What it is
Hyperemesis gravidarum, called HG, is the severe end of pregnancy sickness. If you can't keep anything down, are losing weight, and feel too weak to stand, that is not morning sickness. HG affects about 1 to 3 in 100 pregnancies.
The cause is still being worked out. Research in 2023 pointed to a hormone called GDF15, made by the placenta, and to how sensitive a mother is to it before pregnancy. HG runs in families. If your mother or sister had it, your risk is higher. It is more common with twins and with a first pregnancy.
HG is a medical condition, not a weak stomach or a state of mind. It can lead to dehydration, loss of nutrients, and real mental health strain. Mothers with HG describe it as the hardest thing they have been through.
What's typical
HG usually starts between weeks 4 and 6 and peaks around weeks 9 to 13. About half of mothers with HG feel better by week 20. The rest have it, in some form, until birth. Vomiting many times a day is common. So is spitting all the time, because even swallowing saliva sets it off. Losing 5 percent or more of your pre-pregnancy weight is one of the signs providers use. Many mothers need IV fluids at least once. Some need medicine through the whole pregnancy. Most babies of mothers with HG are born healthy.
What's known
ACOG and the HER Foundation both say early care works better than waiting. Providers have several medicines for HG, some used for decades in pregnancy. Ask what they suggest and what the next step is if the first one fails. Research by Marlena Fejzo and others found that HG raises the risk of depression and anxiety during and after pregnancy. Some mothers describe lasting trauma. Nothing you ate or did caused this, and willpower does not change it.
What helps
- Call early. The sooner fluids and medicine start, the less ground you have to make up.
- Keep a simple log: how many times you vomit, what you kept down, how often you pee. Bring it to every visit.
- Eat whatever stays down, at any hour. Chips, white rice, popsicles, and plain pasta all count. Balance can wait.
- Lie down with the lights low after each try at eating. Strong smells, screens, and motion make it worse for many.
- Ask one person to be your point of contact. You should not have to explain HG to everyone.
- Find other HG mothers. The HER Foundation runs peer support, and mothers say it is what got them through.
When to call someone
- Nowno fluids kept down for 24 hours, no urine for 8 hours or dark urine, fainting, confusion, or a racing heart.
- Nowblood in your vomit, severe belly pain, or thoughts of not wanting to be pregnant or alive. Call 988 or the National Maternal Mental Health Hotline, 1-833-852-6262, and tell your provider.
- Todayweight loss of 5 pounds or more, vomiting more than a few times a day, or medicine that has stopped working.
- At your next visitask about a written plan for flares, IV fluids at home, and a referral for mental health support.
Who helps
Tools: My Birth Team · Due Date Calculator
Related
- Nausea and vomiting in pregnancyPregnancy: Your Body
- Eating when nothing sounds goodPregnancy: Eating
- Depression during pregnancyPregnancy: Mind and Life
- Anxiety in pregnancyPregnancy: Mind and Life
- Drinking enough waterPregnancy: Eating
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Sources
- HER Foundation — Hyperemesis gravidarum patient information and peer support
- American College of Obstetricians and Gynecologists — Practice bulletin on nausea and vomiting of pregnancy
- Nature — GDF15 linked to the mechanism of hyperemesis gravidarum (Fejzo et al., 2023)
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