meals if cooking smells are a trigger and ask someone else to cook when possible.
• Rest, because tiredness can make nausea worse.
• Ginger foods or drinks and acupressure wristbands help some people, though effects vary.

Medicines for morning sickness

You do not have to wait until symptoms become extreme. A doctor or midwife can recommend anti-sickness medicines considered safe in pregnancy, including during the first trimester. Several options exist, and sometimes a combination is needed.

Check before using over-the-counter, herbal or “natural” remedies. Products can vary in dose, interact with medicines or be unsuitable in pregnancy.

Morning sickness or hyperemesis gravidarum?

Hyperemesis gravidarum (HG) is severe, persistent pregnancy sickness that can cause dehydration, weight loss and difficulty managing everyday activities. It often needs medical treatment and sometimes intravenous fluids or hospital care. Early help can prevent symptoms becoming harder to control.