hyperemesis gravidarum

Hyperemesis Gravidarum

DenaNovember 20, 2014

hyperemesis gravidarum

Hyperemesis gravidarum is simply defined as extreme, persistent nausea and vomiting during pregnancy that can lead to dehydration. However, any woman who has lived through the nightmare of it, knows that it is so much more than that.

Note: This post contains graphic depictions of illness. Nothing written in this post or website should ever replace the opinion of a qualified medical professional.

I am not a weak woman. I’ve been through a lot in my life — both physically and mentally. I lived through years of debilitating anxiety and depression. I gave birth to my son naturally without any medication and incurred a third degree tear in the process. However, nothing that I have lived through comes even remotely close to the physical and emotional pain brought on by hyperemesis gravidarum (also called HG).

Living through hyperemesis gravidarum is like living through a nightmare of the worst sort. I know two women who have lived through both chemotherapy for cancer and HG and they agree that HG is the worse fate. This may sound unbelievable to someone who has not lived through it, but to those who have, it makes perfect sense.

I had HG during both of my pregnancies (even though I was not diagnosed with it the first time around). Sadly, one of the biggest problems with HG is that it very often goes undiagnosed and women are left to suffer through it without help. Because HG cannot be detected by a test, it is an “invisible disease.” Many doctors will brush off a woman’s symptoms as “morning sickness” until it is too late.

Hyperemesis gravidarum is not morning sickness. One of the worst things that you can do to a woman suffering with HG is to compare what she is going through to morning sickness or to make light suggestions about how she should treat her nausea. Examples of such suggestions include: drink ginger ale, eat crackers, make sure to keep something in your stomach, sleep with food near your bed so your stomach never gets empty, suck on ginger or lemon candies, etc. While your suggestions are obviously well-intended, they are not helpful. The extent and degree of the nausea brought on by hyperemesis gravidarum cannot be treated by any simple trick, and further, nausea is not the only symptom of HG. Severe lethargy and hopelessness can also be symptoms of HG and that’s just the beginning. Suggesting that “ginger ale and crackers” are a fix can emotionally damage a woman who is suffering through HG. Trust me, she already feels like a failure and when you suggest the simple things that helped make your own pregnancy easier, it is a slap in the face to her.

The most helpful resource that I found while living through hyperemesis gravidarum was the HER Foundation (HER stands for Hyperemesis Education & Research). The HER foundation says that HG is generally described as unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids. If severe and/or inadequately treated, it is typically associated with:

  • loss of greater than 5% of pre-pregnancy body weight (usually over 10%)
  • dehydration and production of ketones
  • nutritional deficiencies
  • metabolic imbalances
  • difficulty with daily activities

I discovered the foundation through an HG support forum that I joined when my symptoms were at their worst. In those days, I didn’t think I was going to make it. I was paralyzed by exhaustion and constant nausea. There were days when I literally could not get off of the couch. I was severely dehydrated and emotionally dead. I felt like a failure as a wife, a mother, and as a person because I could not do anything. I know that this sounds extreme, but I met several women in my support group who were considering terminating their pregnancies because of the effects that HG was having on their lives. Before I lived through this pregnancy, I could have never understood such a sentiment. I mean just the idea of terminating a wanted pregnancy. How could that make sense? But then, when you live through this nightmare that takes everything out of you and you are left physically, spiritually, and emotionally dead — sometimes I guess you just want a way out. When suffering through HG, many women have to make difficult choices. You cannot live through severe HG and do it all. Something has to give — career, family, sanity. I am so lucky that I have an amazing network of support surrounding me at all times and that such a grave thought never had to cross my mind — but my heart literally aches for the women that have to wrestle with it. I mention all of this only because I want people to understand how serious HG is. It’s tragic and there needs to be more support & resources for women who live through this mess.

As for me, at the worst point, I was vomiting every one-to-two hours around the clock. As sick as it sounds, I lived for those few minutes after vomiting when the nausea would subside. I knew that such severe dehydration was taking a toll on, not only me, but on my unborn baby. The thing was, however, there was a part of me that didn’t want to tell my doctor how bad things were because a.) I knew from my first pregnancy that my symptoms would be brushed off and b.) I didn’t want to take medication. I believe in keeping pregnancy as natural as possible. The thought of ingesting synthetic chemicals and the potential for side effects/birth defects (even if rare) scare the hell out of me. I won’t even take a simple pain reliever while I’m pregnant!

