Pregnancy Diary: When is it More Than Morning Sickness?

By: Courtney McCrimmon

I first learned about hyperemesis gravidarum in graduate school, years before I had any plans to get pregnant. One of my professors assigned Atul  Gawande’s book Complications to my nonfiction writing class.  In this collection of essays, Gawande explores the challenge of treating a wide variety of health conditions, from morbid obesity to chronic pain. Two of his essays stood out to me at the time, and have stayed with me since. The first explored the struggle Dr. Gawande faced learning how to insert a central line, and the second was his retelling of a woman who faced crippling nausea throughout the entirety of her pregnancy.

“Fitzpatrick was determined, but she found that she couldn’t tolerate anything except a bite of cracker or toast.  By the end of the week, she needed more hydration, and the doctor arranged for a visiting nurse to come to her parents’ house and administer IV fluids. Fitzpatrick continually felt that she was on the verge of throwing up…riding in a car or just standing up brought on severe motion sickness. She couldn’t make it down the stairs…focusing on a magazine made her head reel.”

How horrifying, I thought.  I consider nausea one of the more disconcerting physical ailments a person can experience. You never know how long it will last, if it will lead to further illness and it can be hard to readily identify its cause.  With both of my pregnancies, I’ve had significant morning sickness. It’s actually been worse this time around than it was the first, but in both instances relief arrived in the middle of the fourth month or so, and ongoing nausea was one pregnancy symptom I could stop worrying about.

I’ve since learned to never, ever refer to hyperemesis gravidarum as “bad nausea” – it’s so much more than that. Most of us can thank the Duchess of Cambridge, Kate Middleton, for making us more aware of exactly what this pregnancy complication entails: unrelenting nausea and vomiting that often leads to dehydration that needs to be addressed by a medical professional.  It generally starts earlier and lasts longer than traditional morning sickness, causes significant weight loss and interferes with the ability to live a normal life.

My friend Jennifer experienced it with both of her pregnancies and described the experience as debilitating.

“There were some days when I threw up as many as 20 times a day. I couldn’t eat, was sensitive to light and motion and spent the first several months of both of my pregnancies in bed. I lost weight and was hospitalized with dehydration several times, but the IV fluids they gave me were just a temporary fix,” said Jennifer, who had to take prescription-strength nausea medication throughout both pregnancies.

According to Steven Caritis, M.D., a maternal-fetal medicine specialist with Magee-Womens Hospital of UPMC, hyperemesis gravidarum is relatively rare, occurring in one out of every 50 pregnancies.

“With proper hydration and treatment, most mothers-to-be and their babies will be just fine,” said Dr. Caritis. “It’s important for women to consult their doctors to rule out any more serious conditions, just to be safe.”

As with anything pregnancy-related, if you are worried about your symptoms, talk to your doctor.

“Ob-gyns are used to answering all sorts of questions,” said Dr. Caritis. “If you are pregnant, and think you are more sick than what you think is normal for pregnancy, we can help. Even if you don’t have hyperemesis gravidarum, (and hopefully you don’t!) we can offer tips and tools to help you manage your symptoms until they disappear.”

For more information about hyperemesis gravidarum, visit Magee-Womens Hospital of UPMC or the Hyperemesis Education & Research Foundation.

This is the one in an occasional series examining pregnancy from the viewpoint of an expectant mom. Courtney McCrimmon is a Manager in the Media Relations department at UPMC.