Many expectant mothers—but not all—experience morning sickness during early pregnancy. It usually does not begin in the first week, but around weeks 4–6 of pregnancy, counted from the first day of your last period, and generally improves by weeks 16–20 (Source: NHS). These symptoms can leave you feeling uncomfortable or frustrated, but the tips and advice in this article can help you cope.
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What are the symptoms of morning sickness and the first trimester?
1. Fatigue
Fatigue is one of the symptoms you may experience alongside morning sickness during pregnancy. It can leave you feeling persistently low on energy. Getting enough rest and eating foods that provide energy can help support your body.
Getting enough rest is an important priority during pregnancy. It helps your body replenish its energy and recover properly, and can also reduce fatigue associated with morning sickness.
2. Itching
Itchy skin is another uncomfortable symptom during pregnancy. Hormonal changes can make your skin drier and more sensitive, while stretching skin over your growing belly may also itch. Itching can affect your abdomen, elbows, ankles, and scalp. It is often worse in the evening or at night, leaving you feeling uncomfortable and unsettled.
To ease itching during pregnancy, care for your skin appropriately. Apply a gentle lotion or moisturizer regularly, choose fragrance-free cleansers, bathe in warm rather than hot water, and wear breathable cotton clothing.
If itching is severe or does not go away, consult a doctor for an appropriate diagnosis and treatment. Avoid potential skin irritants such as dust, smoke, and chemicals. In particular, intense itching on your palms and soles without a rash, usually later in pregnancy, may indicate intrahepatic cholestasis of pregnancy and requires prompt medical attention.
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3. Nausea and vomiting
Nausea and vomiting are common during the first trimester. Although called morning sickness, they can occur at any time of day. They often happen in the morning or when you have not eaten enough that morning. Nausea and vomiting can leave you feeling unwell and tired, making everyday life less enjoyable.
To manage nausea and vomiting, eat small meals frequently and avoid an empty stomach. Have a piece of crispbread or a cracker before getting out of bed in the morning, and choose an easy-to-digest breakfast that provides energy, such as milk, fruit, and grains. Take small sips of water frequently, avoid oily, spicy, or strong-smelling foods that trigger nausea, and get plenty of rest. Some people find foods or drinks containing ginger helpful.
Warning: If you vomit so severely that you cannot eat or drink anything, vomit blood, pass very little or very dark urine, feel dizzy, or lose weight, you may have hyperemesis gravidarum, a severe form of pregnancy sickness that carries a risk of dehydration. Seek medical care promptly (see information from the NHS). Do not buy anti-nausea medicine to take on your own; use medication as prescribed by your doctor (read more about things to avoid in early pregnancy).
4. Food aversions or cravings
Many expectant mothers suddenly find foods they used to enjoy unappealing, become sensitive to smells such as coffee or fried food, or develop strong cravings for particular foods. These symptoms are part of pregnancy sickness caused by hormonal changes, rather than food allergies. For now, choose nutritious foods you can tolerate, and avoid foods that are unsafe during pregnancy (see foods to avoid in early pregnancy).
Food allergies are different from morning sickness
A food allergy occurs when the immune system reacts abnormally to certain foods, such as seafood or nuts. Symptoms include an itchy mouth, swollen lips or tongue, and hives, and can occur both before and during pregnancy. If you develop swollen lips or facial swelling, difficulty breathing, or feel faint after eating, go to hospital immediately.
5. Breast tenderness
During the first few weeks of pregnancy, you may notice changes in your breasts and nipples. Your breasts may become swollen, delicate, sensitive, or tender, and you may feel sharp tingling sensations in your nipples. These changes are part of your body's preparation for breastfeeding. You may also notice darker skin around the nipples, larger nipples, and small bumps around them. These symptoms are part of your body's adjustment and do not necessarily need to cause significant concern. If you have any concerns or questions about changes in your breasts, consult your doctor for advice and further information about pregnancy and caring for your health and your baby's health.
6. Lower abdominal discomfort
A feeling of heaviness or discomfort in the lower abdomen is common during pregnancy and is often normal. It usually occurs as the uterus expands to accommodate your growing baby. The discomfort may feel heavy, develop gradually, or come on sharply, and is usually mild. In most cases, lower abdominal pain during pregnancy is not dangerous and goes away on its own or eases with rest or a change of position. However, if it occurs with other symptoms, such as worsening pain, severe pain or pain on one side, fever, or bleeding, consult a doctor for advice and further assessment to make sure there is no serious pregnancy-related problem.
7. Spotting
Implantation bleeding usually involves a very small amount of blood over a short period and is often light pink to brown (read more in What Does Implantation Bleeding Look Like?). It commonly occurs 10-14 days after fertilization and may be an early sign of pregnancy, but it is not a menstrual period.
Implantation bleeding usually does not require specific treatment and stops naturally on its own. However, if bleeding increases, you pass blood clots, have severe lower abdominal pain, or feel faint, seek medical care immediately, as this may indicate a threatened miscarriage or an ectopic pregnancy.
8. Frequent urination
Frequent urination can occur during pregnancy because of hormonal changes. As the uterus grows, it may press on nearby organs such as the bladder, increasing the need to urinate. Frequent urination during pregnancy is therefore considered normal and often eases after early pregnancy.
9. Changes in body temperature
A rise in body temperature during pregnancy is normal and results from your body adjusting to support pregnancy. This temperature increase is part of the body's preparation for pregnancy, including forming tissue, increasing blood supply, and adapting its various systems. Drink enough water and get sufficient rest to help ease any discomfort.
10. More vaginal discharge than usual
Vaginal discharge is normal during pregnancy. Hormonal changes cause an increase in discharge, which may be clear mucus or cloudy white, resemble a paste, and have no odor. If you notice other unusual symptoms, such as an odor or itching, consult a medical professional for further advice.
Summary
Morning sickness is common during the first trimester. It usually begins around weeks 4–6 and improves by weeks 16–20. Some expectant mothers experience significant sickness, while others have hardly any symptoms. Both experiences are normal.
Getting enough rest, eating small meals frequently, and choosing easy-to-digest foods that provide energy can help reduce fatigue and nausea. Moisturizing your skin and choosing gentle products can help manage itching.
You should also drink enough water, begin antenatal care early, and take prenatal supplements as prescribed by your doctor (read Taking Prenatal Supplements). Seek medical care immediately if vomiting prevents you from eating or drinking, you have severe abdominal pain, or you experience bleeding.
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