What Does Hyperemesis Gravidarum Really Feel Like?
I'm not a doctor and this article is not meant to be used as a diagnosis or medical advice. I hope this article helps you to tell the difference between morning sickness and HG, and to give you talking points to bring up with your doctor.
Overview of Signs It's Hyperemesis Gravidarum and Not Normal Morning Sickness
- You always feel faint, whether you're walking around, standing up or just in bed.
- You're losing a lot of weight, as in, your pants won't stay on or your bra is no longer the right size.
- You have a lot of spit in your mouth, all of the time.
- You're vomiting so often and so violently that you're losing bladder control.
- You spend more time in the bathroom than you do anywhere else.
- Rather than just dealing with a lack of appetite, you're finding it mentally excruciating to eat a meal.
- Most things cause you dizziness and nausea including watching television or looking at a magazine.
- You are never not nauseous.
- Medications like Zofran and Zantac hardly help you feel better.
- You're too sick to work or care for yourself.
- Riding in the car causes nausea and vomiting.
- Nausea and vomiting keep you up at night.
- You're so sick that you can no longer engage in social activities.
- You're so sick that you're experiencing anxiety and depression.
What is Hyperemesis Gravidarum?
First off, I'm going to try my very best to be straightforward in this article so that my readers who are struggling with hyperemesis gravidarum don't have to exert any extra energy to read this. I'm also going to use calm scenes and refrain from mentioning certain triggers more than I have to.
However, to also stay informative, I may use specific words or phrasing that trigger HG symptoms. If you're feeling especially susceptible, hand this article off to a friend and ask them to read it for you and relay the information to you.
If you've never heard of it before hyperemesis gravidarum sounds like something you'd say right before performing a magic trick, and in a way it feels like one too. One minute you're healthy, happy and expecting a new little babe and the next - abracadabra - you're sick as a dog and living a completely different life than what you'd expected this pregnancy adventure to entail.
Hyperemesis Gravidarum (or HG) is defined as extreme nausea and vomiting in pregnancy. It's a condition that can only occur during pregnancy, and it is accompanied by weight loss and dehydration. It is sometimes called "severe morning sickness".
It's not contagious and the baby doesn't experience the same effects as the afflicted mother.
My Personal Experience with Hyperemesis Gravidarum
In late winter of 2013 I wasn't feeling so well. For the past week I'd been experiencing vertigo whether I was standing up or in bed trying to fall asleep. Food tasted weird and I was feeling kind of down and anxious. Lo and behold, I was pregnant, and when I saw that positive pregnancy test everything I'd been dealing with began to make perfect sense, although I was surprised I'd felt strong symptoms so early on.
At exactly five weeks pregnant, only shortly after I'd gotten my positive on the pregnancy test, I woke up to my first bout of morning sickness. I was so relieved! I'd been all over BabyCenter that week and knew that getting sick was a sign of a healthy, progressing pregnancy.
I settled back into bed with a sense of deep pride at the chaos the little growing blastocyst was causing my body and tried to nod back off. But almost immediately, the waves of nausea returned and I was back in the bathroom. I thought maybe I needed to eat something to help soothe my stomach. I'd heard that nibbling crackers and sipping on ginger ale helped so I sent my husband to the kitchen to bring me back a little somethin' somethin'.
But that didn't help either. As the sun rose I found myself unable to leave the bathroom because every time I stood back up I had to turn right back around.
Convinced that something was wrong with the pregnancy I moaned to my mother that I needed to go to the doctor or something, but she reassured me that this kind of sickness was totally normal sometimes when you're pregnant. And I mean, mother knows best, right?
Over the next few days, the sickness didn't dissipate, instead escalating so that I was so weak it became difficult to walk or even control my body so that I ended up peeing my pants crawling to the bathroom.
What was supposed to be the loveliest, glowiest and most magical time of my life had reduced me to a potty-training toddler.
I hadn't showered in days, I smelled, my ribs were sticking out, I cried but no tears came and even picturing certain triggers like food or imagining certain smells caused me to throw up.
