More Than Morning Sickness

Hyperemesis Gravidarum explained: when nausea and vomiting in pregnancy go far beyond the norm.

Sickness in pregnancy is often a welcome sign in those early days when all the evidence you have is the two lines on a stick. The challenge for many of us is that the term morning sickness doesn’t really scratch the surface of our experience and symptoms are rarely limited to mornings.

Pregnancy sickness is a spectrum condition which affects everyone differently. It ranges from periods of mild nausea or the odd vomiting episode right through to constant nausea and regular vomiting. In most cases, a few tweaks to diet and lifestyle can make things easier to manage and symptoms usually ease around 12 weeks.

But what about when those tweaks don’t work? What about when the nausea is so intense it feels like it’s crushing your soul? When vomiting comes regardless of whether you have eaten anything? When it’s so violent you struggle to catch your breath? When the mere thought of food kicks off the awful cycle of vomiting again? What if you can’t keep down even a sip of water - or your own saliva?

That’s Hyperemesis Gravidarum (HG). It’s an extreme form of nausea and vomiting in pregnancy that affects up to 4% of pregnancies and requires medical treatment. Although symptoms start in the early weeks, they often last far beyond the first trimester, with almost a quarter of women needing anti-emetic treatment throughout their entire pregnancy.

For those with a family history of HG, there is an increased risk, and once you’ve had it in one pregnancy, there’s around an 80% chance you’ll experience it again. Which is a pretty tough pill to swallow. Literally. The good news is that a variety of treatments can be safely used in pregnancy.

The key differences between HG and typical pregnancy sickness are the severity of symptoms and the impact they have on women’s and birthing people’s physical and mental health. It’s not uncommon for sufferers to say they feel like they are dying, as though their body is failing in front of their eyes, and yet they are reminded that they are lucky to be pregnant.

Therein lies the contradiction: the gap between expectation and reality. The difference between what is expected of pregnancy and the reality of an HG pregnancy is vast and can lead us to question our experience. If everyone feels this unwell, why aren’t we talking about it more often? Or are we just weak because we can’t cope when everyone else can? It’s easy to see how this leads to isolation.

When should I get help?

Seek help as soon as you are struggling. If nausea and vomiting are impacting your ability to eat, drink or work, seek medical advice. There are medications that can help manage the symptoms.

The free Helpline on 0800 055 4361 is available during office hours for empathy, expertise and support, or visit www.pregnancysicknesssupport.org.uk any time. HG is brutal, but you don’t have to face it alone.

Lindsay is Community & Engagement Manager at Pregnancy Sickness Support. Drawing on her lived experience of HG and a background in teaching, SEN and counselling, she is passionate about raising awareness, improving education, and amplifying the voices of the HG community.