For most pregnant women, the nausea and vomiting they experience (commonly known as “morning sickness”) is uncomfortable and inconvenient, but manageable. There are instances, however, when morning sickness can interfere with a woman’s ability to work and function, and it can even be life threatening for both woman and child in the most extreme cases. In these circumstances, it is essential that the expectant mother let her doctor know what is happening and get the situation fully evaluated. Understanding pregnancy nausea and when to call your doctor will give you peace of mind during your pregnancy.

Morning sickness is a “normal” aspect of pregnancy that in most cases will disappear on its own within 12 to 14 weeks—by the end of the first trimester. It presents no danger to the health of either mother or child, and may even be a healthy defense mechanism, protecting the fetus from exposure to certain toxins. For mild morning sickness, many home and non-prescription remedies are available that can relieve queasiness—changing your diet to avoid certain foods, eating small but frequent meals, drinking herbal infusions of ginger or chamomile, or using a wristband to deliver pressure treatment to the wrist.

But “morning” sickness is not actually confined to the mornings, and if it tends to recur throughout the day, it can interfere with the expectant mother’s ability to carry out her daily tasks, including work. If this is your situation, or if your nausea and vomiting continue past the first two months of pregnancy, it’s a good idea to talk to your doctor. He or she may be able to suggest remedies you haven’t tried, including prescription anti-nausea drugs, or at least reassure that there is no particular problem to be concerned about.

The most severe cases of morning sickness definitely require a doctor’s attention and medical treatment. If common remedies provide no relief, if you vomit 3 or more times a day, or if you go a full day without being able to keep any foods or liquids in your stomach, these are signs that you should tell your physician about immediately. In about one to two percent of pregnancies, morning sickness can reach such an extreme that it is diagnosed as “hyperemesis gravidarum.” This is a fairly rare complication of pregnancy, but one that warrants immediate medical care, since it is likely that you are not getting sufficient nutrition or liquids for either yourself or your growing child.

Hyperemesis gravidarum is likely to start earlier and last longer than ordinary morning sickness. Diagnosis is really just a matter of degree. In addition to constant vomiting, symptoms include significant weight loss (5% or more of your pre-pregnancy weight), dehydration, dizziness, slower digestion and acid reflux, altered sense of taste, even hallucinations. It is very likely to lead to serious nutritional deficiencies and metabolic imbalances, and greatly increases the stress that pregnancy places on both mind and body.

Any woman suffering from morning sickness needs to be alert for signs of dehydration that can result from frequent vomiting. If you find that you are urinating less than usual and/or your urine is unusually dark, that is one sign of dehydration. Your skin, eyes, and mucous membranes may feel overly dry and you may experience frequent headaches. Confusion and fatigue may occur as well. In the extreme, dehydration can cause a drop in blood pressure and dizziness. The first and best precaution against dehydration, obviously, is to be sure you are drinking plenty of water to replenish what you are losing through vomiting in addition to the normal quantity of liquid the body needs. But if you find you are experiencing any of the symptoms noted above, be sure to let your doctor know, for your health’s sake and your child’s.

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