Many people associate nausea with the early stages of pregnancy, often referred to as “morning sickness.” However, nausea can return or even persist into the third trimester. This discomfort is a documented phenomenon.
Is Third-Trimester Nausea Common?
While nausea is more commonly experienced during the first trimester, its recurrence in the third trimester is not unusual. Approximately 15% to 20% of pregnant individuals may experience nausea that continues into the third trimester, with about 5% experiencing it until delivery. This nausea is often a normal physiological experience.
Common Causes of Late Pregnancy Nausea
Several physiological factors can contribute to the return or persistence of nausea in the third trimester. As the uterus expands to its maximum size, it can exert increased pressure on the stomach and other digestive organs. This physical compression can slow down digestion, causing food to remain in the stomach for longer periods, which may lead to feelings of nausea.
Hormonal fluctuations also play a role in third-trimester nausea. While progesterone levels may gradually decrease, estrogen levels tend to rise during this period. These shifts in hormone ratios can affect the smooth muscles of the digestive system, including the stomach and intestines, leading to slowed gastric emptying and increased likelihood of acid reflux or heartburn. Dietary factors can also worsen nausea, with greasy, acidic, or spicy foods often triggering discomfort. Dehydration and fatigue, common in late pregnancy, can also contribute to nausea. Iron supplements can also cause stomach upset and nausea.
When Nausea Signals a Concern
While third-trimester nausea is often a normal part of pregnancy, certain accompanying symptoms can indicate a more serious underlying condition that requires medical attention. Preeclampsia, a condition characterized by high blood pressure, can present with nausea and vomiting, alongside other symptoms such as severe headaches, vision changes, sudden swelling, and upper abdominal pain. A more severe form of preeclampsia is HELLP syndrome, which involves hemolysis (breakdown of red blood cells), elevated liver enzymes, and low platelet count, and also includes nausea and vomiting.
Other concerning causes of nausea in the third trimester can include gallbladder issues, appendicitis, food poisoning, or other infections. Nausea accompanied by extreme tiredness, severe belly pain, or an inability to keep fluids down for more than 8 hours should prompt immediate medical consultation. While nausea can sometimes be a sign of impending labor, especially if accompanied by diarrhea or strong contractions, it is more commonly associated with active labor or the transition phase.
Tips for Managing Nausea
Managing third-trimester nausea often involves daily habit adjustments. Eating smaller, more frequent meals throughout the day can help prevent the stomach from becoming overly full and reduce pressure on the digestive system. Avoiding trigger foods like greasy, spicy, or highly acidic ones can also alleviate symptoms. Staying well-hydrated by sipping fluids throughout the day is also important, as dehydration can exacerbate nausea.
Incorporating bland, easily digestible foods like crackers, toast, or bananas is helpful. Ginger, whether in the form of tea, candies, or extracts, has been traditionally used to soothe nausea. Acupressure bands, worn on the wrists, may also offer some relief. Ensuring adequate rest and elevating your head while sleeping can help reduce acid reflux, which often contributes to late-pregnancy nausea. If these measures are insufficient, discussing medication options, such as doctor-approved antacids or antiemetics, with a healthcare provider can provide further relief.