Still, things came to a breaking point. I was severely dehydrated. There were ketones in my urine. I had tried every natural remedy to no avail. I knew that I had to do something or I could lose my pregnancy and/or be admitted to the hospital for IV/hydration. I decided to begin anti-nausea medication. My doctor prescribed me Zofran and the relief was nearly immediate. It was not a cure. The nausea never went away completely and, unfortunately, there were other side effects. But the main problem — the vomiting — was addressed. I went from vomiting at least 4 – 5 times each day (some days much, much more) to vomiting once or twice a week. Certain things still triggered me — to this day I vomit at least a little bit every time I brush my teeth and certain smells get me every time. But the difference from where I was without medication to where I was with medication was light years.

All of this being said, I experienced two terrible side effects from the medication. First, it caused me to be extremely exhausted (way more so than your run-of-the-mill pregnancy exhaustion). Shortly after I took my pill each morning, I had to take a nap. Luckily, this coincided with Roman’s naps and it worked out. If I had to stay awake through that exhaustion, (like many women who suffer through HG and work outside of the home do) I really don’t know how I would have done it. The other side effect is that Zofran kept food from leaving my body. Yes, it kept me from vomiting — but it also kept me from having any sort of normal digestion whatsoever (i.e. constipation). I don’t even know where to go on with this one, let’s just say it was beyond unpleasant. At the suggestion of friends from my support group, I eventually began using Miralax which helped some, but nothing provided complete relief. It was a matter of choosing the lesser of two evils and relief from the relentless vomiting won out.

This week, I reached 21 weeks of pregnancy. According to some research, half of women who suffer with HG experience partial or complete relief by 21 weeks. The other half of women will suffer for all or most of their pregnancies. Most gratefully, at this point, I am much better. I stopped taking medication a couple of weeks ago and while I’m still nauseous and exhausted most of the time, I don’t vomit anymore (except when I’m brushing my damned teeth!).

I would love to write a neat, useful list of things that you can do to help you survive hyperemesis gravidarum; the sad truth is that there is no neat, useful list. The reality is that HG is a nightmare and the only way to get through is to keep pushing forward and never give up no matter how hard or hopeless it seems. The best advice that I can give is to remember that: There will be an end to the nightmare — this will not last forever. Other than that, you have to do whatever you have to do to survive.

Here are some of the things that worked for me:

  • Deep breathing. Especially at night when trying to fall asleep despite the extreme nausea.
  • Eating. Anything and everything that you can tolerate, no matter how unhealthy! Screw saltines, ugh! I was all about ice cream and ice pops all the time — no remorse.
  • Ice cold water. Honestly, it was so flipping hard to drink anything, but some days I could tolerate ice cold water in little sips.
  • Take help! I took all of the help that I could get. When my father offered to watch Roman for 45 minutes so that I could sleep, I did. When my mother and mother-in-law offered to bring us meals once a week, I took them. And so on and so forth… Put your pride to the side and just take the help.
  • Join a support group. My support group was probably the thing that saved me most of all. HG is just really hard for people who haven’t experienced it to understand. It makes my skin crawl every time I tell someone about it and they compare it to morning sickness or regular pregnancy nausea. Having a group of women who really got it was invaluable.
  • Medicine. Making the decision to take medicine during my pregnancy was one of the most difficult things that I’ve ever had to do. The guilt that I felt (still feel to some extent) in deciding to ingest something that could help me, but potentially hurt my baby was difficult in a way that I will never be able to explain. However, for me, it was the only choice and as difficult as it was to make, I do not regret it.

I wish that I could say that my story ends here and that this was the full extent of my pregnancy sickness and woes. Sadly, that’s not the case. When I was five-and-a-half weeks pregnant, I started to bleed. I went in for an emergency ultrasound and discovered that I had a subchorionic hemorrhage (subchorionic hematoma) which is a blood clot within the layers of the placenta. So, on top of the hyperemesis gravidarum, I had to deal with that… but that’s another story for another day.

