Hyperemesis gravidarum (HG) is a pregnancy disorder that affects 1% to 3% of pregnancies (equivalent to 6 million women worldwide), however as a spectrum disorder with very little research, the impact is likely further reaching than those numbers report.  HG is not morning sickness; it is all-encompassing nausea and vomiting bouts all day, every day beyond what any ginger candy or peppermint tea can ease.  In addition to vomiting and nausea, HG is characterized by weight loss, dehydration and in severe cases, death. Unfortunately, even in 2023, research and needed treatment options are lacking. 

I hadn’t heard of hyperemesis gravidarum until I was diagnosed around 8 weeks in this, my final, of five pregnancies. I have four little boys and this baby is a girl; no explanations have been given as to why this has been my only HG diagnosis, but I believe it’s a factor of very high HCG levels and hormonal shifts with my body adjusting to growing a little girl this time around. Here, I’m sharing about my experience and the way I learned how to cope with hyperemesis gravidarum, in the hopes that it’ll help someone else on their journey.

Related: Hyperemesis gravidarum is about so much more than just morning sickness

My battle with hyperemesis gravidarum 

I knew around week 6 of my pregnancy that something was very different this time around. I was vomiting upwards of 30 to 40 times per day, had extreme and all-encompassing nausea and fatigue, and was struggling with restlessness and an inability to sleep through the night. My day-to-day functioning was drastically impacted to the point I just prayed I’d make it through the 20-minute school drop off line or that 1-hour zoom meeting (which I took from my bed and was ever-grateful for the invention of virtual backgrounds) without having to use my barf bag or embarrassingly excuse myself.   

As a four-time mama, self-employed business owner and that 39-week pregnant woman known to still be clocking runs at 5 am during her other pregnancies, my identity was quickly shifted: I felt helpless, completely dependent on my spouse, and not able to be the mom I always want to be to my other children. 

Related: When does morning sickness start?

Around 8 weeks at our infamous ‘heartbeat’ appointment, my tears flowed as I explained to my OB-GYN how miserable I was. At that point, I had lost about 12 to 15 pounds from my pre-pregnancy weight and felt like a shell of who I was before becoming pregnant with this little miracle baby. At a time when my husband and I usually cried tears of happiness and joy, I couldn’t help but feel extreme guilt for my feelings of despair. 

Soon thereafter, I was diagnosed with something called hyperemesis gravidarum (HG). The diagnosis became somewhat newsworthy due to Kate Middleton’s bouts with the disorder throughout her pregnancies; but, the research, awareness and empathy toward the devastating effects are far from plentiful. As a spectrum disorder, I was diagnosed as having ‘mild to moderate’ HG (those diagnosed as ‘severe’ end up at the emergency room and hospital, hooked up to feeding tubes, catheters and the like in an effort to save their lives). 

Unfortunately, due to lack of answers and treatments, HG sufferers have been known to terminate their pregnancies out of desperation when given inadequate treatment despite the horrific symptoms. 

One of my favorite analogies when trying to compare morning sickness to HG is like comparing a little bit of rain to a hurricane. 

I like to think of myself as a tough woman both physically and mentally—one who has run 7 marathons, about 30 half marathons, birthed 4 other children, once broke an arm on a run and ran home the 3 miles before considering going to the doctor, and survived the tragic death of her father due to a car accident. HG, however, has ripped me to my core–physically, mentally, emotionally. “Strong” is not a descriptor I’d give myself right now. 

Luckily, my husband and I stumbled upon the HER Foundation early on and have found reprieve in their support. The online resource provides virtual support groups with fellow HG sufferers and survivors as well as recommended medical regimens to educate ourselves and advocate for ourselves as patients. The executive director, Kimber MacGibbon, suffered through HG twice herself and founded the 501c3 non-profit after having difficulty getting treatment and dealing with the residual health issues of HG. (Geneticist and HG researcher Marlena S. Fejzo, Ph.D, is on their Board of Directors.) There is hope—and the HER Foundation is working on increasing that hope. 

Related: Hyperemesis gravidarum researcher Dr. Marlena Fejzo is on a mission to understand women’s health

Now at 31 weeks pregnant as I write this, I have had a few weeks of reprieve (around 21 to 24 weeks), but continue to struggle with vomiting bouts of 15 or so times per day, 2 to 4 days per week along, with the mental depression of feeling sick for the past 7 months. 

About 80% of HG cases resolve around 20 weeks gestation but others endure for the entire 40 weeks. Most are diagnosed around 9 weeks gestation. Throughout this journey, I’ve learned some ways to cope, some ways to keep food down and some medical regimens that have eased my symptoms; perhaps they can help you or a friend, too. 