I was, in every sense, a complete mess.
Things did not get better like my mother promised, and over the next five months I became familiar with every curve of the toilet, every fake space in the tiled linoleum of the bathroom floor. My pajamas hung off my bony body and I was too embarrassed to tell anyone I wasn't dying, I was just growing a baby, so I stayed in my room all through the rest of winter, watching spring blossom out the window.
This story has a happy ending and she's four years old now, standing in front of me tearing through each page of her preschool workbook, not a single indication of the havoc she wreaked on my body.
Then there's the sequel dancing next to her in a diaper, clutching a Happy Meal toy and singing.
Unfortunately, hyperemesis gravidarum is a reoccurring condition that rears it's ugly head with each subsequent pregnancy after it's first experienced.
But what's the difference between HG and plain ol' regular morning sickness?
Physical Symptoms and Side Effects of Hyperemesis Gravidarum
The most obvious symptoms of hyperemesis gravidarum are the physical ones which typically start between 4-6 weeks. They often include:
- Nausea that does not subside. This is not like the vague queasiness that you might have otherwise experiencing during a hormonal shift, like right before your period or when taking birth control. This is a constant and heavy nausea that is lessened only with medication or briefly after an episode of getting sick.
- Vomiting several times a day. For each woman this might be a different number. For me it was at least 3-5 times but I had days where I vomited until I couldn't any longer and then dry heaved every 15-20 minutes.
- Loss of appetite. This is pretty obvious, from the nausea. For me, when presented with a small plate of food it took me at least a half an hour to get up the nerve and interest to try it.
- Weight loss. This is a side effect of the loss of appetite and vomiting. I lost a total of 15-20 pounds in both pregnancies before the HG subsided (more on that amazing hope later!)
- Low blood sugar. No food to turn to glucose.
- Dizziness. Dizziness during pregnancy is not uncommon but can be really extreme with HG. I couldn't walk far without support.
- Exhaustion and weakness. As a side effect of the dehydration.
- Sleeplessness. Because nausea persists through the night, it can be really hard to sleep.
- Sensitivity to smells, sights and sounds. I was very sensitive to smells, especially perfumes, soaps and of course, food. I also found myself sensitive to sights that I perceived as overwhelming or dizzying, including bright colors, patterns and movements, computer and phone screens as well as loud or overwhelming sounds like music and particular television shows. Rather than just experiencing feelings of unpleasantness however, these triggers caused nausea and vomiting.
- Darkened urine. Because I was unable to hold down liquids much of the time my urine was very concentrated.
- Infrequent bowel movements. Because I was unable to hold down solid food I only had a bowel movement once every 3-4 days, sometimes more.
- Stomach pain. I'm not a doctor but I would imagine this was a combination of typical pregnancy pains alongside stomach inflammation, dehydration and muscle pain from frequent vomiting.
- Throat pain. Constant throwing up made my throat sore and hurt the muscles along it.
- Dental issues. I lucked out on this one but dental issues are a possible side effect of HG since it's nearly impossible to brush your teeth without becoming sick.
- Skin issues. Because I was so thin during this time the skin that rested along my jutting bones, especially my hips became bruised and sensitive.
The Differences Between HG and Regular Morning Sickness
To understand the difference between regular morning sickness and extreme morning sickness categorized as hyperemesis, it's important to realize that everything that's experienced during HG can be experienced during morning sickness but to a much less extreme.
Symptoms of Morning Sickness vs. HG
Typical Morning Sickness
Nausea is like the hallmark of early pregnancy and you know this if you've watched even one movie involving a pregnancy story line. In typical pregnancy it's common to be nauseous when your stomach is empty, especially in the morning, but it can usually be remedied with a light, bland snack, exercise and medication. It does not interfere too much with your everyday life.
In pregnancies affected by HG, nausea is unrelenting and does not occur randomly or at one time of day. Instead, it's constant and while medication is helpful in taking the edge off, it will not get rid of it.
