Know that you are not alone if you’re having a rough go, and it 

temporary. There are absolutely things you can do to limit the nausea and vomiting and improve your quality of life in these early weeks of pregnancy. Here are our top safe and effective methods for managing and lessening pregnancy nausea:

When we go too long between meals or snacks, the nausea will almost always be worse. This is a horrible cycle in early pregnancy and it is likely the last thing you want to be told, but you have to eat. It can be small amounts. If you can eat a little protein each time, this will help to regulate your blood sugar, preventing big dips and therefore intensified nausea.

1. Eat every 2 hours, prioritizing protein and complex carbohydrates.

You likely are not able to stomach all the seasoning and complex flavors you normally do outside of pregnancy, and that’s okay. This first part of the journey is sometimes about just doing what you have to do to get through it. Plain foods are less likely to cause nausea or aversions. Cold foods and fluids are also shown to reduce nausea over warm meals and beverages. Sour foods and drinks are helpful for limiting nausea and vomiting: think lemon water, frozen raspberries or blackberries, cold greek yogurt. Some people find relief with carbonated drinks. We recommend avoiding soda, but carbonated water with lemon or a small dash of apple cider vinegar, kombucha, or ginger can be a game changer when sipped on frequently between snacks.

2. Choose plain, cold, sour, and carbonated.

Exhaustion and stress intensify nausea and vomiting in the first trimester. If you are able to nap, please do it. Get fresh air and gentle movement.

3. Get good rest.

Ginger can be taken as tea, added to a carbonated drink, or as hard candy. Peach leaves have been traditionally brewed for tea in Appalachia for hundreds of years for stomach discomfort and nausea, and the tea can be put in the refrigerator for cold consumption in early pregnancy. Mint can also be taken in small amounts in tea, or simply used as aromatherapy. Mint can increase symptoms of heartburn or GERD, so we don’t recommend consuming mint if you have this condition.

4. Utilize safe herbal supports.

Vitamin B6 (10-25mg every 6-8 hours) has been shown to improve nausea symptoms. If B6 alone isn’t improving the situation, taking with Unisom is also an option, as well as 1.5mg Thiamine (B1) a day. If you are currently taking an iron supplement, this may be adding to your nausea and vomiting and can be paused for now (unless your unique health picture calls for more aggressive iron supplementation). Taking prenatal vitamins is also a common nausea trigger. Always take prenatal vitamins with food, and take at night if nausea is worse in the morning. You also may need to switch to a gummy instead of a hard pill or capsule for now. Once the nausea has subsided, we recommend switching back to a pill or capsule if possible, as they generally have more nutrients than the gummy prenatals.

5. Prioritize B6, and consider switching to a gummy prenatal vitamin.

Neiguan (P6) is an acupressure point on the wrist that you can press with your fingers, or activate with an appropriate TENS unit. There are bracelets called “seabands” that can be worn to stimulate P6. You can also visit an acupuncturist for this point and more that can support stress relief and better rest.

6. Acupressure points or acupuncture therapy.

When to call your midwife or doctor:

The midwives’ tips for first trimester nausea

It can be a lot, all at once. If we had to compare all these symptoms, by far, we hear the most surprise over the 

 that often comes with the first trimester. There’s tired, and then there’s 

 This and the general yuck the other symptoms can bring proves challenging for many people, especially if you normally pride yourself on being really productive, independent, or active. Many of us are conditioned to pride ourselves on going, going, going, all the time: through stress, through tiredness, through our body’s signals. 

 lazy for needing to rest more at this time. 

We believe that being tired, whether you are pregnant or not, is a healthy reason to rest. But if you need some justification to go easier on yourself, here it is.

In early pregnancy, levels of Human Chorionic Gonadotropin (hCG) increase quickly in the body, often doubling every three days. This hormone is produced by trophoblastic tissue (part of the young embryo), and then by the placenta. hCG maintains early pregnancy by signaling the body to synthesize more progesterone. Progesterone in turn tells the body to continue building up the endometrium (the inner lining of the uterus), which allows the fertilized egg to attach. Progesterone then prevents the uterus from contracting, which is important for preventing miscarriage, and contributes to the growth and development of the baby. At around 10 weeks, the placenta takes over progesterone production, but before that, our bodies are doing more of the work from our ovaries and adrenal glands.

High hCG levels create feelings of fatigue, as well as bloating and water retention. Progesterone is the major culprit, causing feelings of drowsiness. When progesterone binds to receptors in your brain, it increases GABA neurotransmitter production, which causes your brain to reduce its activity and want to sleep. Progesterone is also responsible for increased need to get up and pee at night, further interrupting sleep, not to mention constipation, bloating, breast swelling and tenderness, nausea, and for some people, mood changes and headaches.

