Nausea and vomiting can occur during the third trimester of pregnancy. While often a normal part of the body’s adjustments, these symptoms can also indicate underlying issues that warrant attention. Understanding the various reasons behind third-trimester vomiting can help differentiate between typical discomfort and situations requiring medical guidance. This article explores common causes and more serious conditions associated with vomiting in late pregnancy.
Common Causes of Nausea and Vomiting
As pregnancy progresses, the growing uterus exerts increasing pressure on internal organs, including the stomach. This physical compression can push stomach acid upwards into the esophagus, leading to heartburn and acid reflux, which may manifest as nausea or vomiting.
The baby’s position changes as it prepares for birth, often dropping lower into the pelvis. This shift can alter the pressure on the diaphragm and digestive organs, contributing to feelings of fullness, discomfort, and sometimes nausea. These positional changes are a natural part of the late stages of pregnancy.
Many individuals experience heightened senses during pregnancy, extending to an increased sensitivity to smells. Odors that were once tolerable, such as certain foods, perfumes, or environmental smells, might become overwhelming and trigger nausea or vomiting.
General fatigue and the overall physical strain of carrying a pregnancy can also contribute to feelings of unwellness, including nausea. The body is working harder to support the growing fetus, and this increased demand can lead to a sense of exhaustion that may lower one’s tolerance for minor digestive upsets. Minor food sensitivities or indigestion, exacerbated by slower digestion due to hormonal changes, can similarly cause stomach upset.
Serious Conditions to Be Aware Of
Persistent or severe nausea and vomiting in the third trimester can sometimes signal more serious medical conditions. Preeclampsia, characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys, can present with severe nausea and vomiting. Other symptoms may include severe headaches, vision changes like blurred vision or seeing spots, and sudden swelling in the face or hands.
A rare but severe complication of preeclampsia is HELLP syndrome, which stands for Hemolysis (the breaking down of red blood cells), Elevated Liver enzymes, and Low Platelet count. This condition can cause intense nausea and vomiting, along with upper right abdominal pain, headache, and fatigue. It requires immediate medical intervention due to its potential for rapid progression and serious health risks.
Intense, generalized itching, particularly on the palms of the hands and soles of the feet, accompanied by nausea and vomiting, might indicate intrahepatic cholestasis of pregnancy. This liver condition affects the flow of bile and can lead to bile acids building up in the blood.
Other conditions that can cause nausea and vomiting include:
- Complications related to gestational diabetes, such as very high or low blood sugar levels.
- Acute gastroenteritis (stomach bug) or food poisoning, presenting with sudden onset of vomiting, diarrhea, and sometimes fever. These are typically self-limiting but can lead to dehydration if not managed.
- Appendicitis, characterized by severe abdominal pain that usually starts around the navel and shifts to the lower right abdomen.
- Early signs of labor.
When to Contact Your Doctor
It is important to contact a healthcare provider if nausea and vomiting in the third trimester are accompanied by specific concerning symptoms. Seek medical advice if you experience severe abdominal pain, especially if it is sharp or persistent, or if you develop a fever or chills. These symptoms could indicate an infection or another serious condition requiring prompt evaluation.
Persistent vomiting, particularly if you are unable to keep down any liquids for several hours, warrants medical attention. This can quickly lead to dehydration, indicated by signs such as reduced urination, dizziness, or a very dry mouth. Dehydration can pose risks to both the parent and the baby.
Other symptoms that necessitate contacting your doctor include:
- Severe headache that does not improve with rest.
- Sudden changes in vision, such as blurriness or seeing spots.
- New or worsening swelling, especially in the face or hands.
- Sudden, unexplained weight gain.
- Signs of jaundice, which is a yellowing of the skin or eyes, or intense itching, particularly on the hands and feet.
Managing Nausea and Vomiting
Once more serious causes have been ruled out by a healthcare provider, several self-care strategies can help manage third-trimester nausea and vomiting. Eating small, frequent meals throughout the day can prevent the stomach from becoming too empty or too full, which often triggers nausea. Opting for bland, easily digestible foods like toast, crackers, or plain pasta can also be beneficial.
Staying well-hydrated is important, even if only sipping small amounts of water, clear broths, or rehydration solutions regularly. Avoiding trigger foods, such as those that are greasy, spicy, acidic, or have strong odors, can help prevent digestive upset. Some individuals find relief from ginger, consumed in forms like ginger tea, ginger ale made with real ginger, or ginger candies.
Peppermint, either as a tea or through aromatherapy, may also help calm the stomach. Acupressure bands, worn on the wrists, are another option that some find effective for reducing nausea. Ensuring adequate rest throughout the day and elevating the head of the bed during sleep can help minimize acid reflux symptoms. If these measures are not sufficient, discussing medication options with a doctor, such as antiemetics, can provide further relief.