Vomiting in early pregnancy is normal, even once or twice a day. However, in normal pregnancies you'll be able to recover fairly quickly and look at these as "bouts".
In HG pregnancies it's common to vomit so frequently that you lose track and begin to dry heave. Similar to the worst case of the stomach flu you've ever had, almost nothing stays down, including fluids. Vomiting is violent and can result in broken blood vessels in the throat and eyes and losing bladder control.
Loss of Appetite
Food aversions and loss of appetite are normal in the first trimester but you will still be able to pick foods, however random, to ingest and keep down.
Loss of appetite is dramatic and crosses the line from "not in the mood for" to "hand me a bucket." Almost nothing sounds appealing.
Food cravings in early pregnancy are normal and can be quite dramatic. Usually these cravings result in a happy tummy.
Food cravings, believe it or not, do happen in HG pregnancies, however they may result in projectile vomiting Cocoa Puffs all over your mother-in-law's shower while her sister is over and can hear everything.
Losing a few pounds or not gaining any weight at all in your first trimester is totally normal.
Weight loss is drastic and happens quickly. Losing 1-2 pounds or more a week is typical of HG.
Mental and Emotional Symptoms
Along with physical symptoms, HG brings with it many mental and emotional symptoms and side effects unique to the condition like...
Mental and Emotional Side Effects of HG
When I was experiencing HG it was hard to think clearly, solve problems or hold a conversation because I just couldn't think straight. This was probably do to a lack of energy or nutrition to power my brain.
Depression and Anxiety
Likely due to a mix of factors including not leaving my room much and being sick for a long period of time I found myself crying daily and worrying about the future, especially what kind of mother I would be if I couldn't even handle the gestation period.
Loss of Focus
It became difficult to begin or end anything, even TV shows with plots so I ended up watching episode after episode of Property Brothers.
Along with not being able to leave the house except for doctors appointments, I was also unable to maintain a social life outside of infrequent Facebook logins (because Facebook it turns out, was pretty triggering...) I missed out on many holidays, birthday parties and family gatherings during my pregnancies.
A trigger is something that worsens or escalates nausea and induces vomiting.
Common Hyperemesis Triggers Include
- Overwhelming television shows or movies. This isn't a great time for a Stranger Things binge.
- Reading or focusing your eyes too much on a phone, tablet or computer screen.
- Riding in a car which might as well feel like getting on a roller coaster.
- Thoughts of triggers. Thinking about foods or activities that induce nausea can actually make the nausea worse. Yay.
- Too much physical activity. While you might have moments that make you feel like your can get up and get a lot done, you'll likely feel worse afterward.
Things That Are Difficult or Impossible to Do With Hyperemesis Gravidarum
- Drive. Thanks to dizziness and lightheadedness it's not only hard, it's pretty dangerous to drive.
- Cooking. Cooking involves a lot of triggering sights and smells.
- Cleaning. Again, the sights and smells of cleaning, along with the physical exertion can be triggering.
- Socializing or holding a conversation. Talking can make it harder to maintain.
- Shopping, which can be physically overwhelming.
- Attending classes or doing homework.
When Does Hyperemesis Gravidarum End?
The timeline for HG's progression is different for everyone, but mine followed the most usual timeline which was:
- Onset 4-6 weeks. I became sick the first time at 5 weeks and at 6 weeks in my second pregnancy.
- Peak at 9-13 weeks. For me, my worst weeks were actually weeks 8-10, hands down. This is when I experienced the most pain, weakness and consistent sickness.
- Relief by 14-20 weeks. By the beginning of my second trimester I was experiencing relief in that I wasn't getting sick as often (I went down to just a couple of times a day then to just a few times a week) and the nausea started to relent with random flare ups. By around week 24 I was bouncing back and able to enjoy my pregnancy and my baby bump.
