Nausea in the third trimester

By trimester

Weeks 28–birth

3rd trimester

New nausea now deserves a prompt check with your provider. It could be preeclampsia, which can bring upper-belly pain and headache too, a liver condition called cholestasis, which usually comes with itching, or simply reflux from your growing belly. Figuring out which one it is takes your provider's exam, not guesswork at home.

What does the evidence show for nausea in the third trimester?

• New nausea, upper right belly pain, and severe headache late in pregnancy all warrant a same-day call to your provider, since they can be signs of preeclampsia or HELLP syndrome. 1
• Itching is the main sign of a pregnancy liver condition called intrahepatic cholestasis, but nausea and upper right belly discomfort can come along with it too. 2
• Some women have nausea and vomiting the whole way through pregnancy, but nausea that starts later on might have a different cause and is worth discussing with your healthcare provider. 3
• Pregnancy hormones relax the valve at the top of your stomach while your growing uterus adds extra pressure, which commonly causes reflux-driven nausea in the third trimester, a type that usually responds well once it's identified. 4
• Preeclampsia most often presents as a new headache that does not ease with usual measures, along with right upper quadrant or epigastric pain, nausea, or vomiting, with visual disturbance often alongside it. 5

When should I call my provider about nausea in the third trimester?

Preeclampsia often shows up as new nausea or vomiting together with right upper belly or epigastric pain, a headache that does not resolve with your usual approach, or visual disturbance, and that combination deserves a same-day call rather than a wait-and-see approach. Nausea alone, without any of those other signs, is far more likely to be reflux from your growing uterus pressing on your stomach. New nausea that first appears this late in pregnancy is different from the nausea most people already had earlier on, which is why it is worth naming specifically to your provider rather than filing it under ordinary pregnancy queasiness. If you are ever unsure which side of the line you are on, make the call. Obstetric teams handle these check-ins as routine, not as overreacting.