Morning sickness: what actually helps, and when to call the midwife
When morning sickness starts and stops, the small changes the NHS suggests, ginger and the teas that are fine, the medicine your GP can prescribe, getting through a working day, and the signs that mean you call your midwife
It's 6.40am, your eyes aren't properly open yet, and the smell of somebody's toast downstairs has you heading for the bathroom. Then there's the commute, a meeting at nine, and a team who don't know yet.
It's called morning sickness, but it doesn't keep office hours. Here's what the NHS says actually helps, which teas are fine, how to get through a working day, and the signs that mean you stop coping and ring someone.
Quick answer: Morning sickness is feeling sick or being sick in pregnancy, at any time of day. The NHS says it usually clears up by weeks 16 to 20 and doesn't put your baby at any increased risk. Small plain meals, sips of fluid, rest and ginger come first. If you can't keep food or fluids down for 24 hours, call your midwife, GP or 111.
- Around 8 in 10 pregnant women feel sick, are sick, or both, the NHS says. Plenty of them get it all day.
- There's medicine for it that's safe in pregnancy. Your GP can prescribe it if the food and rest changes don't work.
- The severe form, hyperemesis gravidarum, affects around 1 to 3 in 100 pregnant women and often needs hospital treatment. It isn't anything you've done.
When morning sickness starts, and when it stops
The NHS lists feeling or being sick among the early signs of pregnancy, right next to a missed period, and calls it very common in early pregnancy. What it doesn't do is put a start week on it.
So if someone tells you exactly when yours will kick in, they're guessing.
The end is better documented. The NHS morning sickness page says it usually clears up by weeks 16 to 20. Its page on severe sickness puts it a little wider: for most women it improves or stops by around 12 to 20 weeks, and for some it lasts longer.
It can hit at any time of day or night, or sit with you all day long. That's the version nobody warns you about.
Nobody knows exactly why. The NHS thinks the hormone changes of the first 12 weeks are probably one of the causes, and says you're more likely to get it if you're carrying twins or more, had bad sickness last time, get car sick, have migraines, have it in the family, felt sick on the combined pill, are pregnant for the first time, or have a BMI of 30 or more.
What actually helps with morning sickness
There's no treatment that works for everyone, the NHS says, and every pregnancy is different. What your midwife or GP suggests first is a list of small changes. None of them is a cure. Together they take the edge off enough to get you through a day.
| Try this | How to make it work |
|---|---|
| Something plain first thing | Dry toast or a plain biscuit in the morning, the NHS suggests. Keep a packet by the bed so you don't have to walk past the kitchen to get it |
| Small plain meals, often | Plain food that's high in carbohydrate and low in fat: bread, rice, crackers, pasta. Little and often beats three proper meals |
| Cold food instead of hot | If cooking smells set you off, cold food smells of less. A sandwich is dinner for a few weeks |
| Sips, not glasses | Drink plenty, but sip it little and often. The NHS says that may help stop you being sick |
| Rest | Tiredness can make nausea worse. An early night counts as treatment |
| Ginger | Some evidence it helps, in food or drink. Ask a pharmacist before you take ginger supplements |
| Acupressure | Some evidence that pressure on the wrist helps, with a band or bracelet on your forearm, or your own fingers |
| Dodge your triggers | Whatever food or smell turns your stomach, stay away from it. Somebody else does the bins for a while |
If you only do two, make it the biscuits by the bed and the little and often. They cost a packet of crackers and a water bottle.
Follow your bump. Tell us your due date and we'll send what to expect each week, plus 10% off your first order.
Ginger, tea and what to drink
Ginger is the one remedy the NHS has a good word for. It says there's some evidence that foods or drinks containing ginger may help reduce nausea and vomiting, so ginger biscuits and ginger tea are fair game. Supplements are a different thing, and the NHS wants you to check with a pharmacist first.
The rest of the tea shelf has rules. The NHS foods to avoid page says no more than 4 cups of herbal tea a day, and none with liquorice root in it. Ordinary tea and coffee count towards the 200mg of caffeine you're allowed a day.
Our pregnancy tea bible goes along the shelf tea by tea, and says where the NHS has no view at all, which is more often than you'd think.
If nothing works, there's medicine
If your sickness is bad and the changes above haven't helped, the NHS says your GP may suggest a short course of an antiemetic, a medicine to stop sickness that's safe to use in pregnancy. It's often a type of antihistamine, the kind usually taken for allergies, and it's usually a tablet.
For severe sickness your doctor may suggest an injection, or a medicine you put in your bottom, instead.
You don't have to wait until you're desperate to ask. The NHS says to see your GP if you'd like to talk about medicine, and whatever you're tempted by at the chemist, tell the pharmacist you're pregnant before you buy it.
