the news is out. kate middleton’s royal family is expanding again, and just like her last two pregnancies, even the royal treatment isn’t enough to keep sickness at bay. the dutchess is experiencing hyperemesis gravidarum, a severe case of nausea and vomiting in pregnancy.

isn’t that just regular morning sickness? nope. it’s actually a bit different. we’ll explain.

what is hg?
while nausea and vomiting can be common in early pregnancy, hyperemesis gravidarum, commonly referred to as hg, can last well into a woman’s second trimester and may persist throughout pregnancy. hg is characterized by vomiting several times a day with few days of reprieve, enough to begin causing weight loss.

women with hg are triggered by various smells and tastes and cannot keep anything down. in severe episodes, they may become very dehydrated and can suffer electrolyte imbalances and nutritional deficiencies. if left untreated, these imbalances and deficiencies can affect a developing baby. these women may need to be hospitalized for iv hydration and anti-nausea medications. once a woman is stable, a doctor or midwife may recommend a daily regimen of anti-nausea medicines.

we know, it sounds (and it is) awful. but it’s treatable.

it’s all about preventing dehydration and its complications (like fainting), and poor nutrition. women with morning sickness may find that over-the-counter options such as ginger, peppermint tea, vitamin b6 or unisom work well. women who have hg may need a stronger anti-nausea medication, prescribed by a doctor or midwife. and because they can’t keep food down, these medications may be given by iv or rectally. there are several different types of medications and different meds may work more effectively for some people.

what about weight loss?
losing a few pounds or not gaining any weight can actually be normal in early pregnancy, but women with hg may lose 5% or more of their pre-pregnancy body weight. (this is 7 lbs or more in a woman whose pre-pregnancy weight was 140 lbs.) if managed appropriately, women with morning sickness and women with hg will catch-up to a healthy pregnancy weight later on, minimizing the concern for a low-birth weight baby.

here are some tips from our midwives.

for normal morning sickness:

  • stay hydrated. our bodies need a lot of water when we’re pregnant. if the taste of water is making you nauseous, try adding lemon or cucumber to your water to enhance the taste.
  • try over-the-counter options: ginger, vitamin b6, benadryl, and tea can all help.
  • remember normal morning sickness should pass. morning sickness usually resolves by 12-14 weeks.
  • avoid acidic, high-fat, spicy foods. stick to bland, low-fat foods until you feel better.

think you might have hg?

  • if you are vomiting multiple times in a day, call your healthcare provider. it is important to seek treatment to avoid nutritional deficiencies and dehydration.
  • speak with your doctor or midwife (psst. we may know a few) about medication options. it may take some experimenting to find what works best for you, but there are many options out there. remember that taking medication for hg may be the safest choice for you and your baby to support adequate nutrition.
  • find support. hg is exhausting, emotionally challenging, and can affect your professional and social life. find support among family and moms groups (we have those too).