Morning Sickness vs Hyperemesis Gravidarum: What You Need to Know
Published Date:June 25, 2025
By Ali Weatherford in consultation with Michelle Weston, L.Ac.
TRIGGER WARNING: There is mention of pregnancy loss and termination in this article.
If you’ve taken a birth class with me, you probably heard me say that I’m terrified of nausea and vomiting. I even made birth choices for myself based on this fear. I will avoid anything that might make me feel sick. And yet I decided to get pregnant anyway.
I expected some nausea and vomiting, but I wasn’t prepared for what happened. Hyperemesis Gravidarum is a much more serious and debilitating condition.
My Hyperemesis Gravidarum (HG) Experience
There is some evidence showing that there might be a genetic disposition for morning sickness and Hyperemesis Gravidarum (HG). My own mother had such terrible morning sickness when she was pregnant with me, that they thought she had Malaria. That’s because they were living in Central America at the time, but really?! It must have been extreme. Hearing that story definitely did not make me excited to get pregnant, so I put it off for many years. And then it happened to me too.
My morning sickness was extreme. I couldn’t hold down any food. I couldn’t even hold water down. I lost almost 20 pounds in two weeks. I was severely dehydrated. I didn’t know that this was not normal. It became a serious situation called Hyperemesis Gravidarum (HG). This is unusual. 90% of pregnant people experience morning sickness. For most people this means some nausea and occasional vomiting, but not enough to lead to weight loss and dehydration. Less than 3% of people will have HG.
Coping with Morning Sickness
If you are suffering from morning sickness, it can definitely have a negative impact on your life even though it’s not life threatening. The misery of nausea and the discomfort of vomiting can even lead to anxiety and depression. At the very least, you might not feel all that happy to be pregnant when you are dealing with morning sickness. And for most people, they don’t just feel bad in the mornings. It might be ALL DAY sickness. Most people want to find a solution.
Here are some ideas that might actually work to improve your symptoms:
- Acupressure or acustimulation bracelets: These apply either pressure or electrical stimulation to a very specific point on the inner wrist. They have been shown to be very effective in many cases of morning sickness. Acupressure bracelets like the Sea Band might be enough to help. They are inexpensive and easy to wear. If you need more, acustimulation bracelets like the Reliefband might provide more relief, but they are much more pricey.
- Eat small meals and snacks often. It can make morning sickness worse to go too long without eating. For many people, it helps to have a snack next to your bed that you can eat before you get up for the day. Give yourself 10-15 after eating before getting up, then get up slowly. Michelle even recommends setting an alarm to wake up in the middle of the night for a quick bedside snack. This helps keep your blood sugar more consistent which can have an impact on your level of nausea.
- What you eat might matter too. This can have a big impact on morning sickness. It’s not necessarily true that you need to eat very bland food like crackers. You don’t have anything wrong with your stomach or digestion, so bland foods might not be all that helpful. Eat the kinds of foods that you can tolerate and/or foods that are healthy and helpful for pregnancy. There is some evidence that a high protein or well-balanced snack or meal at regular intervals can better keep the symptoms in check. Some people prefer salty, sour, and/or cold foods.
- How much you eat can make a difference. Try to keep your meals and snacks on the smaller side, and have them more often. Sometimes having too much all at once can worsen things.
- Try supplements or teas like ginger, vitamin B6, and magnesium. If you use ginger, it should be the real thing. Many sodas labeled “ginger ale” don’t actually have much or even ANY real ginger in them, or at least not enough to be beneficial. You can buy ginger root from the produce section of the grocery store and add some to your soups, teas, or hot water, or you can buy ginger teas.
- Take prenatal vitamins at the end of the day. Some people benefit from taking these at night right before bedtime, because they might upset your stomach, or you might worry about vomiting soon after taking them and losing the benefit. Many people sleep just fine after taking the vitamins and then don’t have to worry about having a more upset stomach during the day.
Usually, morning sickness can be somewhat managed with some diet and lifestyle changes, and it doesn’t interfere too much with daily living. Morning sickness usually goes away, or at least gets much better, after the first trimester.
What Makes Hyperemesis Gravidarum Different?
HG is a very different situation. Recent research suggests that morning sickness and HG might be caused by a sensitivity to a hormone called GDF15 which is produced by the growing fetus. Some people are more sensitive to this hormone or make more of it than others, and sometimes there is a genetic cause for that.
