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Is My Morning Sickness ‘Normal’?

Know the warning signs of hyperemesis gravidarum

A person holding their head and leaning on a bathroom sink

Feeling repulsed by the thought (or smell) of certain foods, and sometimes making a mad dash to the bathroom, is an unpleasant reality for many people in the early weeks of pregnancy.

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Thanks to hormonal changes, up to 80% of moms-to-be experience morning sickness (if only it happened just in the morning).

But an estimated 1% to 3% of those people experience next-level nausea and vomiting that can make it hard to carry on with normal life.

Extreme morning sickness is called hyperemesis gravidarum. Because it can lead to dehydration, electrolyte imbalance and malnourishment, it sometimes requires a hospital stay to replenish fluids and nutrients. Healthcare providers can also prescribe medication that may help keep nausea and vomiting at bay.

If you’re a first-time mom or never experienced morning sickness during previous pregnancies, how can you know whether the way you’re feeling is “normal”?

“With morning sickness, you might feel nauseous on and off throughout the day and vomit maybe once a day, but you’re still generally able to eat,” explains certified nurse midwife Shellie Hawk, CNM.

“With hyperemesis, people get in this cycle to the point where they can’t keep anything down.”

Studies show that there seems to be an increased risk for people with a female relative who had hyperemesis, and those who are prone to motion sickness or migraines.

Signs you’re dealing with more than run-of-the-mill morning sickness

There’s no hard and fast definition of what qualifies as hyperemesis, but here are some of the red flags that warrant a prompt call to your healthcare provider.

Common during early pregnancy: You feel nauseous on and off throughout the day and sometimes vomit, starting in the first few weeks of pregnancy. The taste or smell of certain foods may make you especially queasy.
Talk to your healthcare provider if: You frequently vomit multiple times a day and can’t seem to keep anything down — solids or liquids.

Common during early pregnancy: You gain 15 to 35 pounds during the course of your pregnancy.
Talk to your healthcare provider if: You experience weight loss during your pregnancy. Hawk says a couple pounds likely isn’t a big deal, as long as you’re able to eat. But losing 5% or more of your prepregnancy weight is worrisome.

Common during early pregnancy: Morning sickness subsides after the first 12 to 16 weeks of pregnancy.
Talk to your healthcare provider if: Your morning sickness lasts beyond the first trimester.

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Common during early pregnancy: Ginger tea or candies, or vitamin B6, may provide some relief for nausea and vomiting.
Talk to your healthcare provider if: Your nausea and vomiting is frequent and persistent, even with preventive measures. If you’re dehydrated and malnourished, your urine may be dark and smell stronger than usual.

There’s nothing pleasant about hyperemesis, but it might be a relief to know that it isn’t known to be harmful to the health of the fetus. “Babies seem to do fine — it’s mom who is in really bad shape,” Hawk says.

But early treatment is important to minimize the physical and emotional toll it takes. If you recognize any of these signs, call your obstetrician or midwife.

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