Pregnancy sickness and hyperemesis gravidarum

Pregnancy sickness can last all day, even though it’s often called “morning sickness”. There are treatments if feeling and being sick affects your work, home life and mood.

When sickness tends to start and settle

The Royal College of Obstetricians and Gynaecologists (RCOG) says sickness usually starts between the 4th and 7th week. It often gets better as pregnancy goes on, but some people stay unwell for longer. You can ask for help at any stage.

UK and US guidance differ on when it usually stops. The NHS says sickness usually clears by weeks 16 to 20. ACOG says it goes away by 14 weeks for most women, but accepts that it can last the whole pregnancy. Neither means symptoms can’t carry on, or that you won’t need treatment.

Small changes that may make eating easier

For milder sickness, try small, frequent meals of plain foods, such as bread, rice, crackers or pasta. Dry toast or a plain biscuit before you get up in the morning may help. Try to find something you can keep down, rather than forcing yourself to eat a certain meal.

Cold food may be easier if the smell of hot meals is too much. Avoid smells that make you feel sick where you can, and make time to rest, because tiredness can make it worse. Sipping drinks little and often may be easier than drinking a lot at once.

The NHS says there’s some evidence that ginger in food or drinks helps. It advises checking with a pharmacist before taking ginger supplements. If these everyday changes don’t help, or your symptoms are severe, talk to your care team about treatment rather than adding more products yourself.

When sickness becomes hyperemesis gravidarum

Hyperemesis gravidarum (HG) is the severe form of pregnancy sickness. RCOG describes it as sickness that stops you doing daily things and makes it impossible to eat and drink as usual. It can cause dehydration and may need hospital treatment. A clinician can check what’s happening and look for other causes of vomiting.

Contact your GP, midwife or NHS 111 today (UK), or your pregnancy care team or urgent care service (US and elsewhere), if vomiting comes with a high temperature, tummy pain, weight loss, or passing very little dark pee. Tell them if it hurts when you pee too. Say whether you can keep fluids, food and medicines down, and whether you’ve lost weight quickly.

Treatment can include medicines and fluids

Your clinician can talk to you about anti-sickness medicines (antiemetics). Some can be given as an injection if you can’t keep tablets down. Your pharmacist or doctor can advise about the medicine chosen for you. Don’t stop or change a prescribed medicine without talking to your doctor.

A hospital check can include looking at your general health, blood and urine tests, and sometimes an ultrasound scan. Fluids through a drip may help if you can’t drink enough. Some people can go home after treatment. Others need to stay in, especially if they’re dehydrated or can’t keep fluids or tablets down.

RCOG says there’s no evidence that mild to moderate sickness harms the baby. With severe sickness or HG, the baby may be smaller than expected at birth, and you may be offered scans to check growth. Talk to your team about symptoms that don’t go away.

Before you leave hospital, ask who to call if treatment stops working and how to get more of your medicine. Keep these details with your care contacts. RCOG advises getting a repeat prescription before your tablets run out. If symptoms come back and you get dehydrated, contact your care team to be checked again.

Ask for help before you are exhausted

Call 999 now (UK) or 911 (US), or your local emergency number, if you vomit blood and feel generally unwell, faint or dizzy, or have tummy pain.

Get urgent medical help for any blood in your vomit. If you’ve stopped vomiting blood and have no other symptoms, contact your GP or NHS 111 urgently (UK), or your doctor or urgent care service (US and elsewhere).

Contact your GP, midwife or NHS 111 now in the UK, or your pregnancy care team or urgent care service in the US and elsewhere, if you can’t keep fluids down, can’t pee, or feel dizzy or faint when you stand up. Don’t wait for a routine appointment.

Ask about treatment if sickness is affecting daily life. Tell your care team if it’s also leaving you low, anxious or cut off from others. RCOG recognises how hard this can be emotionally, and recommends support. After hospital treatment, contact your team again if the vomiting comes back and you get dehydrated.