Comments (16)

  • Gillian

    November 20, 2014 at 11:22 pm

    Gosh just reading this post gets me all sorts of emotional. I was diagnosed with HG in the first trimester of my pregnancy with Roman and it was absolutely the worst thing ever. I had a milder case with Asher but both of my pregnancies were hell. I still do not feel over the emotional toll that Roman’s pregnancy put me through. Some people close to me did not understand the illness at all and were so hurtful towards me during that time thinking that I was weak / faking it, etc. Suffering from hyperemesis is so lonely in so many ways; people just DO NOT get it. I love that you linked the HER Foundation. Their forums and website meant so much to me when I was pregnant with Roman. So glad that things are a little better for you now and so happy that you are over half way through with this pregnancy! You can do this, Dena!! Thanks for sharing all of this with the world!

  • Suzy

    November 21, 2014 at 9:28 am

    Thank you for sharing your story! While I can’t even imagine what you went through, I have so much respect and pride. Your husband and Roman and baby #2 are so lucky to have you. The Internet is such an amazing place that brings real awareness to things you might’ve just brushed off anywhere else.

  • Julie Arnhold

    November 21, 2014 at 12:39 pm

    I am so sorry you’re going through this Dena. As women, we experience so many pains (and joys) when it comes to pregnancy and motherhood. I know first hand how scary first trimester bleeding can be. After I suffered my public miscarriage in September, I actually became pregnant again 6 weeks later. It was crazy and exciting, but sadly after 1 week I suffered yet another loss. A “chemical” pregnancy the doctors call it, I was heart broken and now we are taking a break from trying. I can only imagine what you’re going through with the nausea and exhaustion, though I never experienced that with Aubrey I want to say I’m here if you ever need to vent or talk. Hang in there, you’ve got this. Xo

  • Kara

    November 21, 2014 at 12:48 pm

    If anyone knows about this it’s me. I was still throwing up the day I had Aden since I wasn’t allowed to take my medicine. The first medication they gave me I would just throw up, so they switched me to a dissolvable tablet. It was the only thing I could. I had to work thru that pregnancy and had to carry a change of clothes with me where ever I went. I would throw up so severely sometimes I would have accidents in my clothes and have to change. I lost 15-20 pounds the first month I was pregnant. I wish someone would have told me about this because you are right – it is NOT just morning sickness, and anyone who says it is, sadly is completely wrong.

  • Leah

    November 22, 2014 at 2:24 am

    Dena, I am sending so many hugs and good vibes your way right now! I wouldn’t wish HG on my worst enemy!!
    I believe I had undiagnosed HG when I was pregnant with Vincent. Within the first two months of my pregnancy, I lost 15 lbs. I was throwing up so violently and often, that I’d often vomit blood. I’d try to eat something and it would often just come straight back up. I was afraid to eat often times, because I began to have a crippling fear of throwing up. I was hospitalized on a few occasions from being so dehydrated. After I was put on zofran, the vomiting lessened quite a bit, but the nausea remained consistent until the day I gave birth. I had an 18 hour labor, with 3 hours of pushing and it was a piece of cake in comparison to how awful I felt for 9 months.
    In the first trimester I had to quit my job (hard to work behind a register when you can’t stop throwing up) and it caused serious issues and arguments with people who didn’t understand or thought I was being overdramatic. I got the unsolicited “ginger, saltines, sprite and sea bands” advice more times than I could count and it was so frustrating.