For some women, they'll experience HG until they give birth, and possibly for a couple of days afterward as the hormones leave their body. Know though, that as uncommon as HG is, having it full-throttle throughout the whole pregnancy is even less common. While I did experience waves of it up until I gave birth, I was through the worst of it by five months.
When to Call Your Doctor
If you recognize that your "morning sickness" isn't normal, you need to call your doctor and discuss treatment options. Not all care providers recognize HG as a serious concern. If your doctor doesn't take your illness seriously or if you're experiencing symptoms of dehydration then you need to head straight to the emergency room for IV fluids.
HeartMom2010 Shares Her Tips for Coping with HG
For more information and to find support for hyperemesis gravidarum, visit helpHER.org
Questions & Answers
Does Hyperemesis Gravidarum last for the entire pregnancy?
No, not usually. Some women will experience HG straight through the pregnancy and even through labor, delivery and for a (very) short time after the delivery but that’s just not the norm when it comes to HG.
I had hyperemesis gravidarum two times, and both times I stopped throwing up around 17 weeks with nausea greatly improving by the third trimester. The timeline for hyperemesis that I noticed in my own pregnancies was:
6 weeks: Onset of severe morning sickness (I usually didn’t feel many symptoms when I first would find out that I was pregnant)
8-12 weeks: These were the absolute worst weeks for me with constant sickness, nausea and dramatic weight loss.
13-16 weeks: Vomiting began to lessen, and I would go whole days without getting sick at all and was able to manage my symptoms with medications. Usually, I would go in a pattern of like one good day then two bad days through this period.
16-28 weeks: Still experiencing some nausea that could be controlled through proper diet, exercise and getting enough rest (with several breaks throughout the day). Almost no vomiting except random bouts.
28 weeks - delivery: Only experienced random bouts of nausea but did deal with a lot of acid reflux!
Every woman, every pregnancy, and even every HG pregnancy is different but take solace in that it almost always gets better (and once that baby is out you’ll be cured!)
Should I get an abortion if I have hyperemesis gravidarum?
This is such a tough situation to be in, especially if you have a lot of other responsibilities looming including other kids to care for, work, etc.
Every woman’s experience with Hyperemesis Gravidarum is different and here’s mine - I had a lot of help in both pregnancies from my husband and our mothers. We were in a position at the time where I didn’t have to work and when I was pregnant the second time my husband and our moms all took turns caring for me and our infant. By 14 weeks I was semi-functional and by 20 weeks I was mostly independent to care for myself and my daughter again. Not everyone’s situation is the same as mine and I can say in all honesty that had I not had the help that I did financially and with childcare I couldn’t have kept my second pregnancy because I already had one child to take care of and HG prevented me from doing that efficiently.
This is a decision you have to make based on your own feelings and situation. If you can get through the pregnancy without a serious risk to your own financial situation or your other children and you want to keep the pregnancy then you can work around the illness. Don’t be afraid to feel like a burden to the people who love you - it’s temporary.
If you have a lot on your shoulders and you can’t see shirking your parental and financial responsibilities for the next few months at least and if the medications your doctor has provided aren’t giving you enough of a break to do the bare minimum then you shouldn’t be afraid to explore the option of abortion.
Neither decision should be made by anyone except you and no one else can judge it until they’ve been in it themselves.
Is it safe to take medication to treat Hyperemesis Gravidarum? Will it hurt my baby?
Deciding whether or not to take medication when you’re pregnant can be daunting, but determining if it’s the right thing to do when you have hyperemesis gravidarum is downright overwhelming on top of how awful you already feel.
The first thing you should do, when you have the energy is to write down your symptoms (or ask someone to help you write them down if you’re having trouble with it). The reason I think this is important is because with my first pregnancy I was so sick that when I would see my midwife I could hardly articulate how sick I was, and often just got out of there as soon as possible so I could get back to my safe bathroom which was the only place I felt truly at home anymore.
