When Does Morning Sickness Peak?

Nausea and vomiting are well known symptoms of early pregnancy, but when does morning sickness usually peak? Read on to find out. 

By OBGYN Dr. Kenosha Gleaton

While the name suggests otherwise, morning sickness can occur at any time of the day. Nausea and vomiting usually occurs during the first trimester, and has been shown to be the most severe during a certain week. 

How common is morning sickness?

Nausea and vomiting of pregnancy (NVP), also called morning sickness, is one of the most common pregnancy symptoms occurring in up to 80% of pregnant people [1]. While most only experience moderate NVP for a few weeks or months, some may have morning sickness throughout their entire pregnancy, and up to 3% of people will experience severe sickness known as hyperemesis gravidarum (HG) [1-2]. This can be a dangerous condition that may result in weight loss, dehydration, and may potentially impact the fetus [2]. 

Why does morning sickness happen?

We don’t know the exact cause of morning sickness, but there are many theories as to why nausea and vomiting occur so often during early pregnancy. Some people think that morning sickness correlates with the sex of your baby, although there’s no definitive research that proves this. A widely assumed belief is that nausea is tied to changing hormones, such as human chorionic gonadotropin (hCG), which is is the hormone detected by pregnancy tests, or other hormones such as estrogen, progesterone, leptin, and others [1]. So far data has been inconclusive, with some studies showing associations between hCG levels and incidence of NVP, others disproving a correlation, and the same goes for many other researched hormones. There are some risk factors associated with the onset of NVP and HG, such as [1]:

• Young age

• First pregnancies

• Non-smokers

• Obesity

• Multiple gestations (twins or triplets)

• Maternal history of NVP

• History of motion sickness

• History of migraines

When is morning sickness the worst?

So how long should you expect to have morning sickness, and when does it peak? For most people, morning sickness will start within the first month or two of pregnancy and often resolves by the end of the first trimester [2-3]. A study of over 350 women found that morning sickness peaked around nine weeks and often stopped around the 14th week [3]. Of these women, 28% felt nauseous but didn’t get sick, 52% felt nauseous and vomited, and 20% had no symptoms of morning sickness. Symptoms can look different for everyone, but most research tells us that NVP should conclude around 14 weeks for the majority of pregnant people, and you’re likely to be at the peak of morning sickness around 9 weeks. 

When should I be concerned about morning sickness?

It’s normal to experience nausea and vomiting during early pregnancy, but you should always speak with your healthcare provider directly if you’re concerned about any symptoms. If you can’t keep any food or liquid down, you begin to lose weight, or you notice additional symptoms such as abdominal pain, fever, headache, or an enlarged thyroid, you should seek medical attention to rule out other conditions [2]. 

How can I prevent nausea and vomiting?

Morning sickness is an unpleasant and sometimes very inconvenient symptom of pregnancy. While there isn’t a definitive way to prevent NVP from happening, there are some things you can try to manage morning sickness and decrease the risk of severe nausea and vomiting.

Supplements and medications

Some research suggests that taking prenatal vitamins before and during pregnancy can reduce the risk of severe NVP [2]. Not only that, but prenatal vitamins are a great source of vitamins and minerals that can ensure you’re getting adequate nutrients even while struggling with morning sickness. Data also supports the use of ginger for reducing nausea, which can be found in nausea relief teas, morning sickness gummies, gummy vitamins, and more [1]. 

For more extreme cases of nausea and vomiting, your healthcare provider may also prescribe specific medications known as antiemetics [1]. If you have specific questions or concerns about any of your pregnancy symptoms, be sure to speak with a healthcare provider. 

Alter your diet

Some foods may help fight pregnancy nausea, but it’s important to note that everyone is different and will have different food aversions and cravings during pregnancy. Many healthcare professionals suggest the BRATT diet for anyone experiencing gastrointestinal discomfort, specifically nausea and vomiting [1,2]. The BRATT diet consists of bananas, rice, applesauce, toast, and tea. These are all easily digested, low-fat foods that should be fairly easy for you to keep down. There is also something known as the bland diet, which includes a broader range of foods that create less work for the GI tract and includes items such as eggs, broth, pudding, lean meat, cooked bland vegetables, and low-fat dairy products [4]. As stated previously, ginger has also been found to be helpful for reducing nausea during pregnancy [1]. Additionally, a research study found that diets low in cereal and high in sugar, oil, and meat, were more likely to contribute to NVP [5]. In general, the best thing you can do is find the foods that you are able to stomach and stick to them. It’s important that you’re able to consume plenty of calories, vital nutrients, and water every day. 

Alter your habits

Other tips you can try to reduce NVP are to change some of your daily habits [2]. Try keeping crackers, fruit, and nuts around you at all times so you can snack frequently. This can prevent you from moving around a lot on an empty stomach. You may also want to try to eat multiple smaller meals throughout the day rather than two to three large meals. Find what works for you and stick to it, and be sure to speak with your healthcare provider about any concerns you may have. 

Key Takeaways

• Morning sickness occurs in up to 80% of pregnant people.

• The cause of morning sickness is unknown, but it’s suspected that hormone levels play a large role in the onset of NVP.

• Risk factors for NVP and HG include a first pregnancy, multiple gestation, obesity, non-smokers, and family history of NVP. 

• Morning sickness is likely to peak around nine weeks of pregnancy, and is usually over around the 14th week of pregnancy. 

• If you notice other symptoms such as headache, abdominal pain or tenderness, fever, etc. you should see a healthcare provider immediately to rule out other conditions. 

• You can treat and prevent NVP through some supplements, eating bland foods like rice, toast, applesauce, bananas, and ginger, and altering your meal times and portion sizes. 

References:

1. Lee NM, Saha S. Nausea and vomiting of pregnancy. Gastroenterol Clin North Am. 2011;40(2):309-vii. doi:10.1016/j.gtc.2011.03.009

2. Morning sickness: Nausea and vomiting of pregnancy. ACOG. https://www.acog.org/womens-health/faqs/morning-sickness-nausea-and-vomiting-of-pregnancy. Published May 2020. Accessed February 15, 2023. 

3. Gadsby R. Pregnancy sickness and symptoms: your questions answered. Prof Care Mother Child. 1994;4(1):16-17.

4. Weir SBS, Akhondi H. Bland Diet. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538142/

5. Pepper GV, Craig Roberts S. Rates of nausea and vomiting in pregnancy and dietary characteristics across populations. Proc Biol Sci. 2006;273(1601):2675-2679. doi:10.1098/rspb.2006.3633