Third Trimester Nausea: Causes And Ways To Prevent It

Hormonal changes, diet, or an underlying issue may cause nausea during this phase.

Medically reviewed by Dr. Irene (Eirini) Orfanoudaki, MD, PhD Dr. Irene (Eirini) Orfanoudaki Dr. Irene (Eirini) OrfanoudakiMD, PhD MomJunction on FacebookFollow MomJunction on Linkedin Specialty: Gynaecology and ObstetricsExperience: 21 years
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Pregnant Woman Feeling Nauseous, Indicating Third Trimester Information

Image: Midjourney/ MomJunction Design Team

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. The information was collected after researching different scientific journals, healthcare websites, and government official websites and has been further reviewed and evaluated by a medical professional.

In This Article

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.

Causes Of Third Trimester Nausea

According to Greg J. Marchand, MD, FACS, FACOG, program director at Steward Health, Providence, Rhode Island, “Acid reflux and stomach bugs (stomach viruses and stomach flu) are common in pregnant women in the third trimester. However, nausea that lasts the whole pregnancy is rare.”

While increasing HCG levels are one of the reasons for the first trimester morning sickness, it can be difficult to understand the cause of third-trimester nausea (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. Pregnancy-related hormonal changes can also slow down the movement of the stomach, prolonging the time it takes for food to empty out and increasing the risk of gastroesophageal reflux disease (GERD). According to a study published in the Canadian Family Physician journal, GERD is linked to heightened severity of vomiting and nausea during pregnancy (3)
  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 pregnancy discomfort, including nausea, heartburn, and vomiting.
Pressure on the digestive system may cause nausea
Image: iStock
  • Diet: Too spicy, greasy, or acidic foods can worsen nausea and vomiting. To manage your nutritional requirements in the third trimester, keep track of what you eat and avoid foods that trigger or intensify your queasiness.
  • 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 cause aggravated, uncomfortable pregnancy symptoms, including nausea and vomiting.
  • Preeclampsia: The sudden reappearance of nausea and vomiting midway through pregnancy may be associated with hypertension and preeclampsia. Inform your healthcare provider about any concerning symptoms (4). According to the American Heart Association (AHA), preeclampsia affects 5% to 7% of pregnant women globally and accounts for 70,000 maternal and 500,000 fetal mortalities annually. In the US, preeclampsia is a prominent cause of maternal mortality, severe morbidity, ICU admissions, cesarean deliveries, and premature births (5).
    • Preeclampsia may cause third trimester nausea
    Image: iStock
  • HELLP syndrome: HELLP syndrome stands for the following blood and liver problems (6).
    • 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.

    Dr. Marchand adds, “Apart from stomach illnesses, worsening acid reflux, or nausea that has never subsided, you should not have a new onset of nausea in the third trimester. If you have a new onset of nausea that is not explained by one of the previously listed conditions, it could be a sign of pregnancy complications, such as HELLP syndrome.”

    1. Acute fatty liver of pregnancy: Acute fatty liver of pregnancy (AFLP) is a rare but serious problem. The exact cause of AFLP is unknown.  However, it starts late in the third trimester of pregnancy and can cause nausea and vomiting (7).
    protip_icon Did you know?
    Prenatal vitamins, especially those containing iron, can also cause nausea in later pregnancy (2).
    It is rare condition that may cause nausea and vomiting
    Image: iStock

    8. Hyperemesis gravidarum: Hyperemesis gravidarum is a condition in pregnancy where one experiences intense nausea and vomiting, which can be highly unpleasant. This condition usually occurs during the first trimester of pregnancy (at around six weeks). The symptoms of hyperemesis gravidarum can last longer than regular morning sickness, typically for weeks, months, or even until delivery, posing challenges in carrying out routine activities. These symptoms may include vomiting more than three times a day, dehydration, lightheadedness, continuous dizziness, and weight loss. If the situation becomes complicated and dehydration ensues, seeking treatment at the hospital may be necessary (8).

