Pregnancy

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Yes, Morning Sickness Can Come Back In Your Third Trimester — Here's Why

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Ugh.

by Cat Bowen and Natalia Perez-Gonzalez
Updated: 
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Morning sickness is awful, but it’s unfortunately a pretty common experience. For most people, morning sickness lingers through the first trimester and subsides by the second. For some, it drags on into the second and (*sobs*) third trimesters, and sometimes it can even go away and return, like those terrible movie sequels nobody asked for.

According to the National Library of Medicine, for most birth givers, the nausea and vomiting associated with morning sickness can diminish greatly with the end of the first trimester. At this point, most pregnant people get a boost of energy, increased appetite, and generally feel better. I've heard parents talk of this magical second trimester energy — you get to feel the baby move, your maternity pants still mostly fit, and you're feeling fine. It would be a real shock to the system for that to fall back into the toilet-hugging horror of morning sickness after that period of bliss.

If you're one of the unlucky few, when does morning sickness come back? Does it return in your third trimester? How can you prepare for it? Here’s what experts have to say.

How long does morning sickness usually last?

"Morning sickness, also known as nausea and vomiting of pregnancy, and in severe cases, hyperemesis gravidarum, is extremely variable within a group of people, within the different pregnancies of the same person, and within each pregnancy,” Kathryn Wright, M.D. from Facey Medical Group, tells Romper. “Typical onset is six to eight weeks. It peaks at 12 weeks, and is typically gone around 16 weeks. However, within that time, it can get better or worse daily or within a given day. Often a mom may notice it almost disappear, only to feel sick again days later." TLDR: Morning sickness is not consistent for most people and might be worse on some days and weeks than others.

Does morning sickness come back in the third trimester?

Later in pregnancy, usually the third trimester, many pregnant people experience a recurrence of their nausea. Unless it never went away in the first place, Wright explains that this is not technically morning sickness, but something caused by the relaxation of the esophageal sphincter (muscle that separates the esophagus from the stomach), as well as increasing intra abdominal pressure from the growing pregnancy. "The relaxation is caused by hormones which help relax the uterus (also a smooth muscle, like the esophageal sphincter) to prevent preterm birth."

The nausea (and sometimes vomiting) recurrence in the third trimester could also be due to heartburn and acid reflux. “Treating with antacids, not eating just before bed, [and] propping up in bed may alleviate the symptoms,” Andrea Eisenberg, M.D., from HealthCentral, tells Romper. “Also, especially near full term, the large uterus is compressing the bowel and many women feel full faster or just uncomfortable eating.”

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When to see a doctor

While the recurrence of morning sickness symptoms isn’t atypical, you should still bring it up to your provider. Third trimester nausea and vomiting, especially when paired with fever, swelling, or headaches, are some of the primary symptoms of preeclampsia.

“Anytime a woman is concerned (about her pregnancy symptoms), she should see her doctor,” Eisenberg says. “But some symptoms that can be concerning are inability to keep any food or liquids down, urinating very little or dark urine, feeling dizzy or overly fatigued, [or] weight loss. If a woman becomes severely dehydrated, she will probably experience more nausea, and this sets up a vicious cycle.” It’s ultimately better to over-communicate with your doctor, even if there’s nothing major to worry about.

Studies referenced:

Lee, N. M., Saha, S. (2013) Nausea and Vomiting of Pregnancy. PubMed Central https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676933/

Experts:

Kathryn Wright, M.D. from Facey Medical Group

Andrea Eisenberg, M.D. from HealthCentral

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