I believe this is part of the reason I never received proper care during that pregnancy. I was taking over the counter Unisom tabs to help ease nausea, but all it did was help me sleep most of the day away to give me breaks from the vomiting. Thanks to that I don’t remember much of the first half of that pregnancy! Not knowing the true level of sickness I was dealing with, my midwife didn’t believe there was anything wrong with me other than typical morning sickness combined with anxiety, and she refused to prescribe Zofran. So you need to have your symptoms and the true day-to-day misery at hand to describe to your doctor so they can get a solid feel for what you’re dealing with and how they can best treat you.
With my second pregnancy, with a new care provider, I was prescribed Zofran (and anti-nausea medication) without question. That pregnancy was still difficult but with the help of prescription medication I was able to be more coherent and vomit less (though still often). It didn’t take my hyperemesis gravidarum away, but it did give me the ability to have okay moments where I could get some Gatorade and a cup of yogurt in me and give me enough time to digest that properly before I got sick again.
There are other medications your doctor may want to prescribe you, depending on your circumstances and some of these include anti-nausea, sleep medications, and acid reducers. The thing I will tell you not to do is to medicate yourself. Always talk to your doctor about the right combination of prescription and over the counter medications and how and when you should take them. They’ll know best what is safe for you and your baby.
Which, on an anecdotal side note - both of my daughters are healthy and have no apparent issues with the medications I took while pregnant with them.
How do I tell the difference between hyperemesis gravidarum and a stomach bug?
If you really want to know what HG feels like, then the closest comparison that I’ve experienced is a stomach bug that feels like it’ll never relent, like norovirus. Unfortunately, the similarities can make it hard to tell the difference between HG and a tummy virus, at first. The thing about tummy bugs is that you recover within 7-10 days (although let’s be real, the effects on your digestive system can linger for a long time after that), and within that time frame symptoms will begin to dissipate gradually. HG isn’t like that.
Here are a few ways to tell the difference between hyperemesis gravidarum and a stomach bug:
The timing of onset is one. If the symptoms start within the first eight weeks of pregnancy, then there’s a better possibility that you’re dealing with HG which doesn’t usually develop later in the pregnancy. Now that we know a gene likely causes the disease this makes sense.
If your symptoms start to taper off after a few days, that’s not HG. HG may fluctuate slightly but within the first trimester, at least, the symptoms never go away, and they really don’t get better. Instead, thanks to prolonged vomiting, you’ll find yourself getting weaker and sicker as the days wear on.
I don’t know about you, but when I get a stomach bug, I’ll get it coming out both ends for the first couple of days. It’s not great, and it feels like satan is trying to leave my body through whichever orifice is most convenient. But with HG, and it does differ from woman to woman, but typically, you’re not going to have excessive, or even any, diarrhea. That’s probably because HG is a disease and stomach bugs are, well, viruses that affect the digestive system and your body needs to rid itself of that virus through whatever means possible. HG, on the other hand, is a disease that causes extreme nausea and what results from extreme nausea? Yeah, the pukes. With HG your body isn’t trying to rid itself of anything; it seems to be reacting to nausea.
To me, and to probably to a lot of other HG moms, I would say the best way to tell the difference between it and a bug is how long it lasts and the severity. If you’re going on a week of non-stop puking, that’s probably not a stomach bug.
Does having hyperemesis gravidarum mean I’m having twins?
No, having hyperemesis gravidarum doesn’t mean you’re having twins. You could be having twins and still have hyperemesis gravidarum, but you’re not any likelier to have it just because of that.
Just within the past year, HG researchers are learning that the cause of this disease isn’t a particular kind of pregnancy, a particular gendered pregnancy or because of the mother’s diet or prior health leading up to the pregnancy as has been suggested by random sources. Instead, HG is being linked to two genes that control appetite. So HG is in your genes and not determined by single or multiples in a pregnancy.
When I was experiencing hyperemesis, I also thought I must be pregnant with twins or more and if not then I was possessed by an alien life form out to kill me. But so far, this research confirms the cause is much less dramatic. Still gross though.
© 2018 Kierstin Gunsberg