    It is so wonderful that you’ve got such a good support system – it is SO important to have loved ones around you to help you and provide care and understanding when you need it most. You can do this, Mama! Although you due date may seem ridiculously far away, this will soon pass and you will be able to hold that precious child in your arms. <3

  • Leah

    November 22, 2014 at 2:24 am

    Dena, I am sending so many hugs and good vibes your way right now! I wouldn’t wish HG on my worst enemy!!
    I believe I had undiagnosed HG when I was pregnant with Vincent. Within the first two months of my pregnancy, I lost 15 lbs. I was throwing up so violently and often, that I’d often vomit blood. I’d try to eat something and it would often just come straight back up. I was afraid to eat often times, because I began to have a crippling fear of throwing up. I was hospitalized on a few occasions from being so dehydrated. After I was put on zofran, the vomiting lessened quite a bit, but the nausea remained consistent until the day I gave birth. I had an 18 hour labor, with 3 hours of pushing and it was a piece of cake in comparison to how awful I felt for 9 months.
    In the first trimester I had to quit my job (hard to work behind a register when you can’t stop throwing up) and it caused serious issues and arguments with people who didn’t understand or thought I was being overdramatic. I got the unsolicited “ginger, saltines, sprite and sea bands” advice more times than I could count and it was so frustrating.

    It is so wonderful that you’ve got such a good support system – it is SO important to have loved ones around you to help you and provide care and understanding when you need it most. You can do this, Mama! Although you due date may seem ridiculously far away, this will soon pass and you will be able to hold that precious child in your arms. <3

  • Kiara

    October 28, 2015 at 12:27 am

    I am so thankful I found this! Finally I’ve found someone who understand what I am going through. I am one of those women who thought about terminating the pregnancy. Its so bad, I can’t handle it. Then for those few seconds of relief, I’m crying because I cannot believe I’ve had those thoughts. I just feel so hopeless and alone. No one understands what I’m going through. I did go to the hospital and everything was great. I stopped taking my medicine and I was handling the morning sickness. Then recently, it came back with a vengeance and I’m not sure how to handle it. I will be going back to the hospital because its worse than before. I’m just afraid to be hospitalized or find out something worse is going on..

  • Veronica

    November 1, 2015 at 1:30 am

    I’m currently 22 weeks pregnant, and I have HG, I have been few times in the hospital and currently have an in home nurse program, I was prescribed every nausea relief medicine but I just vomited right back, had IV to hydrate and every vein in my arms has been used and I still struggling with my ketones but fight to drink as many liquids I can so that I don’t get more IV, I’m currently connected 24/7 to a zofran pump with the highest dose available even that is so painful since I have a needle in my stomach that I change site every 2 days, I’m glad that my vomiting has stopped to maybe once at week, thank you for the information on the support group, I’m constantly misunderstood by who is supposed to be my support system, my husband and family doesn’t understand what I’m going through or how I feel and think is something I should be able to control and I’m making a big deal of it, I lost 25 pounds and thank god I was chubby when I became pregnant since this helped, now at 22 weeks pregnant I weight 14 pounds less than before getting pregnant, feels nice being able to share and be understood

  • Johanna

    March 8, 2016 at 5:43 pm

    I had HG with both pregnancies and ended up on Zofran my entire 2nd pregnancy. It was the only thing that pulled me off of the bathroom floor after weeks of constant vomitting and severe weight loss. The trade of taking medication to ensure that my unborn baby was properly nourished and healthy was worth the risk of potential side effects. HG is horrible. It’s hell. But it does end post delivery. Immediately. And you get the most amazing gift in return! You can do this!!! Hang in there! Oh and for the constipation, I found the squatty potty to be a god send! You can order it to your house on Amazon!

  • Pe

    August 15, 2017 at 12:28 am

    21 weeks today, HG still going. I had it undiagnosed with my first and it stopped at 20 weeks, so I was looking towards this time mark as a certain point when I would feel better. Not happening this time round. I am so exhausted, completely lost interest in any food at all and what’s worst dehydrated 90% if the time. Had been to hospital a couple of times. Drugs they give me either don’t work or make me so drowsy I can’t possible take them whilst taking care of my toddler. Starting to think this will last through and it’s so depressing I don’t know what how on earth am I supposed to survive it… And I swear if one more person tells me to eat a ginger biscuit first thing in the morning I will scream!!

    1. Dena

      August 15, 2017 at 7:27 am

      I am so sorry, friend. It is such a difficult thing — a true nightmare. And, yes, the well meaning suggestions of ginger candies and crackers were enough to make me want to tear my hair out. 2.5 years now since my last pregnancy ended, but there is one thing that I wish I had discovered during my pregnancies and that is essential oils! If you’ve not done so yet, have a look at Young Living essential oils. Peppermint, Lavender and Lemon to be specific. A starter kit may prove to be a truly wise investment for you, if you can afford it. If you’re interested to learn more email me at denabotbyl@gmail.com.

