Nausea is a common—albeit unpleasant, but usually harmless—side effect for most women in the first months of pregnancy. But what if the nausea is so severe that you can hardly keep food down and constantly have to vomit? Then you may be suffering from what’s known as hyperemesis gravidarum. In this article, you’ll learn how to distinguish it from normal pregnancy nausea, what the causes are, and what can help.

Normal nausea or hyperemesis gravidarum?

Between 70 and 80% of pregnant women experience nausea and vomiting during the first twelve weeks of pregnancy—especially in the morning and late morning. However, after about three months, you usually start to feel better. That’s because by then, the level of the pregnancy hormone thought to be responsible for the nausea—human chorionic gonadotropin, or hCG—no longer increases.

Unfortunately, nausea is common in many pregnancies. However, it’s usually not a cause for concern. Very rarely, morning sickness becomes severe. Medical professionals then refer to it as hyperemesis gravidarum, which translates to “excessive vomiting during pregnancy.” If you are affected by this extreme form, you may vomit more than ten times a day and be unable to keep any food or drinks down. Symptoms usually begin between the 6. and 8th week of pregnancy and reach their peak in the 12th week of pregnancy . Improvement usually occurs around the 20th week of pregnancy .

If you are diagnosed with hyperemesis gravidarum, you may be treated on an outpatient basis or hospitalized for a few days, depending on the severity. You will receive infusions to counteract possible deficiencies. All of this probably sounds very serious at first—and it is important to take extreme nausea seriously. If you seek treatment early, therapy often works quickly, and you typically don’t have to worry about health problems for you or your baby.

What are the consequences of hyperemesis gravidarum for you?

Severe nausea and constant vomiting place immense strain on your body. Without proper treatment, the following health problems may occur:

• Weakness and circulatory problems

• Weight loss of more than 5%

• Dehydration (water shortage)

• Electrolyte disturbances

• Deficiencies of vitamins, fats, minerals, sugars, etc.

Hyperemesis gravidarum can also be a severe condition that places stress on your psyche. Your body has to endure an incredible amount, and you’re probably focused on your little explorer in your belly and worrying about how they’re doing. As a result, sleep disturbances and fears can occur in connection with this extreme pregnancy nausea. If you notice that many fears and worries are swirling around in your head, talk to your gynecologist or the medical staff treating you as an inpatient. Together, you can consider what might help you and how you can get support. You don’t have to face this extreme situation alone.

Also talk with your partner about your worries. Communicate openly about how he or she can help you and what you need. At the same time, try to understand that it can also be difficult for your partner to see how badly you are doing. Family or a good friend can provide support so that no one feels left alone.

What are the effects of hyperemesis gravidarum on your baby?

Due to deficiencies during pregnancy, in a worst-case scenario it can lead to a Preterm birth , as well as a reduced weight and a smaller body size at Birth . However, this is usually only the case if you are not treated in time. Doctors will do everything they can to ensure that your little explorer is doing well, too. With early therapy, hyperemesis gravidarum does not cause further complications in the majority of pregnancies.

Causes and Risks

The exact cause of extreme morning sickness is not yet fully understood. For a long time, extreme stress and intense tension were suspected as causes, but this has not been scientifically proven so far. Instead, it is more likely that an interaction of multiple factors causes hyperemesis gravidarum. These can include:

• Special sensitivity to smells

• Psychosomatic disorders

• Elevated hormone levels: hCG (human chorionic gonadotropin), estrogen, prostaglandin, thyroid hormones (T4, TSH)

• Vitamin B deficiency

• Inertia of the esophagus and stomach

• Insufficient lower esophageal sphincter

• Infection with the stomach ulcer pathogen Helicobacter pylori

• Genetic predisposition

Additionally, there are risk factors that can promote extreme nausea:

• Overweight

• Eating disorders such as bulimia or anorexia

• Thyroid disorders such as hyperthyroidism or Hashimoto's thyroiditis

• Diseases of the parathyroid glands

• Late first pregnancy (over 35 years)

• Multiple pregnancy

What helps with hyperemesis gravidarum?

The most important goals with hyperemesis gravidarum are to stop nausea and vomiting and to compensate for deficiencies so that you can regain your strength. As mentioned at the beginning, you should definitely see your gynecologist. Depending on the severity of your symptoms, you may receive medications for nausea and electrolytes , or you may be hospitalized. There, doctors and medical staff will support you with infusions and, if necessary, artificial nutrition to help you get back on your feet quickly.

It can also help to adjust your Eating habits . You may find it easier to tolerate smaller portions six to eight times throughout the day instead of one large meal. Try out what tastes good to you and doesn’t trigger nausea—many women find foods like dry crackers and oatmeal easy to tolerate. When it comes to drinking, low- or non-carbonated beverages are often gentler on the stomach, especially when you sip them slowly.

Some women experience an improvement in symptoms through acupressure, acupuncture, or psychotherapy . Ask your gynecologist what else you can do yourself in addition to medication. He or she will likely have some recommendations. Our LILLYDOO gynecologist Christian shares his tips in the article " This helps against morning sickness ".

We hope you feel better soon and can continue to enjoy your pregnancy!