As you entered your second trimester, your morning sickness most likely went away. But now that you’re in late pregnancy, it seems to have come back…
You’re probably wondering, is nausea in late pregnancy normal?
In this post, we are going to share some tips for battling nausea in later pregnancy. But first, let’s talk about why nausea may return in your third trimester.
What Causes Nausea in Late Pregnancy?
Morning sickness and nausea are terms that are often used interchangeably, but it's important to note that they are not the same. Morning sickness is the unpleasant symptom you experience in the first trimester, where you are constantly running to the bathroom to vomit, or just feeling nauseous.
Nausea, on the other hand, is just a general term to describe an upset stomach, vomiting, or just feeling “ill.” There are a number of things that can be attributed to nausea, especially in the third trimester.
Changes in Our Bodies
Changes in your body are the most common reason for nausea in late pregnancy. As pregnancy progresses, our stomach and gastrointestinal muscles relax to prepare for the baby’s arrival. The hormone, progesterone, causes smooth muscle relaxation and slowing of digestion in the stomach and intestines.
Many of the digestive discomforts of pregnancy, including morning sickness, constipation, and heartburn, are also related to the relaxed and slowed action of the digestive system. Coupled with pressure on the stomach and uterus from our growing baby, it's not surprising so many expecting women complain about this issue.
Diet
Certain foods can exacerbate nausea as well, such as oily, acidic, or spicy foods, which are tougher to digest. If you notice certain foods make you feel nauseous, be sure to avoid them going forward.
The Return of Morning Sickness
After the first trimester, we usually get a break from morning sickness. This makes it all the more frustrating if we start to experience nausea again in the third trimester. But it does happen...
Pre-Eclampsia
Pre-eclampsia is a serious condition that pregnant women are prone to. You are especially susceptible if you have high blood pressure.
This disorder can begin to take hold after 20 weeks, but most cases are reported in the third trimester.
You can differentiate it from other causes of nausea by looking for common symptoms, including:
- Facial swelling, particularly around the eyes
- Severe pain in the upper right abdomen
- Severe headaches with dizziness and a decrease in vision
- Decrease in urine
This is a very serious disorder, and if you suspect you may be affected by it, contact your midwife or doctor immediately.
HELLP Syndrome
This is another pretty serious disorder which may cause nausea and vomiting. HELLP stands for Hemolysis, Elevated Liver enzymes, and Low Platelet count. This disorder becomes more common in the third trimester, and you are at increased risk if you’re suffering from preeclampsia too.
Thankfully, it only occurs in a small number of pregnancies. Some symptoms of HELLP syndrome include mid-upper abdomen pain, tenderness of the liver, and high blood pressure. Again, we recommend you contact your midwife or doctor immediately if you think you may have HELLP.
Hyperemesis Gravidarum
A medical term used to describe persistent severe nausea and vomiting during pregnancy, hyperemesis gravidarum is severe morning sickness that can happen day or night. It usually starts around the sixth week of pregnancy and stops by weeks 16 to 18.
Unfortunately, doctors don’t know what exactly causes hyperemesis gravidarum, but it's thought to have something to do with a rise in hormone levels— specifically a spike in the hormones estrogen and human chorionic gonadotropin (HCG).
Although it’s not necessarily life-threatening, the condition might lead to dehydration. So, it’s of the utmost importance to drink plenty of fluids throughout the day.
To help ease the effects of vomiting, your healthcare provider may be able to prescribe medication, such as doxylamine or recommend pregnancy-safe supplements such as ginger, thiamine, and B6.
Acute Fatty Liver of Pregnancy
Also known as AFLP, this disorder is caused by the production of excess fatty acids in the liver. It is not very common, but can be very serious. It occurs most often in the last few weeks of pregnancy.
This disorder can lead to permanent liver damage, and contribute to high blood pressure, renal failure, or blood clotting issues.
Along with nausea, look out for any abdominal pain and jaundice (yellowing of the skin or whites of the eyes). The combination of these symptoms can be a key indicator of the disease.
Is Nausea in Late Pregnancy Normal?
If morning sickness subsides after the first trimester but then comes back, there may be reason for concern. First and foremost, you should look for a combination of symptoms and see if they match any of the above disorders. If you do, don’t hesitate to contact your doctor, or go to the hospital for a check up. It is always better to be safe rather than sorry!
Can Nausea Be a Sign of Labor?
Every woman’s labor is unique, and feeling nauseous around our due date doesn’t necessarily mean you are going into labor. However, our bodies will start to tell you when the baby is coming - and nausea can be one way of communicating that.
You’ll probably be able to tell if it's just nausea with no real underlying cause at it again, because labor will be accompanied with plenty of other symptoms, including:
- Loss of nasal plug, excess mucus production
- Water breaking
- Contractions (another tell-tale sign of labor)
- Pelvic pressure
Again, look for a combination of symptoms - nausea on its own is no real reason for concern, it is just an unpleasant symptom of pregnancy.
How To Combat Nausea
Once you’ve ruled out any of the serious above disorders, there are a few things you can do to prevent or alleviate nausea. For instance, you can cut out some of the foods in our diet that may be contributing to reflux. Also, be sure to follow a healthy diet that contains a healthy amount of vitamin B6, and stay hydrated by drinking plenty of liquids.
Here are a few other great tips to combat nausea:
Tip #1: Eat with Care
Instead of eating a large meal at breakfast, lunch, and dinner, opt for smaller portions with healthy snacks — such as bananas, rice, dry toast, or any citrus fruit — in between meals. Both an empty stomach and a full stomach can make pregnancy nausea worse.
Tip #2: Grab Some Ginger
Ginger has been used for centuries as a holistic approach to aid digestion and reduce abdominal discomfort. Try adding a thin slice of fresh ginger to hot water or sipping flat ginger ale. A handful of crystallized ginger candy or gingersnaps is a good choice too.
Not a fan of ginger? You can also try peppermint.
Tip #3: Soothe Acid Reflux
In some cases, nausea may be due to acid reflux — a chronic disease that happens when bile or stomach acid flows into the food pipe, ultimately causing irritation to the lining.
Your doctor may be able to recommend antacid medication, or you can try alternative therapies such as acupressure. Applying a little pressure on specific body points may help bring some relief. It can also be helpful to avoid lying down after eating.
Tip #4: Avoid Triggers
If certain things trigger nausea, we must do our best to avoid them.
Strong odors are often a common culprit behind nausea in addition to certain sounds and even bright lights. The flicker from a computer monitor may also contribute to nausea.
To minimize risk factors, it can be helpful to keep track of sudden episodes in a journal. As we go through our pregnancy, you will learn to recognize which triggers lead to nausea — jot these down and steer clear of the things that make you feel anything less than amazing.
A Final Word
So, is it normal to deal with nausea in late pregnancy?
Nausea in late pregnancy is not as common as it is in early pregnancy, but that’s not to say it doesn’t happen.
At the end of the day, every pregnancy is unique — in other words, the experience your bestie has while pregnant may be very different. That said, if nausea is causing some concern, be sure to call your OB-GYN.