Why No One Talks About Spitting in Pregnancy (But We Should)

Ptyalism gravidarum. It sounds like the name of a lost Roman emperor, but it’s actually something far more common — and far less discussed. If you’re pregnant, or have ever been, you might know it by its less clinical name: spitting. Or, more precisely, the relentless buildup of saliva that can hijack your day, your sleep, your sense of dignity. It’s messy. It’s weird. And it’s real.

But unlike the more visible complications of pregnancy — the swollen ankles, the baby bump, the glucose tests — ptyalism often flies under the radar, brushed off as a strange but harmless side effect. That dismissal is part of the problem. Because for many, this condition isn’t just annoying. It’s isolating, exhausting, and tied up with deeper issues in how we approach pregnancy symptoms that don’t fit into neat, Instagram-friendly narratives.

What Is Ptyalism — And Why Does It Happen?

Ptyalism gravidarum is the excessive production of saliva during pregnancy. Also called sialorrhea gravidarum, it’s most common in the first trimester and often shows up alongside nausea or hyperemesis gravidarum (HG), the severe form of pregnancy-related vomiting. For some people, it eases around the 14th to 20th week. For others, it drags on — right up to delivery and sometimes a bit beyond.

Here’s the cruel irony: nausea may make swallowing difficult, but not swallowing leads to saliva pooling in the mouth, which then triggers even more nausea. It’s a loop. A wet, spit-filled loop. And while it may not lead to serious medical complications for the baby, it can be a real mental health issue for the mother. There is no proven cure. And as is often the case with under-researched areas of women’s health, treatment is largely trial and error.

So… Why Don’t We Talk About It?

Part of the silence is cultural. Pregnancy, in our imagination, is either glowing or dramatic — baby kicks and gender reveals, or scary ER visits. The mundane, messy middle doesn’t get much airtime. And spitting? It’s not cute. It doesn’t photograph well. It doesn’t fit in a Hallmark card.

It also doesn’t get much attention from the research community. In fact, there’s so little data on ptyalism that one of the best studies available merely concludes: for 20% of women, symptoms stop around week 20; for the other 80%, they persist until delivery or shortly after. That’s it. No large-scale trials. No biomarkers. Just anecdotal management strategies passed around on support group threads.

Living With It

If you’ve never experienced it, try to imagine this: You’re pregnant. You’re already nauseated and tired. Now add the need to spit every 30 seconds into a tissue, a cup, a sink, the toilet. You carry a towel or cup with you constantly. You might avoid talking. Socializing becomes harder. Sleep? Forget it — swallowing in your sleep can trigger vomiting.

One woman described her evening routine as “spa time” — an hour in the bathroom showering, brushing her hair, applying lotion, and listening to a podcast. Why? Because the bathroom was the one place where she could spit freely into running water. It became a sanctuary — not just from discomfort, but from the exhaustion of holding it all in.

She also described going to bed around 7 p.m., not because she was tired, but because she wanted to end the misery of the day. That’s not “just a little extra spit.” That’s suffering.

What Can Be Done?

There is no one-size-fits-all treatment, but some strategies can help.

• Oral hygiene: Brushing your teeth and using mouthwash can make your mouth feel cleaner and swallowing more tolerable.

• Hydration: Ironically, staying hydrated — taking small sips throughout the day — can help you manage the flow.

• Dietary changes: Avoiding starchy foods like white bread and eating smaller, more frequent meals can help with nausea and the related salivation.

• Chewing gum or sucking on candy: These stimulate swallowing, which can keep saliva from pooling. (Sugarless gum is best to avoid dental issues.)

• Acupuncture or chiropractic care: Anecdotally helpful for some, though not well-studied in this specific context.

• Therapy: Not for the saliva — for your sanity. Talking to a perinatal therapist who won’t blink when you need to spit mid-sentence can be a game changer.

One controversial option is scopolamine, a patch usually used for motion sickness. It can reduce saliva but may come with mental side effects — including paranoia or confusion. For someone already navigating the psychological maze of pregnancy, that can be a risky tradeoff. As one woman put it: “It wasn’t the right choice for me personally… but it’s worth exploring with your doctor.”

Other potential treatments, like Botox injections into the salivary glands, may help reduce saliva production — though they are typically used outside of pregnancy. Some women explore this route between pregnancies if they’re planning another.

The Myths That Don’t Help

There’s no shortage of unhelpful folk wisdom around ptyalism. Let’s debunk a few:

• “It only happens if you have hyperemesis.” Not true. Many women experience ptyalism without the full-blown nausea and vomiting of HG.

• “It means you’re having a boy.” Also false. There’s no evidence connecting the sex of your baby with your salivary output.

• “If you just drank less, it would go away.” Absolutely not. Dehydration only makes everything worse — from nausea to mood to actual health outcomes.

Research

For those seeking a deeper dive, the 2018 article “Characteristics and Outcomes of Ptyalism Gravidarum.  Tracking 23 women with ptyalism over 15 years, the study confirms that while the condition can produce up to two liters of saliva daily and significant emotional distress, it does not pose increased risks to fetal or maternal health. About 40% of participants also had hyperemesis gravidarum, and 37% reported a family history—insights that may help readers feel seen and understood, rather than dismissed. It also highlights that around 20% of women see resolution by week 20, with the remainder finding relief only near or after delivery—underscoring the very real chronicity and need for supportive interventions in the interim.

A Lifeline: The “Ptyalism During Pregnancy” Support Community

One of the most unexpected sources of relief for many women has been the online community that forms around shared experience—particularly the “Ptyalism During Pregnancy” Facebook group. It’s a small yet vibrant hub where people swap tips, vent frustrations, and, most importantly, find validation. A Reddit user, reflecting on their own weeks-long ordeal, described it this way:

“I suffered from severe ptyalism… I had to spit into a bowl nearly every minute for 5 months — if I didn't, I would vomit. It was a horrible, debilitating ordeal.” pmc.ncbi.nlm.nih.gov+5reddit.com+5facebook.com+5

Another summed it up neatly:

“I am so relieved to see that someone else struggled with this as well… Everyone told me to ‘just swallow it’ not understanding that I’d gag so hard I’d puke if I even tried.” reddit.com

These are not isolated voices; they echo across countless posts in the group. Beyond mere commiseration, members share practical workarounds—from concealing a spit cup disguised as a coffee mug to nightly “spa” rituals in the bathroom that offer both physical and emotional respite. It’s the kind of peer support you don’t always get from doctors or well-meaning friends—a place that says, plainly: you’re seen, you’re heard, and you’re not alone.