7 Reasons For Third Trimester Nausea And Its Prevention

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Third-trimester nausea and vomiting are less common. Usually, nausea and vomiting subside by the 16th week of pregnancy in most women. Overall, only 20% of pregnant women experience nausea and vomiting throughout pregnancy (1).

The exact causes of nausea and vomiting in pregnancy are unknown, but knowing and avoiding triggers can help you manage the condition. Occasional incidence of nausea and vomiting in the third trimester may not be a cause for concern. However, seek medical care if you have persistent nausea or vomiting in the third trimester.

Read on to know about the common causes and preventive measures for third-trimester nausea and vomiting.

Causes Of Third Trimester Nausea

While increasing HCG levels are one of the reasons for the first trimester morning sickness, it can be difficult to understand the cause of nausea in the third trimester (2). The following could be the possible causes of nausea in the third trimester.

  1. Changing hormones: Frequent fluctuations in the hormones might cause nausea and vomiting in the third trimester.
  2. Growing baby: The growing baby exerts a lot of pressure on the digestive system. With decreasing space in the abdomen as the baby grows, you may experience symptoms, including nausea, heartburn, and vomiting.
  3. Diet: Too spicy, greasy, or acidic foods can exacerbate nausea and vomiting. Track your diet and avoid foods that may lead to nausea.
  4. Changes in the body: Growing uterus and baby can make you feel ill at times. Pressure from the growing uterus, sleep disturbances, stress and anxiety about labor, childcare, etc., may lead to nausea and vomiting.
  5. Preeclampsia: The sudden reappearance of nausea and vomiting midway through pregnancy may be associated with preeclampsia. Inform your healthcare provider about it (3).
  6. HELLP syndrome: HELLP syndrome stands for the following blood and liver problems (4).
  • H – Hemolysis (It is the breakdown of the red blood cells)
  • EL – Elevated liver enzymes (It can be a sign of liver problems)
  • LP – Low platelet count (It can lead to serious bleeding)

Nausea and throwing up (that gets worse) are the common symptoms of HELLP syndrome.

  1. Acute fatty liver of pregnancy: Acute fatty liver of pregnancy (AFLP) is a rare but serious problem in pregnancy. The exact cause of AFLP is unknown. However, it starts late in the third trimester of pregnancy and can cause nausea and vomiting (5).

Ways To Prevent Nausea In The Third Trimester

The following measures can help in preventing nausea (6).

  • Try to get enough sleep and rest.
  • Avoid caffeinated beverages, including tea, and coffee as they aggravate your symptoms.
  • Eat small, frequent meals throughout the day.
  • Consume a lot of fluids to avoid dehydration and associated nausea.
  • Practice gentle exercises after consulting your healthcare provider.
  • Avoid lying down immediately after meals and have your dinner two to three hours before bedtime.
  • Sugary, spicy, and greasy foods can worsen the nausea symptoms. Identify which food triggers your symptoms to avoid them.
  • Some fragrances or smells can trigger your nausea, so avoid them.
  • Eating bland food when you are nauseated might help. You can include rusk, Jell-O, popsicles, chicken broth, saltine crackers, gelatin desserts, pretzels, etc.
  • Ginger shows varying effectiveness in different women with nausea and vomiting of pregnancy (1).
  • Stay in well-ventilated and lighted places as closed spaces may also aggravate nausea and vomiting in pregnancy.

If nausea and vomiting are too severe, contact your healthcare provider. They might prescribe the necessary medications to help you feel better.

Signs You Need To See A Doctor

While nausea and vomiting of pregnancy are not always a sign of a problem, you should see your doctor in the following scenarios.

  • Inability to keep any food or fluids down
  • Loss of appetite
  • Sudden weight loss
  • Reduction in the fetal movement
  • Severe weakness
  • Dizziness
  • Several episodes of vomiting through the day

Frequently Asked Questions

1. Can I take medication for nausea in the third trimester?

According to the US Food and Drug Association (FDA), a combination of doxylamine succinate and pyridoxine hydrochloride tablet (trade name Diclegis) can manage nausea and vomiting in pregnancy (7)

Some antihistamines, ondansetron, phenothiazines, metoclopramide, and corticosteroids can also treat nausea and vomiting in pregnancy (1). However, do not use any medicine without your doctor’s consent.

2. Can third-trimester nausea be a sign of labor?

While nausea is not a conclusive sign of labor, sudden and persistent nausea in the third trimester can indicate premature labor (8).

3. Is nausea in the third trimester normal?

Nausea in the third trimester is not common. However, it does not always happen due to an underlying pathology. Nausea in the third trimester does not indicate any harm to the mother or fetus, but communication with professionals is necessary since they will be able to handle the condition better.

4. Does nausea while pregnant affect the baby in the third trimester?

Nausea or vomiting do not directly affect the baby but can cause discomfort for the mother. Mild vomiting may not cause any impacts on the mother and the baby. However, excessive vomiting can lead to dehydration, and dehydration can affect the baby.

5. How long can I go without eating while pregnant to avoid nausea?

Nausea may occur or worsen if you go too long without eating during pregnancy. It is recommended to eat every two hours if you experience nausea during pregnancy. Avoid consuming high-fat or greasy foods that are difficult to digest (9).

6. What drinks help with pregnancy nausea?

Some women may find relief in drinking carbonated beverages such as sodas, milk, or tea. Drinking peppermint or spearmint tea can also help reduce nausea and vomiting in some women. Chamomile and ginger tea can also help relieve nausea (9).

In rare cases, severe nausea and vomiting may require hospitalization. The doctor might administer intravenous fluids or antiemetic drugs (medicines to prevent nausea) via a vein or a muscle. Bring it to your OB/GYN’s notice if you experience frequent nausea in the third trimester to prevent dehydration and other complications.

Key Pointers

  • Nausea in the third trimester could be due to the growing baby’s increased strain on your digestive system.
  • Preeclampsia, HELLP syndrome, and AFLP can also cause nausea in the third trimester.
  • Eating small frequent meals, getting enough rest, and doing some light exercises can help prevent nausea.
  • Nausea in the third trimester is uncommon but generally does not indicate any harm to the mother and fetus.

References:

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Dr. Ritika Shah

Dr. Ritika Shah is a certified lactation counsellor from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to inculcate... more

Dr. Irene (Eirini) Orfanoudaki

(PhD, MD)
Dr. Irene (Eirini) Orfanoudaki is a gynecologist-obstetrician, having a private practice in Heraklion, Crete, and collaborating with private health clinic 'MITERA' - Euromeda in Heraklion. With more than two decades of experience as a gynecologist-obstetrician, she specializes in ultrasound, colposcopy, minimal and advance gynecologic surgery, aesthetic gynecology, fertility consulting, menopause consulting, operative obstetrics, high-risk pregnancy, normal deliveries, antenatal, intra-parum, postnatal... more