      My prayers are with you. I know where you’re at. The only true consolation is knowing that it will end eventually. ❤️

  • Kim

    March 23, 2018 at 10:05 am

    Thanks for this article! I had Severe HG with my twin pregnancy! No one can understand how bad it really is until they experience it! I agree that it is still hard to brush my teeth sometimes!! I lost 25 lbs with my twin pregnancy and 20 with my second!! It’s worth it but SO hard while you are going through it!!

  • Ki Baker

    July 11, 2018 at 12:55 pm

    I have quite literally sobbed while reading all of your comments. This is my first pregnancy, and I had a wonderful start. I was eating normally, drinking plenty and coasting through… until 13 weeks. I have suffered severe nausea, dry-heaving on an empty stomach, exhaustion…etc. it’s been hell every moment for the last month. I’m at my 17 week marker, and I am PRAYING with all my might that my OB listens to me. I’ve already had one ER visit, which gave me 8 hours of relief, and I’ve taken Zofran 2x every day. The constipation is beyond uncomfortable. I can’t bear the slightest touch to my abdomen, and I literally rip off my clothes any chance I get. I have extreme fear of vomiting, which has induced daily panic attacks and relentless crying. I am seriously debating on quitting my very demanding job. At the very least, switching to part time, per a doctor’s note. I have all the seabands, crackers, ginger ale, broths, ginger water, vitamin B-6, stool softeners that the local grocery stores can offer. NONE of it gives me complete relief. I sobbed at work watching another girl eat pizza, I miss food THAT MUCH. I literally feel like a hospice patient. My mother, boyfriend, and coworkers insist on me eating anyway and get the sickness over with, pressure me to drink, and offer up very condescending advice. I might end up hurting someone, or myself, if I don’t get some relief! I have also debated on terminating pregnancy, but the only reason I haven’t is because all of these online forums state it ends…eventually. I’d rather die trying for my unborn son, I guess. It’s just excruciating and depressing. I have abandoned all social activities. Hope all of you ladies get a relief or a cure! Thank you for your experiences.

    1. Dena

      July 13, 2018 at 11:50 am

      I am so sorry, Ki. It does get better. You are very strong. Keep fighting. Prayers and love coming your way. xo

  • Rachel

    November 17, 2019 at 6:50 pm

    Dena, thank you so much for your words! As well as to everyone commenting I enjoy reading them also! I’m currently 8 weeks pregnant and have gone to the ER for IV fluids two times in the last week. My nausea is so bad right now that I can’t even be at home because of smells my boyfriends house is giving off. I’m at my moms and I haven’t been to school in a week! I’m absolutely bored out of my mind, I’ve watched every movie known to man! I now hate the taste of crackers because they just bring back bad memories. I’m very worried my baby will have birth defects because lack of nutrition for baby. Or in general having another miscarriage! I had an allergic reaction to one of the only medicines that worked for me! Life right now is literally kicking my but and I don’t know how to stop it. I guess I can’t. I’m hoping it will calm down when I reach my second trimester but I’m so helpless right now. All my family though have been very supportive so that’s good. Thanks for sharing Dena!!

  • Heather

    October 22, 2020 at 1:15 pm

    I feel this so much, I have had 3 babies and had severe HG the entirety of each pregnancy (only getting small windows of relief around month 7) I just found out this morning that I’m pregnant with baby #4 and am trying to find all the natural ways to help because the last pregnancy I was on so much medication (6) that it was causing all over joint pain (protein pump inhibitor) and kidney pain. I’m hoping to get through this pregnancy with medication that doesn’t have so many side effects, but I also have a 9 month old at home so, if I have to take the strong stuff to be able to take care of her I will. I really wish I could just have a permanent line of iv fluids, I always feel better when I have an iv and am receiving electrolytes. I hope the remainder of your pregnancy went better. Thank you for sharing your story.

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