    9. Overheating: Another potential reason for nausea and dizziness during the third trimester may be caused by overheating during the summer or intensive exercise routine. According to the Centers for Disease Control and Prevention, overheating can make the pregnant woman feel dizzy and nauseated anytime during pregnancy more easily than non-pregnant women of her age (9). They may even experience warm heat, muscle cramps, and headaches. Adding to this comment from the CDC by citing the situation during hot summers, Dr. Elizabeth Suzanne Langen, an assistant professor in the University of Michigan’s Department of Obstetrics & Gynecology, says, “It’s not unexpected to see pregnant women come to the hospital … on a hot summer day. When you’re pregnant, your body is already working hard to keep you and your baby healthy, so adding the hard work of keeping cool can push you over the edge” (10).

    Ways To Prevent Third-Trimester Nausea

    The following measures can help in preventing nausea (11) (12).

    • Try to get enough sleep and rest, as it can help subside stress hormones and tiredness that may cause nausea.
    • Avoid caffeinated beverages, including tea, and coffee as they aggravate your symptoms.
    • Eat small, frequent meals throughout the day to be digested easily and prevent an empty stomach (13).
    • Consume a lot of fluids to avoid dehydration and associated nausea.
    • Practice gentle exercises after consulting your healthcare provider to be in better shape and promote relaxation.
    Practice gentle exercises after consulting your Ob-GYN
    Image: Shutterstock
    • Avoid lying down immediately after meals and have your dinner two to three hours before bedtime. Explaining the reason behind it, certified nurse-midwife Jessica Costa, MSN, APRN, CNM, at the Wooster Specialty Center, USA, says, “This (lying down immediately after eating) hinders digestion and contributes to that queasy feeling” (14).
    • 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 due to ever-changing hormones, so avoid them.
    • Eating bland food or high-protein foods might help as they are easy to prepare and do not have a strong smell. 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).
    Ginger may help reduce third trimester nausea
    Image: Shutterstock
  • 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.

    protip_icon Quick tip
    If you can’t keep fluids down, freeze them. Consuming frozen fluids numbs the back of your mouth and removes the bad taste and sensation that brings nausea (2).

    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 throughout the day

    Seek immediate medical attention if you experience abdominal pain or signs of severe dehydration.

    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 (15)

    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 (16).

    3. Is nausea in the third trimester normal?

    Third-trimester nausea 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 expectant mother. Mild vomiting may not have any impact on the mother and the baby. However, excessive vomiting can lead to dehydration and appetite loss. Both dehydration and appetite loss during pregnancy can affect maternal and fetal health.

    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 (17).

    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 (17).

    Nausea is a common occurrence during the initial weeks of pregnancy. However, third-trimester nausea is not a common symptom and should be reported to the doctor at once. If left unattended, nausea during the third trimester might lead to dehydration and also increase the chances of complications for the baby and the mother. Treatment of such severe cases of nausea might require hospitalization and the administration of intravenous fluids. Thus, it is advised that pregnant women should stay hydrated, avoid spicy or oily food and get enough rest and sleep to avoid the symptoms of nausea.

    Infographic: How Can You Avoid Nausea During the Third Trimester

    Just when you were happy that your morning sickness had subsided in your second trimester, it might have bounced back as soon as your third trimester began. The good news is that you can prevent nausea in your third trimester. The infographic below offers tips on controlling or suppressing nausea toward the end of your pregnancy.

    ways to prevent during the third trimester (infographic)

    Illustration: Momjunction Design Team

    Illustration: Reasons For Third Trimester Nausea And Its Prevention

    Third Trimester Nausea_illustration

    Image: Dall·E/MomJunction Design Team

    If you’re pregnant and feeling nausea, learn how to manage vomiting during the third trimester. Learn how to reduce and cope with this bothersome symptom.

