Morning sickness or hyperemesis gravidarum? Knowing the difference

tinekelogan

6 hours ago

4 min read

Woman resting during pregnancy, hyperemesis gravidarum support at ORA Acupuncture Auckland

Most women expect some nausea in early pregnancy. Many are told it is normal. For some women, it is far beyond normal.

Hyperemesis gravidarum, or HG, is severe nausea and vomiting in pregnancy. It affects about 1 to 2 in every 100 pregnancies (Healthify NZ). It is not a bad case of morning sickness. It is a medical condition, and it deserves to be treated as one.

I see women with HG in my Auckland clinics, at Birthcare in Parnell and in Point Chevalier. I have also had HG myself.

While living in Cardiff, Wales, with my husband, I fell pregnant with our first child. I developed severe hyperemesis gravidarum and was hospitalised, unable to work and unable to keep anything down, not even water. I lost a significant amount of weight, relied heavily on medication and felt incredibly unwell. Living away from family made it even harder. I often couldn't leave the house for weeks at a time.

When I became pregnant with our second child, I began to feel the familiar nausea returning. My husband suggested I try acupuncture. While the vomiting was at its worst, I went twice a week. As it eased, I kept going weekly through much of my pregnancies. I simply couldn't deny the difference it made.

Those experiences changed the course of my life. You can read more of my story here.

What is morning sickness?

Morning sickness is very common. It usually starts around six weeks and settles by 12 to 14 weeks. It can be miserable. Still, most women find they can keep eating, drinking and getting through the day, even if it is a struggle.

What is hyperemesis gravidarum?

HG is nausea and vomiting so severe that you cannot keep down enough food and fluid to nourish yourself. It often starts early, around six weeks. Some women vomit many times a day. For many, symptoms ease around 20 weeks. For some, they last until birth.

HG can lead to dehydration, weight loss, weakness and exhaustion. It also takes a real toll on mood. Anxiety and low mood are common, and understandable.

You are more likely to have HG if you are carrying twins or more, if your mother or sister had it, or if you had it in a previous pregnancy (Healthify NZ).

What causes HG?

For a long time the cause was unclear. In 2023, a study published in Nature found that a hormone called GDF15 plays a central role (University of Cambridge, via ScienceDaily). GDF15 is made by the placenta and acts on the mother's brain. Women who are more sensitive to it are more likely to become very unwell. Lower levels of GDF15 before pregnancy seem to increase that sensitivity.

This matters. HG is not in your head. It is not about coping better.

The middle ground

Not every woman with severe symptoms ends up in hospital. Many sit somewhere in between. Not hospitalised, but absolutely not fine. Still working. A shrinking list of foods. Spending the day trying not to vomit. That feeling of life passing you by.

These women are often told it will pass. Eventually it does. That does not mean you have to get through it without help.

When to talk to your midwife or GP

Talk to your midwife, LMC or GP if you are struggling to keep fluids down, losing weight, or getting worse rather than better. There are anti-nausea medicines they can talk through with you. Some women need IV fluids in hospital.

Seek urgent care if:

• You have not kept food or fluids down for 24 hours

• Your urine is very dark, or you have not passed urine for more than 8 hours

• You are vomiting blood

You do not need to wait until you are at your absolute worst to ask for help.

Fluids and food

Fluids come first. Small sips, often. Warm or room temperature, not cold.

Plain water is not always the answer. In Traditional Chinese Medicine, the body makes its own fluids from what we eat and drink. The Stomach and Spleen do that work, and they prefer warmth. Cold water gives them little to work with. Warm broths and congee hydrate and nourish at the same time. I think of it as drinking your food.

Stomach Qi is meant to move downward. In pregnancy it can rise instead, and we feel that as nausea and vomiting. What you drink, what you eat, when you eat and how you eat all play a part in settling it. In clinic, I give each woman a plan for this, with foods, drinks and acupressure to use at home between treatments.

How acupuncture can support women with HG

Acupuncture sits alongside your medical care. It does not replace it. Many of the women I see are also under the care of a midwife, obstetrician or GP, and I am happy to work with them.

Treatment starts with time to talk. I look at the whole picture: how much you are keeping down, sleep, energy, digestion, mood, and how your pregnancy is progressing. I also look at your tongue and pulse.

Treatment is gentle. You can lie on your side or rest semi-reclined. Needle-free options are available, including acupressure and ear seeds. I also teach acupressure you can use at home.

Women with HG are a growing part of my practice. Many find me because of my own experience. I know how isolating it is. I know how much it matters to feel listened to.

Getting in touch

If you are struggling with HG or severe nausea, you are welcome to book or get in touch. I am at Birthcare Auckland, Level 3, 20 Titoki St, Parnell, on Tuesdays, and at 47 Oliver St, Point Chevalier, on Thursdays.

Common in pregnancy should never mean you just have to suffer.