When pregnancy sickness becomes something more
What is the pregnancy sickness spectrum and how do I know if I have hyperemesis gravidarum (HG)?
What is the pregnancy sickness spectrum?
While up to 90% of pregnant women and people experience some level of nausea and vomiting in pregnancy (NVP), HG is a severe and extreme form of pregnancy sickness that sits at the extreme end of the pregnancy sickness spectrum. It affects around 3% of pregnancies each year and can lead to dehydration, weight loss, and serious physical and emotional distress.
Mild to Moderate NVP
The spectrum ranges from mild nausea and vomiting (often called NVP), moderate to severe NVP and then HG.
What is Mild NVP?
Also referred to as morning sickness, though this is an outdated term as sickness can occur at any time of day, you can usually go about your normal routine without too much hinderance, and symptoms usually ease in the second trimester.
It is unlikely that you will lose much weight or it is an insignificant amount.
You won’t be dehydrated as you are able to keep fluids down, or your nausea and vomiting is episodic, meaning that sometimes you are unable to eat and drink in the day but can make up for that loss during other times in the day when you feel better.
Usual advice about eating little and often or avoiding certain spicy or strong smelling foods will help your symptoms.
Moderate to Severe NVP
Whats is Moderate – Severe NVP?
Moderate to severe NVP is often mistaken for mild NVP, which can lead to a barrier in treatment. Unlike Mild NVP sufferers will experience more persistent nausea and may vomit more often.
A barrier to care and treatment either from professionals or from worry or anxiety about taking medications in pregnancy, could lead to severe NVP or HG.
What is HG?
The Windsor definition (2021) characterizes HG as “a condition that starts early in pregnancy, before a gestational age of 16 weeks, and is characterized by severe nausea and/or vomiting, inability to eat and/or drink normally and strongly limits daily activities.”
Other HG facts and indicators.
- Up to 30,000 pregnancies per year in the UK are affected by HG.
- Diet and lifestyle changes will not help alleviate symptoms.
- May begin very early, even before a positive test.
- Symptoms peak at 9-13 weeks, can improve around 16-24 weeks.
- Weight loss may be severe and rapid, and dehydration is common.
- If not managed appropriately complications can ensue.
- Medical treatment is necessary.
- Psychological support is beneficial.
- Spectrum condition, not all HG looks the same.
- 1 in 5 people with severe HG will have symptoms throughout their whole pregnancy.
If you want to know more about HG and the potential genetics surrounding the condition you can read more below.
What do I do if my daily life is being impacted by NVP or HG?
As soon as the quality of your life is impacted, and you can’t go about your usual routine then it’s time to seek medical support.
It is crucial to contact your GP, Midwife or other healthcare professional to seek help.
Early treatment can prevent you from deteriorating and experiencing dehydration so seek support as soon as you can when your symptoms are not “usual”.
Don’t delay in seeking help because you feel like a burden, or too “weak” to be dealing with “morning sickness”.
The reality is that you may have HG you might have severe NVP and you may not get an accurate diagnosis, BUT you do need help to manage your symptoms.
Dehydration
It is important that you seek medical treatment if you are unable to keep any food or fluid down as you can become dehydrated very quickly. Often IV fluids are essential to become rehydrated, and medication is necessary to try and stabilise symptoms.
Recurrent dehydration and weight loss are indicators of HG and you need to seek help.
Please contact your GP, Midwife or if in an emergency call 111 for immediate advice on where to travel to in your area to get treatment.
What now?
Step 1 – Speak to a Healthcare professional
Step 2 – Educate yourself and family on medications
Step 3 – Contact us for support and information
1. It is important that if you feel that your NVP is more than usual pregnancy sickness, or if you believe that you have HG, that you speak to your GP or Midwife as soon as possible.
Untreated pregnancy sickness or HG can lead to complications for both you and your baby.
Malnutrition, dehydration and other complications from vomiting or experiencing nausea must be treated by a heathcare professional.
2. It can feel scary or unnerving to think about taking medications during pregnancy.
Please be assured that there is decades of information and research on medications and treatments currently available for NVP and HG.
You can read about those here. Or you can contact us to talk through any concerns you might have. Your doctor should always consult with you on the risk v benefit of untreated NVP and HG.
3. With over 20 years experience of supporting pregnancy sickness and HG sufferers and their families we have a wealth of information and guidance.
We are striving to make pregnancy sickness more understood amongst healthcare professionals, but there is still work to be done and it is sadly common for sufferers to be dismissed.
If this happens to you please get in touch with our support team and we can help.
Please note that the information on this page is for guidance only and is not medical advice.
“The baby growing in the womb is producing a hormone at levels the mother is not used to. The more sensitive she is to this hormone, the sicker she will become.“
Professor Stephen O’Rahilly | University of Cambridge