When to call the midwife about morning sickness
Ordinary morning sickness doesn't put your baby at any increased risk, the NHS says. The worry is you: not getting enough fluid in, or enough food.
Call your midwife, GP or 111 if you're being sick and any of these are true:
- your pee is very dark, or you haven't been for more than 8 hours
- you can't keep food or fluids down for 24 hours
- you feel very weak, dizzy or faint when you stand up
- you have tummy pain
- you have a high temperature
- there's blood in your sick
- you've lost weight
It isn't always the pregnancy, either. The NHS says a urinary tract infection can cause nausea and vomiting too, which is one more reason to ring rather than wait it out.
When it's more than morning sickness
Hyperemesis gravidarum, HG for short, is much worse than normal pregnancy sickness. The NHS severe vomiting page describes being sick many times a day and not being able to keep food or drink down. It thinks around 1 to 3 in every 100 pregnant women get it, and it often needs hospital treatment.
The signs are severe sickness that goes on and on, weight loss, and dehydration: thirsty, tired, dizzy or lightheaded, not peeing much, and pee that's dark yellow and strong smelling. Unlike ordinary sickness it may not ease by 16 to 20 weeks. For some it doesn't clear completely until the baby is born, though some symptoms may improve at around 20 weeks.
It's treatable. There are medicines that can be used in pregnancy, including the first 12 weeks, and you may need to try a few before one works. If the sickness can't be controlled you may be admitted to hospital for fluids through a drip. Treated properly, HG is unlikely to harm your baby, but losing weight raises the chance of a smaller baby, which is why getting help early matters.
The NHS is plain about this part: HG is not the result of anything you have or haven't done.
Pregnancy Sickness Support, the charity the NHS points to, can put you in touch with someone who's been through it. And if you've had HG before, it's likely to come back, so talk to your doctor about starting medicine early next time.
Getting through a working day
Most people haven't told work at this point, which is what makes it so hard. You're being sick in the staff toilet and then smiling through the 9.30.
A small kit in your drawer or bag saves a lot of panic: toothbrush and toothpaste, wipes, a packet of plain crackers, a water bottle, a spare top, and a couple of sick bags for the car or the bus. Eat at your desk if the canteen smell gets you.
Sit near a window or the door if you can, and leave the house earlier so you're not rushing on an empty stomach.
If sickness is starting to cost you days off, think about telling your manager sooner than you planned. Acas says the Equality Act 2010 covers unfavourable treatment because of a pregnancy related illness, but you're only protected once your employer knows you're pregnant, or should reasonably have known.
The first trimester to do list has the telling people section, and when do you start showing explains why nobody can see anything yet. If you're freezing all the time on top of it, that tends to go with exhaustion and living on toast, and feeling cold in pregnancy explains why.
What morning sickness doesn't tell you
Bad sickness means a girl. You'll hear it at least once, usually from someone who's sure. The NHS list of things that make sickness more likely runs from twins and a first pregnancy to migraines and family history, and your baby's sex isn't on it. The 12 week scan won't tell you either.
No sickness means something's wrong. Around 8 in 10 women feel sick or are sick in pregnancy, which leaves plenty who aren't. Both NHS pages on sickness tell you to ring someone when it's too much, never when it's missing. If anything else is worrying you, ring your midwife anyway. That's what they're there for.
Questions we get asked
When does morning sickness start?
The NHS lists feeling or being sick among the early signs of pregnancy, alongside a missed period, and says it's very common in early pregnancy. It doesn't give a start week, and it varies from one pregnancy to the next.
When does morning sickness stop?
Usually by weeks 16 to 20, the NHS says, and for most women it eases somewhere between 12 and 20 weeks. Severe sickness, hyperemesis gravidarum, can last longer and occasionally until the baby is born.
Can morning sickness harm my baby?
Ordinary morning sickness doesn't put your baby at any increased risk. Hyperemesis gravidarum is unlikely to harm your baby if it's treated properly, but weight loss raises the chance of a smaller baby, so tell your midwife or GP early.
Does ginger help with morning sickness?
The NHS says there's some evidence that foods or drinks containing ginger may help reduce nausea and vomiting. Check with a pharmacist before taking ginger supplements.
What can I take for morning sickness?
If changes to what you eat and how you rest don't help, your GP may prescribe a short course of an antiemetic that's safe in pregnancy, often a type of antihistamine. Tell the pharmacist you're pregnant before buying anything yourself.
Is it normal to have no morning sickness?
Yes. Around 8 in 10 pregnant women feel sick, are sick or both, which means plenty don't. Not feeling sick isn't something the NHS asks you to report. If anything else worries you, ring your midwife.
Crackers by the bed tonight, a water bottle in your bag tomorrow, and your midwife's number saved where you can find it at 6.40am.
