HG in Pregnancy: Recognizing It Early and Supporting Holistically

We see the long-term effects that pregnancy experiences can have on parents and babies alike — which is why early support during pregnancy is so important. One condition that is often under-recognized, under-treated, and incredibly taxing is Hyperemesis Gravidarum (HG).
 

While nausea and vomiting are common in early pregnancy, HG is not just “bad morning sickness.” It’s a serious condition with real consequences — not just physical, but emotional and nutritional — and birthworkers are often among the first line of support in helping pregnant clients get the care they need.
 

Here’s what to watch for, how to distinguish HG from more typical nausea, and natural, integrative strategies that can help.
 

What Is Hyperemesis Gravidarum (HG)?

HG is a severe form of nausea and vomiting in pregnancy that goes beyond the “morning sickness” most people expect. It affects about 0.5–2% of pregnancies and often begins earlier and lasts longer than typical nausea.
 

Key Signs of HG:

●  Persistent vomiting (not just nausea)

●  Inability to keep down food or fluids

●  Significant weight loss (usually >5% of pre-pregnancy weight)

●  Signs of dehydration: dry mouth, low urine output, fatigue

●  Nutritional deficiencies or electrolyte imbalances

●  Symptoms that interfere with daily life (missing work, avoiding food, needing IV fluids)

Why Early Identification Matters
The earlier HG is identified, the better the outcomes — for both parent and baby. Delayed treatment increases the risk of:

●  Poor weight gain

●  Preterm birth

●  Depression and anxiety

●  Poor bonding due to traumatic pregnancy experience
Birthworkers can play a critical role in recognizing symptoms early, validating a client’s experience, and encouraging them to advocate for support and medical care — even when symptoms are dismissed as “normal.”


Supportive, Natural Approaches to Nausea and HG
While moderate to severe HG often requires medical management (including IV fluids, antiemetics, and in some cases hospital care), there are gentle, natural supports that may offer relief — especially in mild cases or as complementary therapies.
1. Ginger

●  Backed by evidence as one of the most effective herbal options for nausea.

●  Can be taken as ginger tea, ginger chews, capsules, or even fresh grated into hot water.

●  Dosing: 250 mg capsules up to 4 times per day (safe under most OB care, but always double-check).

2. Vitamin B6

●  Often combined with doxylamine in prescription treatments (e.g., Diclegis), but can be used alone in milder cases.

●  Dose: 25 mg up to 3 times daily, under guidance.

●  Shown to reduce nausea in multiple studies, especially when taken consistently.

3. Acupressure & Acupuncture

●  P6 (Neiguan) point on the inner wrist is well-studied for nausea relief.

●  Sea-Bands or similar acupressure wristbands can be worn consistently.

● Many clients report improved energy and reduced vomiting with prenatal-trained acupuncture.

4. Small, Frequent Meals with Specific Foods
● The gut is often hypersensitive during HG. Encourage clients to:

●  Eat small bites every 1–2 hours

●  Keep bland carbs on hand (plain crackers, rice, toast)

●  Try cold or room-temperature foods, which may be less triggering than hot foods

●  Add gentle proteins like nut butters, yogurt, or scrambled eggs if tolerated

●  Sip electrolyte-rich drinks or coconut water slowly throughout the day

Note: Food aversions and sensitivities are strong during HG — it’s okay if usual "healthy" foods aren’t tolerated. Survival eating is still valid nutrition.

 

Emotional Support and Validation

HG can be isolating and misunderstood, often leading to feelings of guilt, frustration, and

anxiety. As a birthworker, your emotional presence matters:

●  Reassure clients: “This is not your fault.”

●  Validate that this goes beyond normal morning sickness.

●  Offer referrals to perinatal therapists or support groups like HER Foundation when
needed.

When to Refer to Medical Care
Encourage your clients to seek or escalate care if:

●  They are losing weight

●  Can’t keep fluids down for 24+ hours

●  Are too weak to stand or function normally

●  Have signs of dehydration or electrolyte imbalance

●  Their symptoms are not improving after 12–14 weeks
It’s OK to be persistent. Many pregnant clients are dismissed or told to “tough it out.” Your voice can help them be taken seriously.


Final Thoughts from a Pediatrician
While HG can be overwhelming, early identification and compassionate care can make a real difference — not just for the parent, but for the baby’s growth and development too. As a pediatrician, I’ve seen that babies thrive best when their parents are supported through all stages of pregnancy — especially the hard ones.