Hyperemesis Gravidarum
We have all heard of the infamous morning sickness that occurs in about 70-80% of all pregnancies . In most cases, morning sickness starts around week six of pregnancy and lasts until the beginning to middle of the second trimester. However, there are some cases where a birthing person’s nausea and vomiting are more severe and can last throughout the entire pregnancy. This is called Hyperemesis Gravidarum (HG). HG is reported in 0.3-10.8% of birthing parents, but there is a question as to whether these percentages accurately show how many people are experiencing HG .
The good news is that HG generally does not impact the fetus and its growth. However, having HG can affect the parent’s mental health and lead to higher rates of depression and anxiety . Although there are no clear causes of HG, some studies are beginning to link things like Helicobacter Pylori, hormones, the Thyroid, and hCG back to HG . As care providers, when we have clients with HG, we keep an eye on dehydration, electrolyte imbalances, and excessive weight loss or little to no weight gain.
So, what can you do for HG? In many cases, parents struggling with HG are simply trying to survive. Therefore, whenever they can eat or drink, it is encouraged. If possible, it is recommended to try to fit proteins and fats into those snacks and meals. Sometimes eating your cravings is the best way to get food in. Eating what you crave and sneaking in something with more nutrients can help trick your body into accepting and absorbing the food. Other times a pregnant person with HG isn’t experiencing cravings. In these scenarios, we encourage medicinal eating. This is where people eat food not because they want it but because they know their body needs it.
When it comes to the treatment of HG, some anti-sickness drugs are safe for pregnancy, and many pregnant people have found success in both long and short-term using them. Vitamin B6 and B12, and Thiamine are also recommended and have been shown to help with nausea and vomiting. In addition, people have found other therapeutic and holistic options that can help with nausea and vomiting, like hypnosis, peppermint, acupuncture, ginger, etc. Then there are more aggressive ways to help with HG. One thing that seems to help with HG across the board is IV therapy. IV fluids can help replenish lost intravascular volume, rehydrate, and replace electrolytes . In addition, there are more intense therapies for treating HG, such as Total Parenteral Nutrition or TPN. This nutrient source bypasses the gastrointestinal tract and can help with the lack of absorption of nutrients. Another therapy would be Nasogastric Enteral Feeding, a type of feeding tube that has positively impacted people experiencing HG. Lastly, there is evidence that steroids can eliminate vomiting, help clients resume eating, reverse muscle wasting, and regain weight loss. However, this method should be used as a last resort when all other methods have been attempted, as it has more risks than other treatments .
Each of these recommendations for treating HG should be discussed with your care provider, who will work with you to make the best possible choice for how to move forward in your pregnancy. In the cases where none of these suggestions are accessible or helpful, it is important to remember that, in most cases, pregnant bodies can provide for the babies they carry. And lastly, sometimes pregnancy sucks, and it is okay and normal to feel that way. It is okay if all you did today was survive. You are a great parent. Keep doing the best that you can.
