Hyperemesis gravidarum: coping with the nausea that never ends

The first time I heard the words hyperemesis gravidarum (HG), I was already deep in it — pale, depleted, kneeling over the toilet bowl for what felt like the hundredth time that day. I didn’t know then that this wasn’t “normal morning sickness.” I didn’t know that up to 3% of pregnant women experience HG, or that around 1 in 100 will be sick enough to need hospitalisation for dehydration, weight loss, or electrolyte imbalance. I didn’t know that some women vomit for the entire pregnancy, some only for the first half, and some — like me — fall somewhere in between, sick enough to lose themselves in the fog of it.

I just knew I was exhausted.
And scared.
And grieving the pregnancy I thought I’d have.

HG is more than nausea. It’s more than vomiting. It’s more than “have you tried ginger?”
It’s a full-body, full-life disruption.

And if you’re in it now, or you’ve lived through it before, this post is for you.

What hyperemesis gravidarum actually is

HG is a severe form of pregnancy nausea and vomiting that goes far beyond morning sickness. It can involve:

• Persistent nausea (what an understatement for feeling like you’re coming down with gastro 24/7…for months)
• Vomiting multiple times a day (by multiple we could mean 8..10…12…)
• Inability to keep food or fluids down (or even speak of or think of them)
• Weight loss (or gain actually, if the ‘multiple small meals’ approach sort of works and you are forced to eat constantly while feeling this way to avoid feeling worse)
• Dehydration (even if you can keep it down, it’s so hard to get any in)
• Fatigue that feels bone-deep (pregnancy feels like that anyway I have heard, but this feels like lead for bones)
• Sensitivity to smells, movement, temperature, even conversation (more than a decade on from round one, I am only just about able to hear ‘all about that bass’ without feeling slightly green – it played on the radio every morning and afternoon while I struggled to drive all the way to or from work without having to pull over)

Some women experience it intensely for the first trimester, or 20-24ish weeks and then improve. Others stay sick until birth. Some require IV fluids, medications, or hospital stays. A small percentage experience complications like malnutrition or preterm birth.

But the physical symptoms are only half the story.

The mental load: when sickness steals your joy

HG doesn’t just drain your body — it drains your spirit.

In my first pregnancy, I wanted so desperately to enjoy the experience. I wanted to be one of those glowing, excited, gently-rounding women who savour every milestone. Instead, I spent hours each day curled over the toilet, or lying on the bathroom tiles because standing felt impossible.

I worried constantly about taking medication — terrified it might harm the baby, and made to feel guilty for even considering it. (Thankfully, medical guidance is far more compassionate and evidence-based now.)

I felt like there was nothing to look forward to except sleep.
Work felt impossible.
Socialising felt impossible.
Even hope felt impossible.

And then there was the loneliness — the slow, creeping kind.
At first, everyone wants to help. They offer remedies, meals, sympathy, suggestions. But as the weeks drag on and you’re still cancelling plans, still too sick to attend events, still talking about nausea because it’s swallowing your whole life… people get tired. They stop asking. They stop checking in. They stop understanding.

It’s not that they don’t care.
It’s that they can’t fathom something that doesn’t ease for that long.

But when you’re the one living it, that shift can feel like abandonment.

My story: four pregnancies, four different experiences

Pregnancy one: the shock

HG hit hard and fast. I vomited multiple times a day, every day. Round the clock really. I was terrified of medication. I felt guilty for not coping “better.” I felt like I was failing at pregnancy before I’d even begun. Depression and anxiety worsened (the depression on waking to another vomit on another groundhog day – and night – the anxiety if ever I had an hour or two where I wasn’t noticing the nausea, or  that my ingratitude could somehow harm the baby). I felt physically and emotionally terrible until 41 + 3 when baby finally decided the time was right to exit.

Pregnancy two: the shift

I still had HG — but I also had tools. Yoga. Breathwork. Self-development. A deeper understanding of my own mind. Another child to care for - incredibly difficult to do, but such a distraction at least the hours of a day passed more quickly.  And, importantly, I’d done away with expectation. I no longer clung to the idea that I’d magically feel better at 12 weeks. Or 16. Or 24. I accepted that this was my version of pregnancy.

Acceptance didn’t cure the nausea.
But it softened the suffering.

Pregnancy three: the long haul

HG still came. Some remedies helped in one pregnancy and not in another. Some days were manageable; others were brutal. I was busy with two children, a job, and my yoga teacher training – that helped. But most helpful of all, I had figured out a whole framework now — a way to support myself physically, mentally, and emotionally.

And that changed everything.

Pregnancy eight: the gratitude

By the eighth time I’d fallen pregnant, I was no stranger to HG — or to loss. Four babies gone before the HG even had a chance to show its face. Each loss reshaped me, stripped away old expectations, and rebuilt my understanding of what it means to carry life.

This time, the sickness still came. The exhaustion still pressed heavy. But my perspective had changed so radically that I found myself whispering thank you through the nausea. Gratitude — not for the suffering itself, but for what it signified: a body still capable of holding life, a chance I’d feared I’d never have again. It didn’t carry me through all of every day and night – I was still very much human – but it paled in significance compared to my first pregnancy, now that I had far worse things I’d been through.