Coping with HG

I have learned how to cope, day by day, with these small reminders. 

  • This is temporary. These nine months (give or take) may be the most challenging of your life, but a finish line is there with a beautiful gift of life at the end. 
  • Each day can be better than the last. I like to dub my good days as my ‘fluffy’ days, when I can attend my eldest’s basketball game with a smile on my face, when I can take a 2-mile walk, or when I can actually go to the office for my consulting business. For me, every day hasn’t been extreme misery—and there are small breaks and reprieves. 
  • This is teaching me so many lessons for a future better self. Loss of control. Loss of identity. Loss of daily functioning. Never did I think a pregnancy could cause all of these, but it has. I have garnered so many lessons on empathy and how to show up for friends who are going through a hard season. 
  • I am alive. Each day is a day closer to meeting our newest family member and a day closer to re-establishing my health, my life, my ability to live and be the best friend, daughter, sister, spouse and mother that I know I am. 
  • My support system is strong. My village, especially my husband, have stepped up and are carrying me to the finish line. For that, I will be forever grateful. 

Related: 5 tips on how to manage hyperemesis gravidarum

Foods to manage HG

Eating the following foods has worked best for me.

  • Small snacks throughout the day rather than meals
  • Bland foods like toast, crackers, rice cakes
  • Soups, soups and soups (as yucky as it sounds, it also doesn’t hurt so bad when coming back up)!
  • Popsicles
  • Fresh vegetables and hummus
  • Watermelon (high water consistency means it’s hydrating and easy to get down)
  • Applesauce and yogurts

Related: Have morning sickness? Here’s how to get the nutrition you need, according to a dietitian

Medications for managing HG

I have embraced these medication and supplement regimens to get me through, despite the fact that most of these were not recommended to me until I asked about them. The HER Foundation’s website is full of resources to help you advocate for these treatments with your birth care provider. 

  • Zofran: I used this from about weeks 12 to 20 as sparingly as possible, around 4 mg doses every 6 hours, administered intravenously since I was not able to keep it down otherwise. (The reason I used it sparingly is because of the severe constipation it caused me.)
  • Docusate (Colace) and stool softeners: After many weeks of my digestive system simply pushing food back up, I think my intestines literally forgot how to digest food. I have had a very hard time remaining regular but Colace has helped some. 
  • Pepcid: My heartburn has been through the roof, so this helps manage it. 
  • Unisom and B6: The combination of vitamin B6 with doxylamine (Unisom) has been recommended by The American College of Obstetricians and Gynecologists (ACOG) for treating morning sickness in the first trimester if B6 alone doesn’t help. 
  • 2x weekly intravenous fluid: Though the out-of-pocket expense is steep, we have in-home healthcare come weekly or bi-weekly to assist with IV placement and allow me to get 1 to 2 liters of fluids on an as-needed basis. During my very bad weeks of vomiting, I became pretty dehydrated and this has helped keep me afloat. 

The most heart-wrenching component of HG for me is trying to be a mom for my four other (very active!) little boys, ages 8 and under. I cry… a lot. I am in bed… a lot. 

I am learning to accept more and more help and remind myself daily that this is temporary. There will be a finish line. I have garnered so much empathy for those living with chronic illness who have no such finish line. 

I am also incredibly lucky to have a husband who has done everything in his power to advocate for me, to care for me and to give me grace.  My mom, my sisters, my friends: they are all the angels that keep on giving. 

How to help someone with HG

If you are a friend of someone going through HG, you can help! It may seem daunting to support someone who doesn’t seem to be improving and may seem depressed or not very responsive, but my friends and support circle have shown up again and again. Though you can’t create a magic pill or make the sickness part go away, you can show you care and that goes so very, very far. 

  • Let them cry. Listen and stay positive for them.
  • Send them a text, a card, a voice memo. It’s the little pick-me-ups that mean the most.
  • Take their kids for them for a few hours.
  • Understand that they are probably a shell of who they used to be. Even just picking up the phone could be daunting to them during this time. Give them grace because they will come around—and they will be so thankful you stuck by their side.

A note on coping with HG

You are not alone—and you deserve all the empathy and support right now. I have felt mildly dismissed throughout this pregnancy and shrugged off as being just a ‘hormonal’ pregnant woman who is emotional and dealing with nausea. To feel dismissed by medical professionals when going through HG adds salt to an already very vulnerable wound. If nothing else, know that fellow HG survivors have your back, we believe you, we are rooting for you, and it will get better.