Nausea and vomiting in early pregnancy are very common, and according to NHS they usually stop before weeks 16 to 20. Most people with morning sickness need no medicine at all. But there is a threshold at which it stops being ordinary morning sickness: vomiting so constant that nothing stays down, dehydration, weight loss. According to NHS, that form is called hyperemesis gravidarum and usually needs treatment in hospital. We do not take on maternity care — this article is about the safe boundaries and about when you have to be seen.
Recognising it: how ordinary morning sickness behaves
According to MedlinePlus, morning sickness usually starts around four to six weeks after conception and can last into the fourth month of pregnancy.
- It is not confined to the morning: according to MedlinePlus, symptoms are often worse early in the day but can happen at any time.
- Vomiting in pregnancy is not automatically morning sickness — dealing with vomiting in general has its own article on this site.
- What is worth watching is not the number of times you vomit, but how much you KEEP down, your weight, and the colour of your urine.
When it is no longer ordinary morning sickness
- According to NHS, the severe form is far worse than ordinary morning sickness, and has three groups of signs: prolonged, severe nausea and vomiting; DEHYDRATION — thirst, tiredness, dizziness or light-headedness, passing little urine, dark yellow strong-smelling urine; and WEIGHT LOSS.
- According to NHS, the severe form may NOT ease at the point where ordinary morning sickness stops — “wait for it to pass and it will go by itself” is not a safe plan once you are dehydrated.
- According to NHS, vomiting frequently and being unable to keep food down is the point to speak to a midwife or doctor, or to contact the hospital, straight away; if it cannot be controlled, admission may be needed.
What to do straight away
- Rest and get more sleep — according to NHS, tiredness makes the nausea worse; MedlinePlus advises reducing stress.
- According to NHS, avoid foods and smells that make you feel sick; MedlinePlus advises avoiding closed rooms that hold cooking smells, and tobacco smoke.
- According to MedlinePlus, eat before you get hungry and before the nausea starts; avoid large meals and have small ones spread through the day.
- According to NHS, in the morning have dry toast or a plain biscuit; choose bland, starchy, low-fat food, and eat it cold if the smell of hot food bothers you. MedlinePlus advises eating something just before getting out of bed.
- According to NHS, drink plenty of fluids; MedlinePlus advises drinking between meals rather than with them. Ginger is named by both sources.
- Prenatal vitamins: according to MedlinePlus, take them in the evening, because the iron can upset the stomach — change the time you take them, do not change the product yourself.
- NHS and MedlinePlus both mention acupressure; for acupuncture, choose someone trained to treat pregnant women.
- Keep a note by the day: what stayed down, your weight, the colour of your urine — take it with you when you are seen.
What must NOT be done
- DO NOT buy anti-sickness medicine yourself. According to MedlinePlus, do not take any medicine for morning sickness without asking your provider; according to NHS, it is the doctor who gives you medicine when changes to what you eat and drink are not enough.
- DO NOT stop a medicine you are being treated with because you are afraid for the baby. According to CDC, talk to your doctor before starting or stopping any medicine — sometimes stopping a medicine in pregnancy does more harm than taking it.
- DO NOT treat herbal remedies, supplements or vitamins as “natural, therefore safe”. According to CDC, tell your doctor about EVERYTHING you are taking, over-the-counter medicines and herbal products included.
- DO NOT stop drinking because you are afraid it will come straight back up. Being unable to keep fluids down is a reason to be seen, not a reason to stop drinking.
- DO NOT skip an antenatal appointment because you feel too unwell: your weight and the signs of dehydration need someone to monitor them.
When you must go to hospital
GO TO EMERGENCY CARE or call 115 (the emergency number in Vietnam) NOW if you are pregnant and have any of the following — according to CDC these are signs that mean being seen straight away: severe vomiting, quite unlike ordinary morning sickness; severe abdominal pain that will not ease; fever; a headache that will not go or is getting worse; changes in your vision; difficulty breathing; chest pain or a fast heartbeat; a lot of swelling in the hands or the face; bleeding or fluid leaking from the vagina; the baby moving much less or stopping; overwhelming and unusual tiredness; thoughts of harming yourself or your baby. According to NHS, also make contact straight away if: you are vomiting blood; you have abdominal pain; you cannot keep anything down, not even a sip of water; you have not passed urine for many hours, or the urine has become much darker; you are very weak, dizzy or light-headed on standing. Say at once that you are pregnant. — BE SEEN WITHIN 24–72 HOURS if: you have tried the measures above and they are not helping; you are losing weight; you can still drink but are vomiting frequently and not keeping food down; the sickness is still severe even though the pregnancy is past the stage at which ordinary morning sickness stops; you had severe sickness in a previous pregnancy. — According to CDC, this list does not cover every symptom — if something does not feel right, ask your doctor.
Severe sickness is assessed and treated at a medical facility — the degree of dehydration, the degree of weight loss and which medicines can be used all need someone to examine you; according to NHS the severe form may need fluids into a vein. None of that can be measured or treated at home, and this article is not a substitute for your antenatal appointments.
What Y Te Xanh (GreenCare) can help with is narrower: a remote consultation by video call so you can decide between going now and waiting for an appointment, and a doctor coming to the house to take the history, examine, and say clearly which cases must be admitted. A remote consultation is not for anyone drowsy or having seizures — with a sign in the box above, go in first and call afterwards.
The warning signs in pregnancy and the point about medicines in pregnancy follow the US CDC; the time markers and the severe form follow NHS in England; the eating, drinking and prenatal vitamins follow MedlinePlus. Citing CDC here does not imply that CDC endorses Y Te Xanh or our services.
Need personalised advice for your loved one? Call our hotline 094 368 81 15 (24/7) — calling to ask a question or to book costs nothing. GreenCare has doctors who come to examine, nurses who carry out doctor's orders (injections, infusions, dressing changes), remote consultation by video call, and a review of the medicines you are taking; an in-depth remote consultation, or any one after the first, is a paid service. For children we take examination and acute care only — not long-term care at home, and not newborns or expectant mothers. We confirm we have staff in your area and provide transparent pricing before we begin.
