Podcast Episode #260
Hyperemesis Gravidarum in pregnancy – Causes, Treatment and Management options
If you’ve ever wondered whether your morning sickness is something more, this episode is for you. I’m joined by Dr Emily Rubinstein, women’s health GP and gynaecologist, for an honest conversation about hyperemesis gravidarum (HG)—a condition that can make pregnancy incredibly challenging.
Together, we explore what HG really is, how it differs from typical morning sickness, and the treatment and support options available. My hope is that this episode helps you feel less alone and more empowered with knowledge to navigate pregnancy and seek the support you deserve.
In this episode, we chat about:
- What hyperemesis gravidarum is and how it differs from morning sickness
- Possible causes and risk factors that may increase your likelihood of experiencing HG
- When to seek help and how to advocate for yourself with healthcare providers
- Medical treatment options including vitamins, antihistamines, anti-emetics, and IV fluids
- Non-medical approaches such as food and fluid strategies, supplements, and complementary therapies
- The link between HG, pelvic floor health, and mental wellbeing
- Why a strong support system at home and in healthcare makes such a difference
- How to prepare for future pregnancies if you’ve experienced HG before
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In this article you'll find tips to:
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Understand what hyperemesis gravidarum (HG) is and how it differs from morning sickness
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Recognise the signs and symptoms that mean it’s time to seek professional help
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Explore possible causes and risk factors for HG
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Learn about medical treatment options, including safe medications and IV fluids
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Discover non-medical approaches such as food, fluid, and lifestyle strategies
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Find ways to manage fatigue, dehydration, and constipation during pregnancy
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Support your pelvic floor health when experiencing severe nausea and vomiting
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Access mental health support to cope with the emotional toll of HG
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Build a strong support network with partners, family, and friends
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Prepare and plan if you’ve had HG in a previous pregnancy
In this podcast episode with Dr Emily Rubinstein, a women’s health GP and gynaecologist, we talk about hyperemesis gravidarum (HG)—a severe form of nausea and vomiting in pregnancy. Dr Emily shares her expertise on what makes HG different from typical morning sickness, the medical and non-medical treatment options available, and why support systems are so important for women navigating this challenging condition.
1) Causes of hyperemesis gravidarum (HG)
HG doesn’t have a single cause. Current thinking points to a mix of biological and genetic factors, with research suggesting some women have higher levels of proteins—particularly GDF15 and IGFBP7—that influence appetite and weight regulation.
Other contributors include:
- Genetic predisposition: HG often runs in families and can recur in subsequent pregnancies.
- Fatigue: Tiredness can worsen nausea and vomiting, especially when caring for other children.
- Severity spectrum: HG goes beyond morning sickness, often leading to weight loss, dehydration, and reduced daily function.
2) Medical treatment options of hyperemesis gravidarum
Medical hyperemesis gravidarum treatment usually follows a stepwise approach with your healthcare provider, often involving trial and error to find what works best:
- Vitamin B6 (pyridoxine): Commonly used early, safe, and effective for many.
- Antihistamines (e.g., doxylamine/Restavit): Frequently prescribed; can help with both nausea and sleep but may cause daytime drowsiness.
- Anti-emetics (e.g., metoclopramide, ondansetron): Used when symptoms are more severe; effective but may have side-effects such as constipation.
- IV fluids and hospital care: For women unable to keep food or fluids down, intravenous hydration and electrolyte correction may be required. In severe cases, women may need hospital-in-the-home care or specialist obstetric support.
It is important to note that the choice of medication should always be guided by a trusted healthcare provider, with shared decision-making about risks and benefits.
3) Other treatment options of HG (eg non-pharmacological)
Non-medical approaches don’t cure HG but can help alongside medical care:
- Food and fluids: Eat what you can tolerate, in small amounts. Frozen drinks, slushies, or salty snacks often help.
- Supplements: Adjusting prenatal vitamins—such as temporarily removing iron under medical advice—may ease symptoms.
- Complementary therapies: Ginger, acupuncture, or acupressure wristbands may provide some relief.
- Mental health support: A perinatal psychologist can help with the emotional toll. HG often leads to isolation, low mood, or feelings of hopelessness.
- Practical support: Partners, family, and friends can assist with meals, childcare, and household duties.
- Pelvic floor physiotherapy: Vomiting and constipation can strain the pelvic floor; physio support can help reduce leakage or prolapse risk.
When to seek help
If you are losing weight, unable to stay hydrated, or struggling emotionally, seek professional help early. HG is not “just morning sickness”—and you do not need to suffer alone.
** This podcast has general information only. Always seek the guidance of your doctor or other qualified health professional with any questions or concerns you may have regarding your health or medical condition.
Links
Free Preparing for Birth Workshop: https://www.fitnestmama.com/pregnancyworkshop
Preparing for birth Pelvic health checklist
Free 7 Day Trial Pregnancy Workouts
Free 7 Day Trial Postnatal Workouts
Instagram @kathbaquie.physio
