Third trimester nausea: what should you know?

As the uterus grows, digestion may feel slower and acid reflux can become more noticeable, especially after large meals or when lying down. Nausea with diarrhoea or vomiting may occur with gastroenteritis or food poisoning. Pain under the ribs, fever, yellowing of the skin or eyes, or marked loss of appetite needs a clinician to consider problems such as gallstones or hepatitis A. Nausea by itself does not establish a diagnosis, so timing, triggers and accompanying symptoms are useful details.

Try small, regular meals and bland foods if stronger smells trigger symptoms. Sip fluids often, and consider oral rehydration advice if vomiting has made drinking difficult. Sit upright after eating, avoid foods that clearly worsen reflux and keep a simple record of meals, vomiting and urine output. Ask your maternity team before taking an anti-sickness or reflux medicine; some medicines are suitable in pregnancy, while others are not. Rest in a cool, comfortable place if heat makes nausea worse.

Call your maternity team promptly if you cannot keep fluids down, are passing very little urine, feel faint, have severe abdominal pain, fever, blood in vomit, yellow skin or eyes, a severe headache or visual changes. Seek urgent help for collapse, confusion, severe weakness or breathing difficulty. Contact your clinician if nausea is interfering with food, fluids, medicines or daily activities, even without vomiting.

Could reflux, dehydration or an infection explain this pattern? Which anti-sickness medicines are suitable in pregnancy? What should I drink if vomiting continues? Which abdominal pain or headache symptoms need urgent review? Do I need an examination or blood tests?