Workplace conversations about caregivers usually become visible later. We talk about maternity leave, parental leave, pumping accommodations, childcare, and returning to work. But there's an entire period before many of those conversations begin when women are already adjusting to working motherhood.

"Morning sickness" implies a predictable pattern in pregnancy. However, very little about pregnancy is predictable. Some women get hit with morning sickness during their commute to work, during a presentation, in the office break room, or during the afternoon slump. The nausea isn’t confined to mornings, nor is it confined to a certain stage or pregnancy. It can hit at any point and can persist for months.

Dr. Tracy Shevell, a board-certified, high-risk OB-GYN I interviewed for this article, says nausea and vomiting of pregnancy typically begins around six weeks, peaks around 12 weeks, and can continue until at least 20 weeks. About 70% of pregnant women experience it. Workplaces underestimate how mentally and physically disruptive nausea and vomiting can be for pregnant women, just because it’s incredibly common. Perhaps it's because pregnancy itself is so common , working mothers are expected to do just that: keep working through it. Even the American College of Obstetricians and Gynecologists has acknowledged that nausea and vomiting during pregnancy can be minimized and undertreated precisely because they're so common.

With many women waiting until after the first trimester is complete to announce their pregnancy, this means some women are dealing with significant symptoms when almost no one knows they're pregnant. In the early weeks she may still be processing the news herself or waiting until the risk of pregnancy loss declines. "The concept of morning is an all-day event" for many women, Shevell told me, with symptoms that wax and wane throughout the workday.

Workplaces Aren’t Built For Expecting Mothers

A lot of traditional workplace behavior is incompatible with how doctors recommend managing pregnancy nausea. For example, Shevell points out that office workers often have little control over windows. Most office buildings run on centralized HVAC systems with windows that don't open and thermostats employees can't touch, so there's no built-in way for pregnant women to adjust ventilation or temperature, even when odors and stagnant air make symptoms worse.

The line between home and work also continues to blur as technology advances. Advising women to “take it easy” and “rest often” sounds simple until you put it inside an actual workday. She may be trying not to vomit during a meeting while simultaneously trying not to explain why she needs to leave it, she may look less polished on-camera due to sheer exhaustion, or she may need to reschedule 1:1s after being sick all morning. In workplace cultures that encourage employees to bring their full selves to work, there’s also a big tension: how do you ask for flexibility for a condition you're not yet ready to explain?

Shevell says the two most meaningful accommodations involve time. Flexible start times can let someone avoid commuting during the part of the day when symptoms are most intense. Remote work can eliminate a difficult commute and give a pregnant mother immediate access to food, water, and a bathroom. Shevell also suggested that mints, sour candies, and ginger chews belong in the snack bowls of any office where women of reproductive age work. None of these solutions requires an employer to know every detail of an employee's pregnancy. In fact, Shevell argues that privacy should be part of the workplace response.

These women are carrying the invisible labor of motherhood, before they've even given birth. And with all invisible labor, there is a point when pushing through turns into depletion. The concern increases when a woman can't keep down food, fluids, or oral medications. Most pregnancy nausea doesn't become hyperemesis gravidarum, or HG, the severe form of nausea and vomiting during pregnancy.

Hyperemesis can involve dehydration and significant weight loss; Shevell says a loss of at least 5% of pre-pregnancy weight is one indicator clinicians may consider. Treatment can require IV fluids, electrolyte replacement, and intravenous vitamins, and severe cases may require hospitalization and nutritional support. Shevell estimates hyperemesis gravidarum occurs in approximately 0.3% to 3.5% of pregnancies. Doctors also have to consider whether dehydration could worsen another medical condition, including diabetes, POTS, or epilepsy.

But Shevell says women should know when symptoms have crossed a line that requires medical attention. In work cultures that reward endurance, pregnant women shouldn't wait until they're sick enough to require hospitalization. When "nothing is working" means it's time to call your doctor, not push harder

Even in modern workplaces, the expectation of employees is antiquated. It assumes the same mental, physical, and emotional consistency from women as it did 60 years ago. Arrive at roughly the same time, maintain similar energy, sit through the meeting, finish the commute, meet the deadline, and remain visibly productive. And in 60 years, workplaces haven’t evolved to accommodate the rise of working mothers, or the unpredictability of children.