For many mums-to-be, morning sickness is an unpleasant but expected part of early pregnancy. For others, it becomes something far more serious.
If you're vomiting multiple times a day, struggling to keep food or water down, losing weight, or feeling unable to get through daily life, you may be experiencing hyperemesis gravidarum (HG), also known as severe morning sickness.
Unlike typical morning sickness, hyperemesis gravidarum can affect every part of pregnancy, from physical health and emotional wellbeing to work, family life and sleep.
The good news: you're not imagining it, you're not overreacting, and support is available.
In this guide, we'll explain what hyperemesis gravidarum is, how it differs from regular pregnancy nausea, treatment options that may help, and practical ways to cope during recovery.
Hyperemesis gravidarum is a severe form of pregnancy sickness that causes persistent nausea, frequent vomiting, dehydration and often weight loss.
While up to 80% of pregnant women experience some degree of nausea and vomiting during pregnancy, HG affects a much smaller percentage but can have a far bigger impact on daily life.
For some women, symptoms become severe enough to require IV fluids, medication or hospital treatment.
Common signs include:
The important thing to remember: HG is a medical condition, not a sign of weakness or a low pain threshold.
One of the biggest challenges is recognising when normal pregnancy nausea becomes something more serious.
| Morning Sickness | Hyperemesis Gravidarum |
|---|---|
| Unpleasant but manageable | Can be debilitating |
| Usually able to eat and drink | Often unable to keep food or fluids down |
| Mild weight changes | Weight loss is common |
| Symptoms may ease during the day | Symptoms can be constant |
| Rarely requires medical treatment | May require medication or hospital care |
Many women with HG describe feeling dismissed at first, because people assume they're experiencing "normal" morning sickness.
Trust your body. If symptoms are affecting your ability to function, speak with your healthcare provider.
Researchers don't yet have a complete answer.
Current evidence suggests that hormonal changes during pregnancy play an important role, particularly hormones linked to nausea and appetite regulation.
Some factors may increase the likelihood of developing HG:
It's worth remembering that HG is not caused by stress, diet choices, or anything you did during pregnancy. Growing a person is demanding enough on its own.
This is often one of the first questions women ask, and unfortunately there isn't a single answer.
For many women, symptoms improve around weeks 16 to 20. For others, symptoms continue well into the second trimester, and occasionally throughout pregnancy.
Severity can also fluctuate from week to week. Some days may feel manageable. Others may feel like starting over.
That unpredictability is often one of the hardest parts.
Treatment depends on symptom severity and individual circumstances. According to RCOG clinical guidance, healthcare providers may recommend:
The goal isn't to "push through" on your own. The goal is to keep you safe, hydrated and supported.
Medical treatment is essential, but day-to-day survival matters too. Many mums find it helpful to:
HG doesn't only affect the body.
Many women describe feeling:
While social media often portrays pregnancy as glowing and joyful, HG can feel very different. And that's okay.
You can love your baby and hate being sick. Both feelings can exist at the same time.
If you're struggling emotionally, speak with your healthcare provider and lean on trusted friends, family or support groups. Your mental wellbeing deserves as much support as your physical health.
Certain signs mean you should contact a healthcare provider promptly:
If any of these apply to you, contact your GP, midwife or maternity unit without delay. The NHS advises that persistent vomiting or an inability to eat or drink may need hospital treatment. Early intervention helps prevent complications such as electrolyte imbalance or Wernicke's encephalopathy.
Hyperemesis gravidarum can be a difficult and demanding experience during pregnancy. It can affect your body, your emotions, your relationships and your expectations of what pregnancy "should" feel like.
But you don't have to endure it in silence. Support exists. Treatment exists. And you're not alone.
Some pregnancies are filled with glowing skin and nursery planning. Others are about making it through the next hour without being sick. Both are real pregnancies. Both deserve compassion. Both deserve support.
Hyperemesis gravidarum is a severe form of pregnancy sickness that causes persistent vomiting, dehydration, and often more than 5% body weight loss. It's far more intense than typical morning sickness and can require medical treatment, including hospital care in severe cases.
Morning sickness is common and manageable - you can usually still eat and drink. Hyperemesis gravidarum is far more severe, often making it impossible to keep food or fluids down, and is much more likely to need medical treatment.
First-line treatments include vitamin B6 (pyridoxine) combined with doxylamine, along with anti-sickness medicines such as ondansetron or metoclopramide. For more severe cases, IV fluids and hospital monitoring may be needed. Your GP or midwife will advise what's safe for your specific situation.
Yes, for some women. Small, frequent portions of bland, high-carb foods (crackers, toast, rice) and sipping fluids often throughout the day can ease symptoms. Ginger products or acupressure wristbands may also help. These should be used alongside prescribed medication, not instead of it.
No, there's currently no way to prevent hyperemesis gravidarum from developing. The best approach is recognising risk factors early - such as a previous hyperemesis gravidarum pregnancy or a family history of it - and contacting your provider as soon as symptoms start, rather than waiting to see if they pass.
Seek urgent care if you can't keep any fluids down, show signs of dehydration (extreme thirst, dizziness, dark urine), or have lost a significant amount of weight. In hospital, you can receive IV fluids, anti-sickness medication, and close monitoring.
Often, yes. If you're diagnosed with hyperemesis gravidarum, your care team will likely monitor your pregnancy more closely than usual to make sure you and your baby stay healthy and well-supported throughout.
When treated, hyperemesis gravidarum is unlikely to harm your baby - which is exactly why proper treatment matters. Untreated severe vomiting can reduce fetal growth, raising the risk of low birth weight.
Most cases improve by around week 20 of pregnancy. Some women experience symptoms until delivery. Your care team will monitor you closely throughout, and symptoms almost always resolve after birth.
by Lola&Lykke Team
Please Note
The information shared in this article is intended for general educational purposes only and should not replace medical advice, diagnosis, or treatment from a qualified healthcare professional. Every pregnancy, recovery, and feeding journey is different. If you have concerns about your health, your baby’s health, or any symptoms mentioned in our blogs, please speak with your doctor, midwife, or healthcare provider before making changes to your care routine.
