Nausea during pregnancy is generally referred to as morning sickness. The term “morning sickness” doesn’t fully describe what you may experience. Some women only have nausea and vomiting in the morning hours, but sickness with pregnancy can happen at any time of the day or night.

The severity of sickness varies from woman to woman. You may feel mildly queasy unless you keep your stomach full, or you may feel severely ill and throw up even after only drinking plain water.

Read on to learn more about morning sickness at night, how to manage this condition, and when you should seek help.

Doctors don’t fully understand why pregnancy sickness occurs. The hormonal changes that happen during pregnancy and how you respond to them likely plays a role. In rare cases, unrelated conditions, like thyroid or liver disease, may cause particularly severe nausea or vomiting. Women carrying twins or multiples may also have more pronounced sickness.

Nausea in pregnancy generally starts before the nine-week mark. In some women, it may even start as early as two weeks after conception. Some women experience sickness early, later on, or not at all. Morning sickness may last for a few weeks or months, but generally eases up near the end of the first trimester.

Some women may experience nausea and vomiting throughout their entire pregnancies. This more severe form of morning sickness is called hyperemesis gravidarum. Only around three percent of women develop this condition. It’s diagnosed after a woman has lost five percent of her prepregnancy weight, and often requires medical treatment to manage dehydration.

Does morning sickness at night mean you’re having a girl or boy?

There doesn’t appear to be much connection between your baby’s sex and the timing of nausea. However, some research suggests that women who experience hyperemesis gravidarum are more likely to be carrying girls.

There’s no proven way to totally prevent morning sickness, but there are some lifestyle changes you can make that may help with your nausea, no matter when it strikes. You may need to experiment with several changes to see relief. And what may work one day may not work the next.

  • Eat before getting out of bed each morning to avoid an empty stomach. Bland foods like dry toast or saltine crackers are good choices.
  • Avoid triggers, like strong smells, that make you feel nauseous.
  • Get fresh air when you can. Something as short as a walk around the block may ward off nausea.
  • Try incorporating ginger into your day. For example, you can make ginger tea with fresh ginger by steeping a 2-inch peeled piece of ginger in 1 to 2 cups of hot water for 10 to 20 minutes. You can also find ginger capsules and ginger candies at many grocery stores.
  • Ask your doctor about alternative medicine. Acupressure, acupuncture, aromatherapy, and even hypnosis may help.
  • Take a prenatal multivitamin every day. You can find many brands over the counter or your doctor may prescribe one to you.

If you find that most of your nausea happens at night, try keeping a diary to look for triggers. Is your stomach empty? Are you eating hard-to-digest or fatty foods that are unsettling you? Do any foods or other measures make you feel better? Finding relief may involve a bit of detective work.

Even your daily multivitamin may contribute to your sickness. Try taking it at a different time of the day to see if that helps. Or perhaps try taking it with a small snack. If nothing seems to work, ask your doctor to suggest a different type of multivitamin that may not make you feel as sick. Sometimes the iron in your multivitamin can make you feel queasy. There are varieties available that don’t contain iron and your doctor can suggest other ways you can meet this nutritional need.

Mild to moderate morning sickness doesn't usually affect your baby’s health. If lifestyle changes aren’t helping, there are other treatments available:

  • Vitamin B-6 and doxylamine. These over-the-counter (OTC) options are a good first-line of defense against nausea. There are also prescription drugs that combine these two ingredients. Taken alone or together, these drugs are considered safe during pregnancy.
  • Antiemetic drugs. If B-6 and doxylamine don’t do the trick, antiemetic drugs can help prevent vomiting. Some antiemetic drugs have been deemed safe for pregnancy while others may not be. Your doctor is your best resource for determining the benefits versus the risks in your individual case.

If you have hyperemesis gravidarum, you may need to seek immediate medical attention. Not being able to keep any foods or liquids down may be dangerous for your health and for your growing baby. You may also develop issues with your thyroid, liver, and fluid balance.

Watch for symptoms like:

  • severe nausea or vomiting
  • passing only small amounts of urine that may be dark in color, which could be a sign of dehydration
  • being unable to keep down liquids
  • feeling faint or dizzy upon standing
  • feeling your heart race
  • vomiting blood

Extreme bouts of nausea and vomiting may require a hospital stay to replenish fluids and vitamins via an intravenous (IV) line. You may also receive additional medications while in the hospital. In some cases, your doctor may even recommend tube feeding to make sure you and your baby are getting enough nutrients.

Don’t worry too much if you’re unable to eat your normal diet. In many cases, you should start feeling better after your first trimester.

In the meantime, try these tips:

  • Keep your stomach full, but not too full, by eating frequent small meals, about every one or two hours.
  • Consider eating a “BRAT” diet with bland foods like bananas, rice, applesauce, toast, and tea. These foods are low in fat and easy to digest.
  • Try adding protein to all your meals and snacks, such as nuts, seeds, beans, dairy, and nut butters.
  • Stay hydrated by drinking fluids, like plain water, often. Drinking beverages that contain electrolytes can also help prevent dehydration.

If your “morning” sickness is interfering with your sleep, make sure you’re not lying down too soon after eating a meal. When you need to get out of bed, make sure you’re rising slowly. And try your best to get rest throughout the day when you can.

Otherwise, ask your doctor about taking vitamin B-6 and doxylamine. Doxylamine is the active ingredient in Unisom SleepTabs, an OTC sleep aid. A side effect of this medication is drowsiness, so taking it at night may help with both sleep and nausea.

Morning sickness can be a difficult hurdle to cross in your pregnancy. Don’t shy from asking for help from friends and family while you’re feeling sick. Try your best to identify your triggers and to experiment with various lifestyle measures until you find a mix that works for you. And don’t hesitate to contact your doctor for treatment options and other advice.