Morning sickness affects up to 80 per cent of pregnancies and rarely confines itself to mornings — nausea can arrive at any hour, and for many women evenings are worst. It is driven by rising hCG and oestrogen in the first trimester, and while it is miserable, mild to moderate nausea is associated with a healthy pregnancy.

When it starts and when it ends

Symptoms typically begin around week 6, peak between weeks 9 and 11, and ease by weeks 12 to 14. A minority continue into the second trimester, and a small number experience it throughout. Its absence is not a cause for concern on its own.

What actually helps

• Eat small and often. An empty stomach worsens nausea. Plain biscuits before getting out of bed, then something every two hours.
• Ginger. Tea, fresh ginger in warm water or ginger sweets — one of the few remedies with reasonable evidence behind it.
• Vitamin B6 (pyridoxine). Effective for many women. Ask before starting, so the dose is right.
• Hydrate between meals rather than with them, in small sips.
• Avoid your triggers. Cooking smells, perfume and fried food are common ones; cold food smells less than hot.
• Rest. Tiredness reliably makes nausea worse.

If food is hard to keep down, focus on what you can manage rather than a perfect diet — our pregnancy nutrition chart is useful once appetite returns.

When it is more than morning sickness

Hyperemesis gravidarum is persistent severe vomiting causing dehydration and weight loss. It affects roughly 1 to 3 per cent of pregnancies and needs medical treatment — not endurance. Seek review if you:

• Cannot keep fluids down for 24 hours
• Have lost more than 5 per cent of your pre-pregnancy weight
• Pass little urine, or urine that is dark
• Feel dizzy or faint on standing
• Vomit blood, or have abdominal pain or fever alongside the vomiting

Safe anti-sickness medication is available in pregnancy, and there is no reason to suffer through severe symptoms untreated.

Other causes worth excluding

Nausea that begins after week 9, or comes with other symptoms, sometimes points elsewhere — thyroid dysfunction is one example, covered in our note on thyroid disorders in pregnancy. Existing conditions such as diabetes in pregnancy also need closer monitoring during a sickness-affected first trimester.

Support through the first trimester

Our antenatal care service covers symptom management alongside routine monitoring. Book an appointment with Dr. Asavari Karani at Tulsi Clinic, Matunga, Mumbai.