Understanding Hyperemesis Gravidarum: More Than Morning Sickness
As a midwife, I’ve supported many women through the highs and lows of pregnancy, and one condition I’ve seen too often go misunderstood and underestimated is Hyperemesis Gravidarum (HG). It’s more than just “bad morning sickness”, it’s a debilitating condition that can seriously impact both physical and mental wellbeing.
While I didn’t have severe HG myself, I did experience relentless nausea throughout my entire pregnancy. Even in its milder form, it took a real toll on me. I remember feeling utterly drained, physically and emotionally; day after day. Eventually, I was advised to try Vitamin B6, and thankfully, it made a huge difference. But I know not everyone gets that kind of relief.
For many women, even the standard treatments aren’t enough. And that’s where HG becomes more than a challenge; it becomes a crisis. It’s why we need to keep talking about it, raising awareness, and ensuring that no one faces it feeling dismissed or unsupported.
What Is Hyperemesis Gravidarum?
Hyperemesis Gravidarum (HG) is a severe form of pregnancy sickness that causes the mother relentless nausea, frequent vomiting, dehydration, and significant weight loss, often making it impossible to eat, drink, or function day-to-day. It's not only physically draining but can be emotionally traumatic as well. For babies, HG can increase the risk of low birth weight, prematurity, and Small for Gestational Age (SGA).
While the exact cause isn’t fully understood, it’s believed to be linked to rising pregnancy hormones and genetic influences. Most specifically maternal genotype and familial connections. You're more likely to develop HG if you’re carrying multiples, had it in a previous pregnancy, have a family history of HG, or have a molar pregnancy.
Symptoms usually begin early in pregnancy and include:
Severe, persistent nausea
Vomiting multiple times a day (sometimes bile or blood)
Inability to keep down food or fluids
Weight loss (typically over 5% of pre-pregnancy weight)
Dehydration signs: dark urine, dry mouth, dizziness, headaches
Heightened sensitivity to smells, movement, or sound
Beyond the physical symptoms, HG can deeply affect mental health. Many women experience anxiety, depression, or emotional exhaustion due to the constant distress and isolation it brings. Some are unable to care for themselves or others, adding to the emotional toll. Recognising HG early is key, with the right support and treatment, women don’t have to suffer in silence.
Hyperemesis Gravidarum
Hyperemesis can last the whole pregnancy for some women.
Managing Hyperemesis Gravidarum (HG)
Treatment for HG depends on the severity of symptoms, and often requires a combination of approaches. For milder cases, some people find relief with home-based strategies, including:
Vitamin B6 and antihistamines like doxylamine
Ginger supplements
Small, frequent meals to avoid an empty stomach
Hydration techniques, such as sipping fluids slowly and regularly throughout the day
However, when symptoms become more severe, medical treatment is often necessary. This can include:
Prescription antiemetics like ondansetron or metoclopramide to control nausea and vomiting
IV fluids to treat dehydration
Electrolyte replacement to restore essential minerals
Thiamine (Vitamin B1) to prevent complications such as Wernicke’s encephalopathy
In extreme cases, hospital admission may be required. Some individuals may also need nutritional support via feeding tubes if oral intake is not possible. The most important takeaway is that intervention can make a difference. Prompt treatment can reduce complications, support maternal mental health, and improve outcomes for both mother and baby.
What the Statistics Tell Us
Recent data highlights just how serious and life altering Hyperemesis Gravidarum (HG) can be:
4.9% of women in a UK study terminated a wanted pregnancy due to the severity of their HG symptoms.
Over 52% considered termination; not because they didn’t want their baby, but because they felt physically and emotionally broken by the condition.
In a separate study, 15.2% of participants had terminated at least one pregnancy as a direct result of HG.
The same UK research found that 25.5% of women reported occasional thoughts of suicide, and 6.6% said they thought about it regularly.
These are not just numbers, they represent real women, real families, and real pain. They reflect the depth of suffering HG can cause when it goes unrecognised or unsupported. These statistics are a call to action: to listen, believe, and do better for those living through it.
A Call for Greater Awareness and Compassion
Despite its severity, Hyperemesis Gravidarum is still too often dismissed as "just bad morning sickness." But HG is far more than that. I’ve supported women antenatally who were isolated, exhausted, and desperate, not just for physical relief, but for someone to truly hear and believe them.
Early intervention and compassionate care can make a profound difference. As a society, we have a responsibility to improve awareness and outcomes. Here's how we can do better:
Improved medical support: Ensure timely diagnosis and access to effective treatment plans tailored to each woman’s needs.
Mental health resources: Offer counseling, peer support groups, and emotional care for those navigating the mental toll of HG.
Increased awareness: Educate healthcare professionals and the public about the realities of HG to prevent minimisation and delay in care.
We need to talk about HG openly, honestly, and without shame. Every woman deserves to be listened to, supported, and treated with dignity through every stage of pregnancy.
If You're Struggling, You're Not Alone
Whether it’s unrelenting nausea or diagnosed HG, your experience is valid. There is help, there are managenent options, and there are people who are here to support you.
If you suspect you may have HG or are supporting someone who does, here are some useful resources:
Every pregnancy is different, but no one should suffer in silence. Whether you’ve experienced HG yourself, supported someone through it, or are only just learning about it, please help keep this conversation going.
Nyisha x