For many pregnant women, morning sickness is an expected part of the journey. But what happens when the nausea and vomiting become unrelenting, severe, and life-disrupting? That’s when it might be something more serious—hyperemesis gravidarum (HG). Recognizing the early signs of HG is crucial to getting the care you and your baby need.
In this post, we’ll explore the top 10 early signs of hyperemsis gravidarum and provide actionable tips on how to advocate for a proper diagnosis and treatment.
What Is Hyperemesis Gravidarum?
Hyperemesis gravidarum is a severe form of nausea and vomiting during pregnancy that goes far beyond typical morning sickness. It can lead to dehydration, weight loss, and nutrient deficiencies, requiring medical intervention. Early detection and treatment are vital to preventing complications.
10 Early Signs of Hyperemesis Gravidarum
1. Persistent Nausea
The first early sign of hyperemesis gravidarum is constant nausea. Unlike morning sickness, HG-related nausea doesn’t go away after a few hours or improve as the day progresses. It’s constant and can feel all-consuming. It also persists past the first trimester. While HG may resolve by week 21 of pregnancy, about less than 50% of women experience it throughout their entire pregnancy.
2. Severe Vomiting
While occasional vomiting is common in early pregnancy, HG often involves vomiting multiple times a day, making it difficult to keep anything—even water—down. If your stomach is completely empty and you continue to vomit green stomach bile, call your doctor.
3. Rapid Weight Loss
Losing more than 5% of your pre-pregnancy weight within a few weeks is a major red flag for HG and warrants immediate attention from your care provider. We want to see healthy weight gain in pregnancy, which can be extremely difficult when you can’t keep any foods down.
4. Inability to Stay Hydrated
If drinking water or fluids leads to vomiting, it can quickly result in dehydration, one of the hallmark dangers of HG.
5. Extreme Fatigue
While fatigue is common in pregnancy, the energy depletion from constant nausea, vomiting, and dehydration in HG can be debilitating and cause physical, emotional, and mental exhaustion.
6. Food Aversions
Many pregnant women experience food aversions, but HG can make the sight, smell, or thought of most foods intolerable. While food aversions are normal during morning sickness in the first trimester, many moms with HG have triggers that can cue nausea or vomiting almost immediately, and these triggers may change over time.
7. Dizziness or Fainting
Dehydration and malnutrition caused by HG can lead to frequent dizziness, lightheadedness, or fainting episodes.
8. Dark or Minimal Urine Output
Dehydration from HG often results in very dark or infrequent urination, signaling that your body isn’t getting enough fluids.
9. Heartburn and Acid Reflux
Persistent vomiting can lead to painful heartburn and acid reflux, which may further limit your ability to eat or drink.
10. Anxiety and Depression
The constant physical toll of HG can take a heavy emotional toll, leading to feelings of hopelessness, isolation, and anxiety.
How to Advocate for a Diagnosis and Treatment
After recognizing the early signs of hyperemesis gravidarum, you’re going to have to advocate for a diagnosis. If you’re experiencing these symptoms, don’t dismiss them as “just morning sickness” and don’t let anyone else dismiss them, either. Hyperemesis gravidarum is a serious medical condition that requires proper care. Here’s how to advocate for yourself:
1. Track Your Symptoms
Keep a detailed log of your symptoms, including the frequency of vomiting, weight changes, and what (if anything) you’re able to eat and drink. This information will help your healthcare provider understand the severity of your condition.
2. Speak Up Early
Don’t wait to see if things improve on their own. If you’re experiencing extreme nausea or vomiting, bring it up with your doctor or midwife as soon as possible.
3. Request Specific Tests
Ask your healthcare provider to check for signs of dehydration, nutrient deficiencies, and other complications through blood tests or urinalysis.
4. Advocate for Treatment Options
If your provider doesn’t take your symptoms seriously, don’t hesitate to seek a second opinion. Treatments for HG may include anti-nausea medications, IV fluids, or nutritional therapy, and you deserve access to them.
5. Bring a Support Person
Having a trusted friend or partner with you during appointments can help you communicate your concerns more effectively and feel supported.
6. Seek Another Opinion
If you are not receiving the adequate care you have a right to, seek another opinion. Visit the Maternal Fetal Medicine (MFM) specialist at your clinic, make another appointment with a different midwife/doctor within the same practice, or visit a different practice all together.
Why Early Detection Matters
The earlier HG is diagnosed, the sooner you can start managing symptoms and preventing complications. Left untreated, HG can lead to:
- Severe dehydration
- Electrolyte imbalances
- Malnutrition for both you and your baby
- Increased risk of anxiety and depression
By recognizing the signs and advocating for care, you can protect your health and your baby’s development.
When to Seek Immediate Help for Extreme Nausea/Vomiting
If you experience any of the following, seek medical attention immediately:
- Inability to keep fluids down for more than 24 hours
- Severe dizziness or fainting
- Signs of severe dehydration (e.g., no urination for 8+ hours, confusion)
- Rapid weight loss
You’re Not Alone
Hyperemesis gravidarum can feel isolating, but you’re not alone. Many women have gone through it and found ways to manage their symptoms with the right support. If you’re struggling, don’t hesitate to reach out for help. You deserve to feel cared for and understood.
Ready for More Support?
If you’re looking for guidance on managing hyperemesis gravidarum, I’m here to help. Check out my 6-Week Coaching Program designed specifically for moms like you. Together, we can create a plan to help you feel supported, nourished, and empowered during this challenging time.