Morning Sickness and Spotting in Pregnancy

Morning Sickness during pregnancy

What is morning sickness?

About half or two thirds of pregnant women in Singapore suffer from morning sickness. Its symptoms include nausea and vomiting. Morning sickness can occur any time of the day or night and usually begins around the 4th week and settles by 12-14 weeks, although in some women it may last longer. Rarely, some women develop Hyperemesis Gravidarum, a condition that causes severe morning sickness symptoms to the point of dehydration or a loss of more than 5% pre-pregnancy bodyweight. 

Do I need to worry about morning sickness or hyperemesis gravidarum (HG)? 

In some cases, vomiting can persist into the 2nd/3rd trimester or even till the end of pregnancy. Most women can be treated at home. Signs of dehydration include feeling very thirsty, becoming drowsy/tired, dark yellow urine/low urine output. In these cases, hospitalisation may be required. Contact your doctor if you:

  • are not able to retain any food or water for more than a day
  • vomit more than 10 times a day, or have blood stained vomit
  • have very concentrated urine, or do not have any urine to pass for more than 8 hours
  • feel extremely tired or giddy
  • lose more than 2-5kg during the first trimester
  • have fever, abdominal pain or vaginal bleeding

In most cases, morning sickness has no harmful effect on your baby. However, women with severe or prolonged HG may have a baby with lower than expected birthweight. You may require more scans to monitor your baby’s growth.

Sometimes, hospitalisation may be recommended if you: 

  • Are dehydrated with ketones in your urine, or low blood pressure/ fast heart rate
  • Have severe vomiting, unable to tolerate any food/fluids, not able to take your oral anti-nausea medications
  • Have abnormal blood tests
  • Have lost significant weight
  • Have other medical conditions

How can I make my morning sickness better? 

  • Eat small meals frequently e.g. 1-2 hours. Eat whatever you can manage. Try meals that are high in carbohydrates and low in fat e.g. pasta, rice. Dry foods e.g. plain biscuits/crackers may be easier to eat. Avoid fried food.
  • Avoid foods/smells that trigger your symptoms
  • Take ginger products e.g. warm ginger drinks
  • Sip on high energy, high protein drinks throughout the day e.g. fruit juices, smoothies
  • Rest as much as possible, and involve your partner, family and friends for help
  • If you are taking iron supplements, stop them temporarily as it can make HG worse
  • Speak to your doctor and take anti-nausea medications as prescribed
Lady experiencing morning sickness
Speak to our Obstetrics and Gynaecology Specialists Today!

Call Us
Email Us

Spotting during pregnancy 

What is spotting? 

Spotting is a small amount of pink, red, or brown blood on your underwear, or when you use the toilet. It is lighter than your period, and does not cover the whole pantyliner. Spotting can feel scary, but it does not always mean that something is wrong. Most women will go on to have a healthy pregnancy.

Spotting is different from heavier bleeding, where you need a pad/tampon to keep blood from getting on your clothes – if you experience this, you should contact your doctor or go to A&E immediately.

Is it normal to spot in early pregnancy?

Spotting during first trimester 

25% of pregnant women experience spotting during the first 12 weeks. This could be due to: 

Low progesterone levels
Implantation bleeding

This occurs 6-12 days after conception and is usually light pink to dark brown, lasts a few hours or couple of days, and will stop on its own. Not every woman will experience implantation bleeding.

Ectopic pregnancy

This is a dangerous condition where the embryo implants outside the womb, most commonly in the fallopian tubes. Bleeding or spotting when one has an ectopic pregnancy can be associated with abdominal or pelvic pain or weakness, dizziness and fainting.

Early pregnancy loss/miscarriage

This can occur in up to 20% of pregnancies and typically occurs within the first 12 weeks. Bleeding/spotting may be associated with abdominal pain/cramps and tissue-like material passing from your vagina. Your doctor may need to do serial blood tests to check your pregnancy hormones (HCG). Most women with previous miscarriages will not have difficulties getting pregnant in future.

Spotting during second and third trimester

Spotting during your second or third trimester may be caused by cervical irritation e.g. after sex, as during pregnancy there is increased blood supply to the cervix. This is common and usually not a cause for concern. Another reason could be a cervical polyp, which is a benign growth on the cervix – your doctor will do a cervical check to rule this out. If you are nearing your due date, it can be due to “show” – a sign that labor may be starting! 

However, if you have polycystic ovaries, please visit your doctor immediately as spotting may indicate an impending miscarriage.

What should I do if I have heavy bleeding during pregnancy? 

If bleeding is heavy, contact your doctor or go to A&E immediately as this may be a sign of:

  • Placenta previa (low-lying placenta covering the cervical opening)
  • Placenta abruption (placental separation from the uterus before delivery of the baby)
  • Premature labor
  • Late miscarriage

Also contact your doctor or go to A&E immediately if you experience other associated symptoms such as:

  • No or reduced fetal movements
  • Abdominal cramps/pain
  • Fluid/tissue passing from the vagina