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What Should I Know About Hyperemesis Gravidarum?

Hyperemesis gravidarum is more extreme than morning sickness and can have serious consequences for both the mother and baby. It can make it difficult for pregnant women to do normal activities like going to work. Getting treatment early can help prevent long-term complications.

What is Hyperemesis Gravidarum?

Hyperemesis gravidarum is a disorder where pregnant women experience extreme, persistent nausea and vomiting. This isn’t the same as morning sickness because it’s more severe and lasts longer into the pregnancy.

Hyperemesis gravidarum symptoms can put a woman and her child at risk for complications like: 

  • Weight loss.
  • Dehydration and electrolyte imbalances.
  • Miscarriage, stillbirth or premature birth.
  • Depression and mental health disorders.
  • Prolonged postpartum recovery.

How to Help Someone with Hyperemesis Gravidarum

If you or someone you know experiences hyperemesis gravidarum, encourage her to work with her doctor on a treatment plan.

Medication

While there is no medication for hyperemesis gravidarum, health care providers can treat each symptom. Early intervention often results in better health outcomes. Talk to your provider about symptoms as soon as possible.

Nutrition

You and your child need vitamins and other nutrients to grow. Hyperemesis gravidarum can make it difficult to get nutrients from food. Work with your doctor to create a nutrition plan, which may include intravenous fluids, electrolytes and vitamins.

Mental Health

Hyperemesis gravidarum can impact a mother's mental health. You may find it difficult to work, fear future pregnancies, and feel depressed or anxious. It’s important to know the symptoms of depression and talk to your doctor as needed.

Physical Activity

Health care professionals may suggest exercises to help improve your and your child’s health. Be as active as you can but understand you may need to rest often.

Rest

Mothers with hyperemesis gravidarum may need to rest often. Try to remove any chores you can from your day. Limit yourself to only tasks you can finish with little or no strain.

Recovery

It can take mothers with hyperemesis gravidarum several months after pregnancy to feel like themselves again. Continue to work with doctors to treat any lingering symptoms or effects.

Building Awareness

Because hyperemesis gravidarum can begin with similar symptoms to morning sickness, it’s often undertreated. The physical and emotional impact of the condition on women and children can be lasting. 

To increase treatment and reduce the impact on maternal health, Texas Health and Human Services is working to build awareness of hyperemesis gravidarum.

To learn more, read the HHS Hyperemesis Gravidarum Strategic Plan< (PDF). 

Hear Her Texas

The Texas Department of State Health Services developed the Hear Her Texas campaign to raise awareness of urgent maternal warning signs. To learn more, visit the Hear Her Texas webpage.

Watch this Hear Her Texas video about one woman’s experience with hyperemesis gravidarum and another condition called cholestasis of pregnancy. 

What Symptoms Should I Look For? 

Hyperemesis gravidarum can look different for each woman. It often starts early in the pregnancy. 

During prenatal appointments, health care providers review your condition for symptoms. They look for signs of significant weight loss, recurrent ketosis (the body burning fat for energy) and frequent or severe nausea. 

Health care providers also determine if nausea is: 

• Keeping the mother from performing her job. 

• Keeping the mother from performing simple household chores or caring for herself. 

• Causing dehydration. • Causing severe fatigue. 

• Putting psychological stress on the mother. 

To learn more about diagnosing hyperemesis gravidarum, visit the National Library of Medicine's "Diagnosis and Treatment of Hyperemesis Gravidarum."

Calculate Weight Loss

Unlike morning sickness, women with hyperemesis gravidarum experience significant weight loss. Use the calculator and table below to check if weight loss is significant or severe.

Enter the usual weight and current weight, then select “calculate” to view the percent change. Compare the percent change with those listed in the table. Women with significant or severe weight loss should contact their doctor.

TimeSignificant Weight Loss (%)Severe Weight Loss (%)
One Week1-2%Over 2%
One Month5%Over 5%
Three Months7.5%Over 7.5%
Six Months10%Over 10%

Source: Fejzo MS, Poursharif B, Korst LM, Munch S, MacGibbon KW, Romero R, Goodwin TM. Symptoms and pregnancy outcomes associated with extreme weight loss among women with hyperemesis gravidarum. J Womens Health (Larchmt). 2009 Dec. 18

A pregnant woman standing in front of the crib

“As a whole in your pregnancy, if you’re feeling that something is wrong, if you innately feel that something is not right, know that you know your body best. Go find help. Talk to somebody … You could be saving your life by finding the help that you need.”

Testimonial, Hear Her Texas

Support for Mothers Experiencing Hyperemesis Gravidarum 

Mothers who need treatment for hyperemesis gravidarum may be eligible for support through various programs in Texas.

CHIP Perinatal

CHIP Perinatal is for pregnant women who can't get Medicaid and don’t have other health insurance. It helps cover doctor visits for your pregnancy and care for your newborn. This may help with diagnosis and treatment for hyperemesis gravidarum.

For more details, visit the Medicaid for Pregnant Women and CHIP Perinatal page. If you still have questions, read CHIP Perinatal FAQsto learn more.

Medicaid For Pregnant Women

Medicaid for Pregnant Women is a health care program that helps expecting mothers with low income to get the care they need. This coverage now extends to one year postpartum and can help with treatment for issues resulting from hyperemesis gravidarum.


For more details, visit the Medicaid for Pregnant Women and CHIP Perinatal webpage

WIC Nutritional Support

WIC is the Special Supplemental Nutrition Program for Women, Infants and Children. WIC works to improve the health of pregnant women, including those with hyperemesis gravidarum. 

WIC can provide nutritious foods to supplement diets, education on nutrition and breastfeeding, and referrals for women with hyperemesis gravidarum to health care professionals.


For more details, visit the Texas WIC page.