These hormones, along with estrogen, set off a cascade of events that make up the 

in which every single major structure of your baby’s body is constructed!

 It takes incredible amounts of energy to create a tiny neural tube, all the organs of a new person, and tiny limb stems. If you feel like you have less life force, it’s because you’re sharing it. Your blood volume starts to expand right away, and your heart rate and respiration rate often increase to keep up with the demands.

Here’s why you’re so tired in early pregnancy:

Whatever capacity you have in your day to day for resting more, take advantage of it. This will help you to pace yourself through the marathon that is pregnancy and birth. Most healthy pregnancies grace us with more energy once we enter the second trimester. Know that this chapter is 

your worth is not lessened by needing to slow down.

 Lean into the supports you have, and talk to your midwife about how to best support your body and mind as you begin this new chapter of your life.

The first trimester is an opportunity to practice honoring your body’s need for rest.

Learn what's happening in the body during early pregnancy and why it's common to feel exhausted, among many other first trimester symptoms.

Early Pregnancy Fatigue

In the first trimester, honor your need for rest

Multiple recent, high quality studies point to early pregnancy ultrasound actually being more accurate in calculating estimated due dates than going off last menstrual period

. This is likely due to more than a few factors, the first being that many people do not have regular or consistent 28 day cycles. Additionally, many of us do not ovulate on exactly the 14th day of our cycles. The time it takes for a fertilized egg to implant in the uterus and become an embryo is also not the same for everyone. Remembering LMP can also be tricky! Research shows that we are more likely to remember a date with the number 5 or with even numbers, so there’s potential for misremembering the correct date our last period began.

 you without a doubt know the date of conception because you have been consistently and accurately tracking your cycle for an extended period of time and know without a doubt the day you ovulated, or if you got pregnant with in vitro fertilization, your EDD can be accurately calculated by simply adding 266 days to the day you conceived. This is more accurate than using Naegele’s Rule because it doesn’t rely on the assumption of ovulation at day 14.

Even with greater accuracy, it’s important for your sanity during pregnancy to have the expectation that you very likely will not have a baby on your estimated due date!

 Research shows that in first time parents, 50% of pregnancies end by 40 weeks and 5 days, and 75% complete before 41 weeks and 2 days. For women who have previously given birth. 50% will give birth by 40 weeks and 2 days, and 75% give birth by 41 weeks.

So why even calculate with ultrasound if EDD itself isn’t really precise? 

Research shows that families who calculate estimated due date with an early pregnancy ultrasound are less likely than those who calculate with LMP to have an induction for post-date pregnancy

, or going a certain amount of time past their estimated due date.

In early pregnancy between 11 weeks and 13 weeks 6 days, development and size are very consistent across healthy pregnancies, so during this time it is easier for ultrasound to calculate an estimated due date. Families in studies who have had early ultrasounds in this window of time had the highest chance of going into labor within 11 days (give or take) of their due date. After 13 weeks 6 days, there’s more differences across pregnancies in development and overall size, based on parental genetics. Because of this variation, it’s harder to accurately calculate EDD after 13 weeks 6 days with ultrasound.

Having an accurate estimation of where we are in pregnancy can be important for reliably being able to answer questions like, “Is this normal at this point?” and for overall risk assessment.

 We do not require our families in and around Nashville to have early pregnancy ultrasounds, but we do want you to have all the facts when making these kinds of decisions about your pregnancy care, starting from the very beginning.

The Evidence On: Due Dates, Evidence Based Birth

Ultrasound for fetal assessment in early pregnancy, Cochrane Library

Predicting date of birth and examining the best time to date a pregnancy, Khambalia et. al

Want to read more? Here are some sources we trust, in order from most approachable to not as approachable:

It’s 2025, and as midwives in prenatal appointments we find many more people than even five years ago know that Estimated Due Dates (EDDs) are more so projected windows of time when babies 

 arrive than precise eviction dates. The traditional method of calculation, called Naegele’s Rule, was created in 1812 based on the belief that all pregnancies naturally end at 280 days, or 40 weeks after the first day of the last menstrual period (LMP). 

His theory is based on the assumption of a 28 day menstrual cycle, ovulation on day 14, and is not based in any modern research standards

. It’s calculated by adding seven days to the first day of your LMP, and then subtracting three months. Most apps and online calculators use this method to generate EDD.

How to find your Estimated Due Date

Respectful treatment in the Midwifery Model of Care means honoring your right to informed decision making when it comes to tests and screening, recommended procedures, and interventions. Respectful treatment also includes honoring your family’s spiritual and cultural beliefs.

