Everyone knows that nausea and vomiting can be a ‘normal’ part of pregnancy. But how severe is normal?
If you’re struggling to keep anything down, losing weight, and finding it impossible to get through the day, you might be dealing with hyperemesis gravidarum (HG), or severe pregnancy sickness.
It’s important to know what you’re dealing with. So, in this guide, we’ll go through the differences between HG and regular sickness, who’s at risk, and how you can get the help you need.
Three key takeaways
The main symptoms of hyperemesis gravidarum include severe nausea and/or vomiting that lasts a long time, dehydration, and weight loss.
HG can be caused by hormonal changes, family history (genetics), or if you have motion sickness, migraines, or certain conditions.
Although there’s no cure for HG, there are treatments like Xonvea that can help manage your symptoms.
Who is at risk of hyperemesis gravidarum?
The cause of hyperemesis gravidarum isn’t fully understood, but there are several likely factors:
Hormonal changes. Hyperemesis gravidarum is linked to hCG, the hormone that rapidly rises during early pregnancy. Higher hCG levels may explain why it’s more common in twin or multiple pregnancies. Rising levels of oestrogen may also play a role. There's also research to suggest that pregnancy sickness is caused by the hormone GDF15 produced by the foetus, with severity depending on the amount released.
Hyperemesis gravidarum runs in families. This means that if your sister or mother had it, you’re at a higher risk of developing it, too.
If you had it during a previous pregnancy, you’re more likely to get it in your next pregnancy.
A history of motion sickness or migraines increases your risk.
you feel so unwell that you can’t do everyday things like work or look after yourself
your sickness lasts longer than the usual 16-20 weeks
Can HG harm your baby?
“Whether hyperemesis gravidarum can hurt your baby is naturally going to be one of your biggest worries. But it's unlikely to cause any harm if managed and treated effectively.
“If HG causes weight loss during pregnancy, there's an increased risk that your baby may be born smaller than expected and may not get enough nutrients.
"That’s why it's so important to seek help as soon as you can, to get anti-sickness medication to ease your symptoms, and treatment if you become dehydrated.”
We’ve compiled a table of the differences between normal and severe morning sickness to make it easier for you to understand what you’re experiencing. That’s because understanding what you’re dealing with is the first step to getting the help you need.
Normal pregnancy sickness
Severe pregnancy sickness (hyperemesis gravidarum)
Nausea that comes and goes
Constant, intense nausea that rarely lets up
Vomiting once or twice a day, or not at all
Vomiting multiple times a day
Can still keep food and drink down (even if adjustments need to be made, e.g. plain, bland foods, little and often)
Struggling to manage to drink/keep down fluids
Little to no weight loss
You’ve lost 5% or more of your pre-pregnancy weight
Unpleasant but manageable symptoms, no dehydration
Dehydration (feeling thirsty, tired, dizzy, not weeing often, and having dark and strong-smelling wee
Can mostly still go about daily activities
Unable to go to work or continue daily activities
Symptoms usually improve at around 16-20 weeks
Symptoms may persist beyond the first/second trimester
How to get help for hyperemesis gravidarum
If you think you have hyperemesis gravidarum, contact your GP or midwife right away. They can assess your symptoms, prescribe anti-sickness medication, like Xonvea, arrange tests, or even refer you to hospital if needed.
If you can’t get an appointment quickly, call NHS 111 for advice, or go to A&E if you’re severely dehydrated or can’t keep fluids down.
You can also access free expert support from Pregnancy Sickness Support, a UK charity that offers advice and information about hyperemesis gravidarum. They provide guidance on where you can access Xonvea on the NHS and can help you advocate for yourself if you're struggling to get a diagnosis or access first-line care.
It’s important to note that we're unable to prescribe Xonvea for hyperemesis gravidarum. This condition requires close medical supervision that we aren't able to provide through our online service. Your safety is our priority.
If your symptoms are severe, you may need hospital treatment like IV fluids or injectable anti-sickness medication, both of which require in-person monitoring and care. Please reach out to your GP or midwife, or visit A&E if you're struggling with hyperemesis gravidarum.
Frequently asked questions about HG
How long does hyperemesis gravidarum last?
Unlike regular pregnancy sickness, hyperemesis gravidarum may not improve by 16-20 weeks. It may continue throughout the entire pregnancy, but some people may notice improvement at around 20 weeks.
How do I know if I have hyperemesis gravidarum?
If you’re being sick so often you can’t keep food or water down, have debilitating nausea, you’ve lost weight, your wee is dark, or you feel too weak and tired to do everyday tasks, you may have hyperemesis gravidarum. Speak to your GP or midwife for advice to ensure you have access to the help you need.
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