One of the first questions you'll be asked when you tell someone that you are pregnant is, "How are you feeling?" People are usually inquiring about nausea and vomiting, the dynamic duo that makes up the most infamous of the pregnancy symptoms—70% of women experience at least some degree of nausea and vomiting, and it can be quite unpleasant. Nausea tends to start around week five of pregnancy, peaks in severity during week nine, and improves between week 12 and 14.

That is, unless you have hyperemesis gravidarum, or HG.

What is hyperemesis gravidarum—and why do people get it?

Defined as severe nausea and vomiting in pregnancy that causes weight loss, dehydration and electrolyte imbalances, HG is an entirely different beast than normal morning sickness. It is fairly rare, affecting only 1% of pregnant women.

We don't fully know why some people get such severe nausea during pregnancy, though a recent study suggests that there is a genetic component to it—indeed there is a strong hereditary aspect to HG. If your mother or a sister had it, you are at a much higher risk of having it as well. And if you've had it in a previous pregnancy, there is a good chance you will have it again.

Women with HG tend top experience nausea into their second trimester, and some will even have it their entire pregnancy.

Many scientists believe that nausea and vomiting help to protect you and your growing baby. During the first trimester, when nausea is usually at its worst, the baby is starting the delicate process of developing all their major organs. Nausea greatly reduces the variety of food a woman is able to eat, meaning that there is less risk of harmful substances being injected and negatively impacting that organ development.

Anthropologist Kari Moca writes that morning sickness may exist to help the embryo develop. When you are nauseous and vomiting (and therefore eating less), your body burns fat stores. This generates more ketones in your body, which are awesome brain-developing-fuel for your baby.

What can you do about it?

Most women find that they have to try different techniques to figure out what their nausea-reducing recipe is. But, one thing first: HG is a big deal. When you are going through it, it can be truly miserable. It is okay to complain about how you feel—it doesn't make you ungrateful to be pregnant.

It's also okay to ask for help, both in your daily life and from your provider. It is very possible that you will require medical attention, in the form of medications or even hospitalization. If you go 24 hours without being able to keep food or water down, or if you feel lightheaded or just really ill, call your provider or head to an emergency room.

Here are some ideas to try.

  • Acupressure: Acupressure, therapy that involves applying pressure to certain points in the body, may be effective in decreasing nausea.
  • Acupuncture: Acupuncture has not had much evidence to support that it works for morning sickness, however, many women swear by it, so it may be worth considering.
  • Eat often: Many times women find that they get nauseous just as they are also getting hungry. To avoid this, keep crackers (or something else that you enjoy that is easy to eat) with you at all times. Your bag, your bathroom… everywhere. Try to graze on the snacks all day (and in the middle of the night when you get up to pee) to keep that yucky tummy at bay.
  • Ginger: Ginger comes in many forms and can help with nausea. You can add ginger to your food, or find capsules, candy, or (real) ginger ale.
  • Mint: Peppermint candies and mint tea can be excellent for nausea. Smelling mint can also be lovely—you can get a few mint leaves and grind them up to release the smell, smell a bag of mint tea, or add a few drops of mint essential oils to a diffuser if you have one.
  • Prescription medications: There are a number of prescription medications available to help so be sure to talk with your provider about it if you are interested.
  • Tart food: You may find that tart food (like a lemon) makes you feel better (I used to suck on lemon slices). Just be careful—citrus fruits are not great for the enamel of your teeth.
  • Vitamin B6 (Pyridoxine): This vitamin has helped women lessen their nausea. It can be purchased over the counter, but it's best to talk with your provider about it first since it is already in your prenatal vitamin (they can also write you a prescription for it). B6 can be found in milk, sunflower seeds, salmon, eggs, sweet potato, bananas, beans, and many kinds of cereals.
  • Make a kit: Include bags to throw up in, gum or mints, snacks, a fresh shirt (and maybe pants too), and wipes for when you leave the house.

It has an emotional toll as well

There is a huge psychological component to HG. It can be emotionally draining to feel that rotten for that long. It can also be isolating, as it is difficult to leave the house and do all the things you normally love to do. Lastly, you may be experiencing some degree of unhelpful comments from people who don't really understand the extent to which you are suffering:

"Yeah, I threw up a few times when I was pregnant, too."

"Well, at least you know it's a baby that's causing it and not an illness."

"It's in your head. Just try to distract yourself."

Thanks, guys.

The truth is that people just don't get it. Motherly co-founder Liz Tenety wrote: "The happy news that I was pregnant was quickly overwhelmed by morning sickness so severe that I lost 10% of my body weight. I became severely dehydrated. I couldn't work. I couldn't even get out of bed. I could barely talk on the phone to tell my doctor how sick I was—begging them to please give me something, anything—to help. When government helicopters flew over my apartment in Washington, D.C., I found myself wishing they would crash into my house and put me out of my misery. Hyperemesis Gravidarum is that bad."

There is light, though, mama. This will get better. You will be able to e-a-t again, and life will return to normal. Until then, do not be afraid to advocate for yourself. Get the medical treatment you need, and take care of your mental health as well. If you feel depressed or like hurting yourself, call a therapist or 911 right away.

Hang in there. You've got this.

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