It is our belief that respectful treatment cannot exist in frameworks that do not work to uphold the 

. Freedom to move as you please, eat to maintain your energy, and bathe is a standard part of our care. 

We do not “prohibit” or “allow” you to do x, y, or z

. We uphold your bodily autonomy and sovereignty and are present to provide patient guidance that is grounded in our expertise and familiarity with physiologic birth.

Lastly, respectful treatment includes an understanding that each birth process unfolds in its own unique way, and is a normal part of life. We do the work to regulate ourselves so that we bring calm to your birth space, even after experiencing secondary trauma. We are confident in the body’s ability to birth, and maintain healthy respect and preparation for the unexpected.

Respectful Treatment

Most of our appointments are 60 minutes long to allow adequate time for building a relationship with you and your family, answering your questions, counseling on your unique needs for birth preparation and wellbeing, as well as addressing worries and working through fears, all while moving through the clinical aspects of our time together with mindfulness and consent.

Personal Attention

Throughout our time together, we incorporate lots of information sharing about pregnancy, birth, postpartum, the newborn, lactation, and newborn care. We want you and your family to have all the practical knowledge needed to make sure you and your baby’s needs are met and your experience becoming parents for the first time or expanding your family is one of upmost joy. We share connections to community doulas and childbirth education classes, as well as other professionals and knowledge resources.

We continuously provide full information about risks and benefits of recommended tests, screenings, procedures, or interventions so that you can make choices that feel best to you, even if hard to make.

Information and Education

When we say “monitoring,” we mean regular, intentional, and thorough check-ups for you and your baby throughout the time you are pregnant, in labor, in the hours immediately after birth, and our time together postpartum to make sure all vital signs and experienced symptoms point to low levels of risk. Part of why midwifery leads to better outcomes is because of how much time we spend together and openly communicate in order to prevent complications whenever possible, and catch them early whenever they do develop. We refer to other healthcare specialists to collaborate or to transfer to a different birth setting when occasionally needed.

Appropriate Monitoring

We approach your birth with confidence in the body’s ability, and a willingness to support it. We do not incorporate routine treatments or arbitrary timelines that are likely to interfere with the labor process. We support your privacy, and individualize our care as needed to support you in doing the hard work of birthing your baby. 

We do not “deliver” our families’ babies: we witness them deliver their children as we provide expert care and attention.

Confidence in the Body

We spend time in prenatal appointments sharing information about natural comfort measures with you and your family so that you have time to prepare and practice. We strongly recommend childbirth education classes for first time parents or parents who are having a homebirth for the first time to further fortify their preparedness. We also highly recommend hiring a doula to support you! We share best practices for maintaining your energy during the labor process, limiting risks that could lead to need for intervention, grounding in calm and relaxation, working with discomfort, and relieving intensity. This frequently includes position changes, encouragement, instruction on massage and other forms of hands-on support for family members or loved ones, and laboring in water.

Natural Comfort Techniques

We encourage our clients to schedule prenatal appointments with all three of our midwives so that before labor everyone knows one another well, and families feel safe and familiar going into their birth. Once you are in active labor, we are with you providing continuous individualized care, and stay two to four hours after your baby is born to make sure everyone is transitioning well. We will continue to provide care to you and your baby through the first six weeks postpartum. During this time, there is always space to discuss the birth and for families to provide feedback, in addition to our clinical tasks and discussions on the newborn phase and postpartum transition.

The Midwifery Model of Care is aspired to by many midwives, but it is important to understand that some do not practice it. There are some rare doctors who practice this model of care, but our current healthcare and insurance system makes it incredibly difficult for Ob’s to practice this way, even if they would like to. When interviewing midwives, it can be helpful to reference the Midwifery Model of Care to form your questions.

” was copyrighted 1996-2008 by the Midwifery Task Force. As of 2024 the North American Registry of Midwives owns the copyright. The 

was developed in 1996 by Midwives Alliance of North America (MANA), the North American Registry of Midwives (NARM), the Midwifery Education Accreditation Council (MEAC) and Citizens for Midwifery (CfM).

Continuity of Care

The Midwifery Model of Care is a hands-on, relationship-centered approach to care during pregnancy, birth, and postpartum, which has been proven to result in 

respectful treatment, personal attention, information and education, appropriate monitoring, confidence in the body, natural comfort techniques, and continuity of care

. We feel honored to practice this framework, which allows us to 

Stories, insights and encouragement

The midwives’ tips for first trimester nausea

In the first trimester, honor your need for rest

How to find your Estimated Due Date

What is the Midwifery Model of Care?