Nausea Beyond the First Trimester

Pregnant woman having nausea third trimester of pregnancy, in Baltimore, Towson

Nausea in the first trimester is pretty common. You may have even noticed that morning sickness is everyone’s favorite/not favorite topic during your early pregnancy. Strangers want to know how often you’re throwing up. Your mother may fuss over you and entertain you with her own long-ago stories of what she ate and what she couldn’t stomach looking at. Your partner might approach you with fear and anxiety at every meal time, hoping for a green light to discuss food selections. Accompanying every interaction is likely to be a reassuring “At least it’s almost over! A few more weeks and you’ll feel much better!”

Why isn’t this nausea going away??

For most of you with morning sickness, you will indeed find that it resolves as you enter the second trimester. But for an unlucky few, nausea may continue for the duration of the pregnancy, or in a more likely scenario will fade for months and return in the third trimester. Usually the reappearance of nausea is benign and does not signal a cause for concern, although discussing your symptoms with your healthcare provider is always recommended, especially as late nausea may be a sign of preeclampsia. Assuming that you’ve had a patient/provider conversation about your symptoms, let’s discuss some reasons for the late-term nausea and some coping techniques.

Third trimester nausea: Cameron’s story

Cameron is one of the unlucky ones. A mother of three, she had routine first trimester morning sickness with all three pregnancies, which faded away with the first two babies by 16 weeks. With the third pregnancy, however, she had some memorable bouts with nausea in the last 5 weeks before delivery.

“I was so tired all the time, with two young children at home and a traveling husband. I wasn’t taking time to eat well or to sit and put my feet up, so I shouldn’t have been surprised one morning when I had to bolt for the front door and throw up in the bushes.” Her next unexpected attack was the following week, at Christmas at her mother’s house. With so much going on and a crowded house full of relatives, she and her husband were sharing a bathroom. “He farted in there, and the whole house heard me throw up. Funny in hindsight, but it wasn’t pretty at the time!”

Cameron said she frequently felt queasy during those weeks, and struggled to find enough to eat to fuel her body and combat the fatigue that built every afternoon. In her 36th week she caught a stomach virus and ended up in the ER for IV fluids and anti-nausea medication, after 3 days of being unable to keep anything down. Her baby was born healthy at 38 weeks after an induction for hypertension, and the nausea disappeared.

So what can you do if you find yourself in Cameron’s shoes?

(Please note that what we are discussing here is typical morning sickness, and not the more serious hyperemesis gravidarum. If you suspect you have HG we recommend contacting your provider immediately to receive care for this severe form of nausea and weight loss.) 

Identifying causes may be helpful so that you can target your treatment, but if it’s the common issue of hormones and the growing baby, there’s not much you can do other than try coping techniques. Think about what you’re taking in:

  • Are there spicy or greasy foods causing heartburn?
  • Is your prenatal vitamin triggering stomach upset?
  • Are you staying well hydrated?
  • Do you eat small, frequent meals, or carry snacks with you?
  • Can you try ginger tea, or suck on a peppermint candy?
  • Above all, finding some time to rest is likely to help you cope with the nausea, and is also an essential component of preparing yourself for labor. Who can you call on to help you disconnect and focus on self-care for a while every day?

This Healthline article provides some more helpful suggestions, and discusses the link between nausea and labor: When Morning Sickness Doesn’t Go Away: Third Trimester Nausea ( Your doula can also be an excellent source of information and support, so reach out! And hang in there, because relief is in sight!