Hyperemesis Gravidarum in Pregnancy

We’ve all watched movies or TV shows, or known someone that was pregnant. Most of us can recall at least one moment where a pregnant person, who is very early pregnant, moves towards the trash can or mentions an aversion to a certain smell.

Morning sickness is a natural occurrence in pregnancy with 70-80% pregnant individuals experiencing morning sickness at some point prior to giving birth. Morning sickness is very common in the first trimester and is typically associated with nausea and/or vomiting that can occur at any point in the day, despite the name. Morning sickness traditionally occurs before nine weeks gestation and will typically improve by the end of the first trimester. For most, this nausea or vomiting is difficult and something pregnant women are thankful for when it passes, however, it typically does not cause a great impact in overall functioning.

But what about when this “morning sickness” is so severe that it does impact functioning? What about when you are vomiting 4+ times a day and feeling like you are unable to get out of bed? What if it doesn’t go away after the first 3 months? What if you start losing a bunch of weight because you can’t keep anything down?

Hyperemesis Gravidarum (HG) is a condition in pregnancy that is very rare (less than 3% of all pregnancies), but does happen, and is often widely misunderstood. HG is often described as “terrible morning sickness” or “morning sickness that doesn’t go away”, however, it is a lot more than that.

Hyperemesis Gravidarum is defined as severe nausea and vomiting that can lead to long-term health issues, significant weight loss, malnutrition, and dehydration according to the HER Foundation. HG typically does not come with many days that are symptom free for the entire pregnancy, but especially during the first trimester. This can lead to significant mental health symptoms, health concerns, inability to function in daily living, and impacts for the developing fetus.

Why does this matter? “Morning sickness” is a part of pregnancy.

Hyperemesis Gravidarum significantly impacts the entire unit from the individual who is pregnant, to the developing baby, to other members in the household. The individual with HG can often times be unable to work, have to go to the ER or other medical appointments frequently for maintenance, and will often have difficulty with mental health, all of which can impact the developing baby.

There are some interventions that can support, but due to the vulnerability of pregnancy, many are lacking as much research as we would like which leads to some individuals not feeling comfortable with some or all of these interventions. Some individuals have no luck with any medical interventions at all. This is significant. Imagine vomiting 4+ times a day, unable to keep anything down, losing weight, having to go to the ER frequently, and not having anything that truly helps other than birth. This matters. This is significant.

76% of individuals with HG report that HG has changed their plans for future children.  

28.7% reported their health-care providers either did not seem to care or did not understand.

15.2% voluntarily terminated at least one pregnancy because of HG.

And this is just the research we currently have on Hyperemesis Gravidarum which is highly limited. This research doesn’t even go into the impacts of the family unit. What if the pregnant individual has other kids? A spouse? A job? If they are unable to function and care for themselves, that is only going to impact their other kiddos, their relationship, and their ability to earn a living.

One of the most common features that we see in our clinic related to HG is PTSD. Individuals for many years after pregnancy can have symptoms of fear, avoidance, flashbacks, and difficulty with sleep. Individuals can have difficulty attaching to their child due to feelings around being so sick, highly irritability towards others, and feelings of being incompetent or useless due to their body’s limitations with Hyperemesis Gravidarum.

So, what do you do if you have Hyperemesis Gravidarum or suspect you have it?

ADVOCATE! If your provider seems uncaring or like they don’t understand, talk with them. If they still don’t improve, find a new provider. Find a mental health professional that specializes in this area to support with the mental health side of things. Find times to try to connect with your partner or other children to educate and validate both sides. And, know that you are not alone. While less than 3% seems like a very low number, that is about 200,000 individuals each year that will develop HG, and while more supports are needed and more research is needed, there are supports!

Know that it is okay if pregnancy isn’t all butterflies and rainbows. It is okay if you are desperately awaiting some relief. It is okay if you have had thoughts of terminating because “then this would be over”. It is okay if the thought of going through this again makes you want to crawl out of your skin. This does not make you a bad parent. This makes you a human going through something unimaginable.

If you or your partner are experiencing any mental health related difficulties in the pregnancy or postpartum period, please reach out to us! We offer complimentary mental health consultations, as well as individual, group, and couple’s therapy. We are here to support you, and we get HG. Contact us today.