Some people are actually genetically predisposed to be less sensitive to it and have developed some immunity to it such as people with an inherited blood disorder called beta thalassemia which causes chronically high levels of GDF15. These people seem to be protected against HG, as well as milder forms of pregnancy sickness, presumably because their bodies have become accustomed to the hormone. HG seems to happen when a body is very unprepared and unaccustomed to very high levels of the hormone. Until this very recent research and some other more recent theories, the causes of HG were very much a mystery, and often a woman’s experience was dismissed as purely psychological.
Having HG is very different from having morning sickness. HG can be life threatening, and most people can no longer continue with their normal daily activities. They miss work, they can’t exercise, and of course getting enough nutrition and hydration becomes a serious problem. In extreme cases, people with HG are hospitalized, have miscarriages, or even terminate a wanted pregnancy because of the severity and risks. Many people need regular medical intervention due to complications caused by the condition. Devastatingly, HG can often last the whole pregnancy. HG is still a little bit mysterious and can make pregnancy miserable and even potentially dangerous.
Why Early Treatment Matters
There are treatments that can help considerably, but in some cases, standard treatments are minimally effective. Unfortunately there hasn’t been enough research on this condition to provide a well-established and effective standard of care. Many care providers don’t understand HG and don’t know about the treatment options that are having positive impacts. It’s starting to get more attention, and the study showing a link to the GDF15 hormone even suggests that treatments might become available in the form of a sort of immunization given before conception. The idea would be to start introducing the hormone into the body in smaller doses to prime the body for the high doses of the hormone that come with pregnancy. This might be a treatment in the future for people who are at high risk for developing HG.
What does seem to be important is starting treatment as early as possible. You are more likely to get control of the symptoms with early intervention. If your symptoms continue to worsen, it might be harder to find an effective treatment. It’s best not to wait until you’ve experienced a lot of weight loss, dehydration, and undernourishment. The HER Foundation has a lot of great information about HG.
Some of the treatments listed above for morning sickness might provide some temporary or minor relief, but are much less likely to be effective for HG.
In most cases, the frontline treatment is medication. There are some medications that are shown to produce good results for many people with minimal side effects. Of course it’s important that the medications are safe to take during pregnancy, and it’s important that you find a care provider who stays updated with the latest research. The HER Foundation has this very comprehensive list of medication treatment options, including information about their safety and efficacy.
Can Acupuncture Help with HG?
Acupuncture is being evaluated for effectiveness against morning sickness and HG. Unfortunately, there is limited research, and what exists has had mixed results. However, most of the research shows that acupuncture can at least be slightly effective in improving the symptoms and/or outcomes for people with HG. Acupuncture can be done either as a standalone treatment or alongside medication or other treatment options since it is safe and will not cause any negative treatment interactions.
For some people, the results are very positive. I tried acupuncture for the first time because of HG. I was desperate for something to work, and was on the verge of needing to go to the hospital. At the time, medication options were much more limited. I had lost 11% of my body weight at that point and wasn’t keeping down food or water. I was severely dehydrated. I most definitely qualified for a diagnosis of HG, but I didn’t know that. I had only had one prenatal visit at that point, and things hadn’t been so extreme when I had that visit. I didn’t know that this was not the usual morning sickness.
My sister is a nurse, and she’s the one who convinced me that something was seriously wrong. I decided to try acupuncture and Chinese medicine first on the advice of a family member, and I never needed to go any further. I was immediately able to keep down water and small amounts of food. Things got better with more treatments. After a couple of weeks I was no longer vomiting at all and the intensity of my nausea was reduced. I never felt completely nausea-free, but I slowly started gaining weight, and my baby and I were safe.
Something that a lot of HG sufferers come to realize is that they might not feel 100% normal until after the baby is born. It’s good to have reasonable expectations and to find comfort in improvement, even when complete resolution is not achieved.
Getting Support and Protecting Your Mental Health
I would definitely recommend seeking the treatment options that you feel comfortable with, and that work for you. I also recommend getting mental health support. HG is a very serious condition which often gets dismissed as the regular nausea and vomiting of pregnancy. Feeling unsupported when you are also coping with a debilitating condition like HG can lead to a serious decline in mental health. I recommend finding a specialized perinatal mental health provider. In my local area of central Texas, nurturedTX is a great resource. Their provider directory is called Kristi’s List and it’s a searchable, easy-to-use directory to help you narrow down your options and find the right provider for you. NurturedTX also has programs to help pay for this care if you don’t have insurance benefits or income to cover it, and even a free virtual support group.
Postpartum Support International (PSI) is another great organization for mental health care related to pregnancy and birth. There are resources for pregnancy care as well as postpartum support.
This interview is a conversation with my actual acupuncturist! She is still doing this work and helping people deal with morning sickness and HG with good success rates.
