Hyperemesis gravidarum (HG) is a severe form of pregnancy sickness which affects between 1 and 3% of pregnant women. Historically, it was mistakenly thought to be a psychosomatic illness and women were treated as though they had a psychotic disorder. This view has been comprehensively disproven by numerous research studies in recent decades, and it is now known to be an illness of organic origin, although its causes have yet to be fully understood. There is a persistent common belief that no drugs should be given to women in the ﬁrst trimester of pregnancy. This is not true. There are a number of effective anti-emetic (anti sickness) drugs which can safely be taken in early pregnancy. Unfortunately, the erroneous views that HG is a psychosomatic conditions and that no drugs are safe in the ﬁrst trimester still persists in many places, shockingly, even amongst GPs and midwives. Sadly, many women still come across unsympathetic health professionals who are ignorant of current treatment methods.
HG is worse in the ﬁrst trimester for the majority of sufferers, but most women will suffer symptoms at some level for the entire duration of the pregnancy. If you have close relatives (mothers, sisters) who have had HG, you are also at signiﬁcantly higher risk of being a sufferer yourself. HG is the most common cause of hospitalisation of pregnant women in the ﬁrst trimester. In the past, before IV ﬂuids and antiemetics were available, HG was a cause of death of small numbers of pregnant women. It is thought that Charlotte Bronte died of HG as she was pregnant when she died and her diaries speak of unremitting sickness.
HG is at the most severe end of the spectrum of pregnancy sickness, and as such, requires a different medical approach. The usual non-medication strategies for coping with 'normal' pregnancy sickness simply do not work. If you are reading this you have probably already tried eating little and often, high protein meals, high carbohydrate meals, ginger, seabands etc. The only treatments that most women find successful for HG are antiemetic medications (see Treatments) and rest. Some women also find accupuncture useful.
Lack of knowledge, poor health professional education and a lack of research has led to a situation in which doctors and midwives often give completely useless advice. This advice is based on what works for 'normal' pregnancy sickness, which is still being referred to as morning sickness despite decades of professional calling for that name to be scrapped. In the professional literature it is referred to as Nausea and Vomiting of Pregnancy (NVP), so this is the term that will be used here. The ubiquitious advice that it will stop at 12 weeks and ginger biscuits or tea will help are irrelevant and actually wrong in the case of HG. While there is evidence that ginger foodstuffs help for mild to moderate nausea, there is no evidence that it helps with HG.