Nausea in the third trimester can be an unexpected and uncomfortable symptom. While morning sickness is common early in pregnancy, its reappearance later is also common. This sensation can range from mild queasiness to pronounced sickness.
Common Causes of Third Trimester Nausea
The expanding uterus places increased pressure on surrounding internal organs. The stomach and intestines can be compressed, which may lead to nausea. This physical displacement can hinder the digestive process, making it more challenging for food to move through the digestive tract.
Hormonal shifts continue to play a role throughout pregnancy, and while different from the early surge of human chorionic gonadotropin (hCG), they can still influence digestive function. Progesterone, a hormone that remains elevated in pregnancy, relaxes smooth muscles throughout the body, including those in the digestive system. This relaxation can slow down the movement of food, contributing to a feeling of fullness, bloating, and subsequent nausea.
The slowed digestive process, often termed gastroparesis in pregnancy, can exacerbate feelings of discomfort. Food may remain in the stomach for longer periods, increasing the likelihood of indigestion and a queasy sensation. This sluggishness can also contribute to an accumulation of gas, further adding to abdominal discomfort.
Acid reflux, or heartburn, is another frequent complaint in the third trimester that can manifest as nausea. The growing uterus pushes stomach acids upward into the esophagus, particularly when lying down or after eating larger meals. This acidic irritation can trigger a nauseous response, making it difficult to distinguish from other causes of queasiness.
Managing Third Trimester Nausea
Eating smaller, more frequent meals throughout the day can help manage third trimester nausea by preventing the stomach from becoming overly full. Instead of three large meals, consider consuming five or six smaller portions. This approach can reduce the pressure on the digestive system and allow for more consistent nutrient intake without overwhelming the stomach.
Staying well-hydrated is also important, as dehydration can worsen feelings of nausea. Sipping on water, clear broths, or decaffeinated teas throughout the day can help maintain fluid balance. It is often helpful to drink liquids between meals rather than with them, which can prevent the stomach from feeling too distended.
Identifying and avoiding specific trigger foods can significantly alleviate nausea. Foods that are greasy, spicy, highly acidic, or have strong odors are common culprits for many individuals. Opting for bland, easy-to-digest foods like toast, crackers, plain pasta, or rice can be more tolerable during periods of nausea.
Ginger, in various forms such as ginger ale, ginger tea, or ginger candies, has long been recognized for its anti-nausea properties. The active compounds in ginger can help calm the digestive tract and reduce feelings of queasiness. Consuming small amounts of ginger throughout the day can offer relief for some pregnant individuals.
Ensuring adequate rest is another practical strategy, as fatigue can intensify nausea. Prioritizing sleep and taking short naps during the day can help the body cope with the demands of pregnancy. If prenatal vitamins seem to worsen nausea, discussing this with a healthcare provider might be beneficial, as they may suggest taking them at a different time of day or trying a different formulation.
When Nausea Requires Medical Attention
While third trimester nausea is often harmless, certain accompanying symptoms warrant immediate medical evaluation. Preeclampsia, a serious pregnancy complication, can present with nausea alongside other concerning signs. These include a severe, persistent headache, visual disturbances such as blurred vision or seeing spots, and sudden, significant swelling in the hands, face, or feet.
HELLP syndrome, a rare but life-threatening liver and blood clotting disorder, is another condition where nausea can be a symptom. This syndrome often involves upper right abdominal pain, fatigue, and sometimes jaundice. The presence of these symptoms alongside nausea should prompt urgent medical consultation.
Cholestasis of pregnancy, a liver condition, can also cause nausea, frequently accompanied by intense itching, especially on the palms of the hands and soles of the feet. This itching is often worse at night and may not be relieved by typical anti-itch remedies. Any severe, unexplained itching during pregnancy, particularly with nausea, requires medical assessment.
Nausea, when accompanied by signs of preterm labor, indicates a need for immediate medical attention. These signs can include regular or painful contractions, persistent abdominal cramping, a dull ache in the lower back, or a gush or trickle of fluid from the vagina. It is important not to self-diagnose these symptoms and to contact a healthcare professional promptly for proper evaluation.