    References

    MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
    1. Adrienne Einarso et al.; (2007); Treatment of nausea and vomiting in pregnancy.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2231543/
    2. Morning Sickness.
      https://www.stanfordchildrens.org/en/topic/default?id=morning-sickness-1-2080
    3. SIGNS & SYMPTOMS.
      https://www.preeclampsia.org/signs-and-symptoms
    4. Ruth Law et al.; (2010); Treatment of heartburn and acid reflux associated with nausea and vomiting during pregnancy.
      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2821234/
    5. Sarosh Rana et al.; (2019); Preeclampsia: Pathophysiology, Challenges, and Perspectives.
      https://www.ahajournals.org/doi/full/10.1161/CIRCRESAHA.118.313276#d1e2216
    6. HELLP SYNDROME.
      https://www.marchofdimes.org/find-support
    7. Acute Fatty Liver of Pregnancy.
      https://www.stanfordchildrens.org/en/topic/default?id=acute-fatty-liver-of-pregnancy-90-P02465
    8. Hyperemesis Gravidarum.
      https://my.clevelandclinic.org/health/diseases/12232-hyperemesis-gravidarum
    9. Heat and Pregnancy.
      https://www.cdc.gov/heat-health/risk-factors/heat-and-pregnancy.html
    10. Summer heat brings special health risks for pregnant women.
      https://www.heart.org/en/news/2019/07/01/summer-heat-brings-special-health-risks-for-pregnant-women
    11. Morning Sickness.
      https://familydoctor.org/condition/morning-sickness/
    12. The Pregnancy Book.
      https://www.stgeorges.nhs.uk/wp-content/uploads/2013/11/Pregnancy_Book_comp.pdf
    13. Ease Nausea with Natural Remedies
      https://www.nationwidechildrens.org/family-resources-education/family-resources-library/ease-nausea-with-natural-remedies
    14. Morning Sickness? 12 Remedies That Really Work.
      https://health.clevelandclinic.org/morning-sickness-10-tips-to-tame-your-turbulent-tummy-day-or-night
    15. DICLEGIS- doxylamine succinate and pyridoxine hydrochloride tablet, delayed release.
      https://www.accessdata.fda.gov/drugsatfda_docs/label/2013/021876s002lbl.pdf
    16. Premature Labor.
      https://my.clevelandclinic.org/health/diseases/4498-premature-labor
    17. Coping With Common Discomforts Of Pregnancy.
      https://www.ucsfhealth.org/education/coping-with-common-discomforts-of-pregnancy#:~:text=Going%20too%20long%20without%20eating,are%20more%20difficult%20to%20digest

    Community Experiences

    Join the conversation and become a part of our nurturing community! Share your stories, experiences, and insights to connect with fellow parents.

    Dr. Irene (Eirini) Orfanoudaki
    Dr. Irene (Eirini) OrfanoudakiPhD, 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 around 21 years 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 care, breast diseases, and teenage issues.

    Read full bio of Dr. Irene (Eirini) Orfanoudaki
    • Greg J. Marchand
      Greg J. MarchandMD, FACS, FACOG, FICS Dr. Marchand, originally from Providence, RI, is dual board-certified in Ob/Gyn and minimally invasive gynecologic surgery. He is extensively published in the field of minimally invasive surgery and is accredited by the Society of Laparoscopic & Robotic Surgeons (SLS). He is a fellow of both the American College of Obstetrics and Gynecology (ACOG) and American College of Surgeons (ACS).
      Dr. Marchand, originally from Providence, RI, is dual board-certified in Ob/Gyn and minimally invasive gynecologic surgery. He is extensively published in the field of minimally invasive surgery and is accredited by the Society of Laparoscopic & Robotic Surgeons (SLS). He is a fellow of both the American College of Obstetrics and Gynecology (ACOG) and American College of Surgeons (ACS).
    Dr. Ritika Shah
    Dr. Ritika ShahBDS, CLC
    Dr. Ritika Shah is a certified lactation counsellor (CLC) 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.

    Read full bio of Dr. Ritika Shah
    Rebecca Malachi
    Rebecca MalachiBSc
    Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU).

    Read full bio of Rebecca Malachi
    Dr. Joyani Das
    Dr. Joyani DasM.Pharm, PhD
    Dr. Joyani Das did her post-graduation from Birla Institute of Technology, Mesra and PhD in Pharmacology. Previously, she worked as an associate professor, faculty of Pharmacology, for two years. With her research background in preclinical studies and a zeal for scientific writing, she joined MomJunction as a health writer.

    Read full bio of Dr. Joyani Das
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