During those first months of pregnancy, dreaded morning sickness can have you reaching for the saltines. But for some women the condition is so severe that nothing settles their stomach. And unlike typical morning sickness, hyperemesis gravidarum (HG), lasts all day and doesn’t subside after the first trimester.
In fact, according to The Washington Post, women with HG end up losing more than 10 percent of their body weight and are often forced to take unpaid medical leave.
“These women are starving,” Miriam Erick, a nutritionist at Brigham and Women’s Hospital in Boston, tells The Post. The result is serious malnutrition that can affect moms-to-be as well as the babies they’re carrying.
One hyperemesis gravidarum researcher, Marlena Fejzo, Ph.D., knows that all too well. After miscarrying while suffering from HG herself, she began studying the genetic components of the condition.
Fejzo found that having a sister with HG increased one’s risk of having it too. She also discovered a mutation in a gene that signals vomiting in the brain might also increase the risk for HG. But while 60,000 American women are hospitalized with HG each year (and many more visit emergency rooms with symptoms of this severe form of morning sickness), the disease is still not well understood—or easy to treat.
During her first pregnancy, Barbara Phal of Ceres, Calif., lost 50 pounds in the first month alone—and was unable to tolerate food, liquids, motion, light or smells.
“The doctors had no idea what was wrong with me, so they just kept admitting me to the hospital,” Phal says. Six months passed before she was finally diagnosed with hyperemesis gravidarum and given medication to control her vomiting.
Of course, many doctors are understandably concerned about birth defects, and are therefore reluctant to prescribe drugs to treat HG. But Fejzo says there are safe intervention options.
The American College of Obstetrics and Gynecology recommends a combination of doxylamine, an over-the-counter antihistamine, with vitamin B6, which has shown a 70 percent reduction in nausea and vomiting during pregnancy, and Zofran, a drug used to treat nausea in chemotherapy patients. Still, the U.S. FDA, which classifies Zofran as a Category B pregnancy drug (meaning the medication's safety during pregnancy has been studied in animals but not in humans), warns that it “should be used during pregnancy only if clearly needed.”
As an alternative, Marikim Bunnell, an OB-GYN at Brigham and Women’s Hospital, favors first taking a medication-free approach to treating HG. She’ll start by tweaking a woman’s diet and providing intravenous fluids as needed. “My goal is not to make you feel well,” she admits. “My goal is ‘Can we get you to vomit less?’”
With no magic solution to help HG sufferers feel better, most are forced to struggle through their 40 weeks of pregnancy, nibbling on whatever they can keep down. Fortunately, there’s a silver lining at the end: a healthy baby. Plus, once women give birth, the nausea and vomiting finally subside.