FAQs about Hyperemesis Gravidarum + Nausea and Vomiting in Pregnancy

michalina-1264044-unsplash.jpg
 

1. What are NVP and HG and how are they different to regular morning sickness?

Imagine pregnancy sickness as a spectrum. On one end you have morning sickness, which is very mild, doesn’t interfere with your daily life too much and subsides after the first trimester. In the middle, you’ll find NVP which is more intense than morning sickness, can last beyond the first trimester and will impact your ability to function normally. At the other end you have HG, the most severe of the pregnancy sicknesses. HG affects every facet of your life, lasts well beyond the first trimester (often until delivery) and makes it almost impossible to function normally.

2. How do I know if I have NVP or HG?

The simplest way to determine whether your pregnancy sickness is more than just morning sickness is to ask yourself this question: are your symptoms impacting your ability to live your life as you had prepregnancy? If your nausea and/or vomiting are preventing you from eating, drinking, sleeping, working or leaving the house as normal then you need to discuss it with your doctor. In first pregnancies, women are more likely to delay seeing their doctor about this kind of sickness. We all just assume that nausea and vomiting are part of early pregnancy and we’re not sure whether to seek help. The sooner you get help for your symptoms, the less severe your NVP or HG is likely to become. If you feel your doctor doesn’t understand the condition, feel free to direct them to our website for more information. We can also recommend a HG Friendly doctor in your area, so get in touch if that would help.

3. How long will this sickness last?

Unfortunately, there’s no real answer to that question. For some women, symptoms will clear up near the conclusion of the first trimester - between 11-15 weeks. For others, symptoms persist until the moment they deliver their placenta. In the rarest cases women can experience symptoms in the weeks post-birth while their hormones continue to level out. That’s not the answer you’re looking for, we know. The only thing we can say is that it WILL end. We just can’t tell you exactly when. And in the meantime, we’re here for you.

4. I can’t stop vomiting and haven’t been able to keep any food or drink down. When should I go to the hospital?

We always say, if you are thinking about going to hospital then you probably should. Healthy people don’t think about when to go to hospital! If you haven’t kept down, at an absolute minimum, 500ml of water in 24 hours, then you need to head to hospital for rehydration. This might mean you are going to hospital very regularly, in which case, your hospital should organise a rehydration plan that allows you to be treated as an outpatient. Some areas might have a pregnancy day stay unit, Early Pregnancy Assessment Unit or Hospital In The Home that will keep you from being admitted to hospital. We recommend that any rehydration plan includes receiving fluids every two to three days as a preventative measure to keep you from slipping into dehydration. We’re working on a database of hospitals that offer outpatient or in-home services, so check back regularly - or get in touch - to find one near you.

5. Will pregnancy sickness hurt my baby?

As with most questions relating to NVP and HG, there is no simple answer to this question. The truth is, we don’t really know, but research shows that most women with NVP and HG will go on to have healthy babies. The greatest risk factor for both mothers and babies lies in untreated NVP and HG. When symptoms go unchecked for weeks, or months, dehydration and malnutrition set in depriving the mother of important vitamins and nutrients which are depleted by both the sickness and the growing baby. With the help of a supportive team of healthcare practitioners, who are knowledgeable about treating NVP and HG, as well as organisations like HGA there is no reason for you, or your baby, to be adversely impacted by HG long term.

6. If I get pregnant again will I be this sick?

There is no guarantee that you will or won't have sickness in your next pregnancy. We currently believe there is around a 70-80% recurrence rate of Hyperemesis Gravidarum. The best thing you can do when planning for another pregnancy is to prepare for the worst case scenario - that is, that you will be sick again. Many of the medications we use to treat NVP and HG can be taken preemptively, meaning you can start taking them before you begin trying to conceive. Tackling the cause of symptoms like nausea and vomiting before they set in is crucial to mitigating the severity of HG and NVP long term. When you begin planning a subsequent pregnancy be sure to involve your healthcare providers as early in the process as possible. Working with a team who are knowledgeable about the conditions, are supportive of you starting prophylactic treatment and will work with you to manage your symptoms for their duration is an important part of pre-pregnancy planning.

7. I’m worried about taking prescription medication while pregnant. What happens if I don’t take it?

We understand that the thought of taking prescription medication while pregnant is very distressing for some women. As with all things relating to pregnancy and health, it’s a case of weighing up various risk factors. Current research shows that you are likely to cause more harm to your baby, and yourself, by not treating NVP and HG than you are by using the recommended medications. It also shows that NVP and HG pregnancies that went without medication had worse outcomes than the ones that did. That is not to say that taking medication during pregnancy does not come with risks - your doctor will outline them all as they are prescribed. But you must weigh up these risks with those posed by chronic dehydration and malnutrition - which are severe. We encourage you to discuss your concerns with your prescribing doctor, to contact us for support and advice, and visit our Useful Links page for current research papers relating to the safety of certain medications. If you have any questions, please don’t hesitate to get in touch with us.

We also recommend contacting one of the following if you have immediate questions about any medications you’re taking:

  • Mothersafe: a clinic run by The Royal Women’s Hospital (for NSW residents)

  • Rodney Whyte: a specialist in medication use during pregnancy and breastfeeding

  • Pregnancy, Birth and Baby: an online and telephone service run by Maternal Health nurses

8. I’m struggling with my mental health. What should I do?

You are not alone. As many as 50% of women with HG or NVP will develop depression and/or anxiety during their pregnancy. The most important thing to remember is that you have done nothing to deserve or cause this and you WILL survive it. There are so many great services, including us at HGA, committed to supporting you during this difficult time. Please seek help if you need it. You can ask to see your delivering hospital’s perinatal mental health team or speak to your GP. Pregnancy is an incredibly difficult time for a woman’s mind - and sicknesses like NVP and HG only serve to compound it. Please read our resources on taking care of your mental health and get in touch if you need more support.

9. I feel like my family, friends and doctors aren’t taking me seriously. How do I help them understand?

Pregnancy sickness like this can really only be properly understood once it has been lived. Even the people sharing your home, or witnessing your symptoms on a daily basis, may not understand their magnitude or the affect they can have. The best piece of advice we can offer is to educate, educate, educate! Direct people to this website, and our section specifically designed for support people. We also recommend sending people to the Pregnancy Sickness Support and HER Foundation websites for even more information. Where possible, take your partner or immediate carers with you to appointments and invite them to ask questions of your doctors to get better insight into your condition. And, as always, if you need more support in dealing with these people please contact us.

10. How can I get extra support?

We understand that you probably feel very isolated and alone at the moment. We’ve been exactly where you are and it’s a lonely place. But there are sources of support available to you and coming to this website is a great place to start. You can email us any time, join our Facebook page and closed support group (it’s totally private so if you haven’t announced your pregnancy no one will know you’ve joined) and send us a DM. We’ve also got a round up of amazing services on our mental health page.

11. I’m still breastfeeding and suffering from pregnancy sickness - what medications can I take?

We recommend discussing this with your care team to decide what is the best course of action for you at this stage. You can also receive additional support from one of the following:

  • Mothersafe: a clinic run by The Royal Women’s Hospital (for NSW residents)

  • Rodney Whyte: a specialist in medication use during pregnancy and breastfeeding

  • Pregnancy, Birth and Baby: an online and telephone service run by Maternal Health nurses