Hyperemesis Gravidarum (Severe Morning Sickness)

What is Hyperemesis Gravidarum? 

Some degree of nausea and vomiting is normal during pregnancy. In fact, about 70 – 80% of women experience this. However, extreme and persistent nausea and vomiting while pregnant is referred to as hyperemesis gravidarum (aka HG). This condition is rare and occurs in only about 2% of pregnancies.  

HG is most likely to begin between weeks 4 and 6, with a peak toward the end of the first trimester. In many cases it resolves by 16 or 20 weeks, and in rare cases it can last the whole pregnancy. The cause is still unknown, although it is believed to be related to a rise in hormone levels. Proper diagnosis and treatment is important to prevent dehydration, electrolyte imbalance and weight loss.

How is hyperemesis gravidarum different from morning sickness? 

Typical morning sickness symptoms include: 

• Aversion to some foods or smells 
• Loss of appetite
• Nausea that subsides at 12 weeks or soon after 
• Occasional vomiting

The symptoms of hyperemesis gravidarum include: 

• Severe vomiting multiple times a day (eg: 3 – 4)
• Nausea that is consistent and does not subside 
• Significant weight loss 
• Dehydration 
• Headaches 
• Decreased urination
• Lightheadedness 
• Constipation
• Decreased appetite
• Low blood pressure
• Rapid heart rate
• Jaundice
• Fatigue

Treatment for Hyperemesis Gravidarum 

If you have experienced one or more of the HG symptoms above, be sure to speak with your care provider right away. Early and effective treatment can ease the symptoms and misery that come with HG.

For regular morning sickness your care provider might recommend natural methods such as vitamin B6 (known to help reduce nausea) or ginger. Eating smaller, more frequent meals and bland dry foods such as crackers may also help. Additionally, staying hydrated is important.

However, the treatment of HG will depend on the severity of your symptoms. In severe cases sometimes hospitalization is required. 

Medical treatment may include some or all of the following:

• IV fluids to restore hydration, electrolytes, vitamins, and nutrients
• Tube feeding – restores nutrients through a tube
• Medications – anti-nausea, antihistamines, and anti-reflux medications

Weigh the risks and benefits of any medication and discuss the side effects with your healthcare provider. 

Other treatments may include:

• Bed Rest for comfort 
• Acupressure 
• Herbs, ginger or peppermint
• Homeopathic remedies prescribed by a doctor.
• Hypnosis

Resources for HG Support

a) Education & Research: 

HER (Hyperemesis Education & Research) Foundation is an excellent online resource for further education and support. They offer peer support from their volunteer network, a weight loss calculator, educational articles and more. They also have an app to track your symptoms.

b) Knowledgable doctors: 

If you feel like you’re not receiving proper care, HER offers a physician’s network to find an HG-knowledgeable provider. Switching care providers may help you get the proper treatment you need to relieve your symptoms.

c) Support Groups:

Find your community. There are helpful online groups available. Knowing that others have been through the same illness and that your symptoms are real can make a world of difference. Get tips and encouragement from your peers. 

d) Tell your family and friends what you need. 

While you are coping with this illness you will need support. Let your community know what you need from them: meal prep, helping with other children, or even just providing a listening ear. Don’t be afraid to ask for help. 

Lastly, remember that this will end and you will not be pregnant with HG forever. When you are feeling your worst, remind yourself that eventually this will just be a memory and you will have your sweet baby in your arms.