 I do not wish this to diminish or cast aspersions on anyone else’s experience, because it truly is a terrible thing, this HG, I share it only in case my four very different experiences with HG pregnancies helps anyone else to feel seen and heard - less alone.

The endless suggestions (and the exhaustion of hearing them)

If you’ve had HG, you know this part well.

Everyone wants to help. Everyone has a remedy. Everyone is well-intentioned. And everyone is a little bit exhausting.

I tried:

• Ginger – tea (nope), lollies (double nope), tablets (went down but didn’t help)
• Sea sickness bands – left marks on my wrists but no impact on nausea
• Crackers before getting out of bed – terribly scratchy on the way back up, learned to use bananas instead (but can’t eat a banana even now, so take care if it’s your favourite fruit)
• Peppermint tea - not for me, but chamomile was better (mostly)
• Regular small meals – would reduce the vomiting, but not the nausea (so a real struggle to manage but a necessity to get through the day)
• Homeopathics – sometimes a help, usually more effective for me after 20 weeks (not so much for my two girls though, nothing helped with them)
• Acupuncture – occasionally helped a bit same day (but such a struggle to lay on the bed for 20 minutes with no distractions)
• Pressure point self-massage - didn’t help me much but felt soothing (youtube it or ask your acupuncturist to teach you)
• Kinesiology – some days helped a little (by appointment, or you can learn to use some on yourself, try asking your practitioner)
• Cardamom pods – fresh, opened and seeds put under the tongue (surprisingly helpful in one pregnancy, useless in the others)
• Juices of all the varieties – for a little while OJ was ok at breakfast (not at other times…HG is fickle)
• Coke – despite struggling with the idea on health grounds (and it didn’t even help)
• Flat lemonade – as above (didn’t even finish this one)
• Sparkling water – did not expect this one to help, but yay I could finally get some water down without the struggle, so now recommend it to others (noting that clearly not all women respond to all remedies the same way)
• Fruit tingle or gobstopper lollies (only things that still tasted as I remembered, and helped somewhat, shame about all the refined sugar though)

As you can see, some things helped a little, some didn’t at all. Some helped one week and not the next. That’s the nature of HG — unpredictable, relentless, and deeply personal.

And then there were the medications.
Metoclopramide did nothing for me. Vitamin B6 helped a bit.
But a combination of ondansetron and doxylamine made a meaningful difference. I was still nauseated, but at least not vomiting.

(Always speak with a qualified healthcare professional about medication options — what’s safe, what’s appropriate, and what’s recommended for your situation)

The things that helped me cope (beyond the remedies)

1. Adjusting my expectations

This was the biggest shift.

Instead of hoping I’d feel better at 12 weeks (or any other magical number), I prepared myself for the long haul. Not in a defeatist way — in a grounded, realistic, self-protective way.

Hope is beautiful.
But false hope can be cruel.

2. Yoga — not to cure HG, but to support me through it

Yoga didn’t magically stop the vomiting.
But it helped me:

• Manage anxiety
• Reduce the hopelessness that can come with constant nausea
• Feel less trapped in my body and mind
• Create small pockets of relief
• Reconnect with myself

Some poses helped one day (wide legged child’s pose was usually a winner) and not the next. That’s okay. The point wasn’t perfection — it was presence.

3. Breathwork

Gentle, slow breathing helped calm my nervous system, which often made the nausea feel less overwhelming. Even a few minutes of 360-degree rib expansion or straw breathing (yogis recommend sitali, but this didn’t suit me)…could shift me from panic to “I can get through the next five minutes.”

4. Self-development & emotional support

I worked on:

• Accepting what I couldn’t control
• Focusing on other things, because what you focus on intensifies and persists
• Softening the guilt
• Releasing the pressure to “enjoy every moment”
• Letting myself grieve the pregnancy I thought I’d have
• Finding small ways to feel empowered again
• Giving myself permission to take what I needed

HG can make you feel powerless.
Reclaiming even a sliver of agency matters.

The joy no one thinks to mention: the instant relief after birth

For all the suffering HG brings, there is one moment of pure, indescribable joy:

The moment the baby is born and the nausea disappears.

For me, it was like flipping a switch.
One second I was sick.
The next, I was me again.

Food tasted good.
Water tasted good.
Breathing felt good.
Life felt good.

It was like stepping out of a dark room into sunlight — blinking, stunned, grateful.

That moment doesn’t erase the hardship.
But it does remind you that your body is still yours.
And that you will feel normal again. The HG beast is, ultimately, time limited. Though it feels you will be pregnant forever - and trapped in these sensations forever - you will be freed.

If you’re in it now

Please know this:

You’re not weak.
You’re not dramatic.
You’re not failing.
You’re not alone.

HG is real.
It’s medical.
It’s physical.
It’s mental.
It’s relentless.
And it’s survivable.

If you’re struggling, reach out to a qualified healthcare professional — especially if you’re unable to keep fluids down, losing weight, or feeling emotionally overwhelmed. Support is available, and you deserve it. Also consider a mental health care professional if the emotional impacts are affecting your daily life.

And if you need gentle, grounding practices to help you through the emotional and physical intensity of pregnancy, you’re warmly invited to explore the Becoming Mama Yoga online courses. They’re designed to support you — your body, your breath, your mind — through every version of pregnancy, including the hard ones.