Beyond Morning Sickness: The Pregnancy Condition Few People Understand

Ten kilograms. That’s how much Sarah Perlman lost during her first pregnancy at a time when most women are expected to gain weight.

“For days on end I didn’t eat or drink,” she recalls. “My world shrank to just two places: the bed in my bedroom and the bathroom. I was vomiting dozens of times a day. Anything that went into my mouth came right back out, and when there was nothing left left to throw up, I was vomiting stomach acid.”

At first, the people around her did not understand what she was going through.

“The doctors tried to convince me it was stress or a mental health issue,” she says. “Even people around me said things like, ‘Everyone goes through this. What’s wrong with you?’ But they didn’t realize that I wasn’t just feeling a little sick. I couldn’t eat, I couldn’t drink, and instead of gaining weight, I kept losing more.”

Sarah is a registered nurse who had already worked in several hospital departments. Yet even with her medical background, she had never heard the term that would eventually explain everything.

“I didn’t know the condition called hyperemesis gravidarum,” she says. “I had simply never heard of it. That’s part of why I now feel it’s my mission to help other women in this situation. Even today, many people still don’t realize it is a real medical condition.”

Not “Just Vomiting”

When Sarah became pregnant a second time, she hoped things would be different.

“I started the pregnancy with optimism,” she says. “I told myself, ‘This time it will be easier.’ I even thought that maybe during my first pregnancy I had just been young and overwhelmed.”

But soon the same symptoms returned.

“I was vomiting 20 to 30 times a day. I couldn’t function at all. I realized I had to understand what was happening to me.”

Eventually she reached a well known specialist who finally gave her an answer.

“He told me, ‘You have hyperemesis gravidarum.’ It was the first time I had ever heard those words.”

Hyperemesis gravidarum is a severe form of pregnancy nausea that goes far beyond typical morning sickness. For many women it leads to dehydration, extreme weight loss, and repeated hospital visits.

“When I started reading about it, I suddenly understood I wasn’t imagining things,” Sarah says. “There was a clear name for what I was experiencing.”

Research suggests that between 0.3 percent and 3 percent of pregnant women suffer from this condition.

Sarah later learned that genetics can also play a role.

“Studies of sisters, mothers, and daughters show that the placenta releases several hormones during pregnancy. One of them is called GDF-15,” she explains. “For most women it causes mild nausea, but women who are more sensitive to it can develop severe hyperemesis.”

She notes that genetics are not always the only factor. Some women experience hyperemesis in only one pregnancy, and multiple pregnancies such as twins can also increase the risk.

“While most women stop vomiting after the first trimester, women with hyperemesis often continue into the second trimester, and sometimes even into the third,” she says. “For some, the symptoms stop only when the baby is born and the placenta is delivered.”

Turning Pain Into a Mission

Sarah says the turning point for her came when she realized how many women with hyperemesis were considering ending their pregnancies because they felt they simply could not continue.

“That broke my heart,” she says. “You go through day after day feeling like you’ve lost your humanity. You’re so sick that you can’t imagine surviving nine months like this.”

After her second pregnancy ended and she began to feel like herself again, Sarah decided to dedicate herself to helping other women facing the same struggle.

“Women constantly reach out to me,” she says. “Some are thinking about terminating their pregnancy. Others are dealing with domestic tension because people around them don’t understand what they’re going through.”

According to Sarah, this lack of understanding exists in every community.

“It can happen to anyone,” she says. “My goal is simply to be there and help however I can.”

Searching for Solutions

As part of her advocacy work, Sarah contacted many doctors to learn more about the condition.

“What I discovered was surprising,” she says. “Some doctors know hyperemesis very well, but many have barely heard of it.”

Even among those who are familiar with the condition, many still do not know that recent research suggests a genetic cause.

“This also affects treatment,” she explains. “Many doctors prescribe standard nausea medications in pill form. But women with hyperemesis often cannot even swallow those pills because the nausea is so severe, and even when they can, the medication usually isn’t strong enough.”

Sarah also explored complementary medicine.

“One reflexologist told me that if my stress went away, the symptoms would disappear,” she recalls. “I politely told him that wasn’t helpful.”

At the same time, she says treatments such as massage or reflexology may provide comfort, even if they do not cure the condition.

“Sometimes women just need something that feels good in the middle of a very difficult experience,” she says.

Why Is There Still No Cure

With so many advances in medicine, many people ask why a cure still hasn’t been found.

According to Sarah, researchers have tried to develop medications that suppress the hormone responsible for the nausea. However, testing drugs during pregnancy is extremely complicated because of the potential risk to the fetus.

“There is discussion about a future treatment that women could take before becoming pregnant in order to reduce the body’s reaction to the hormone,” she says. “But at this stage the research is still ongoing.”

Supporting Women Through the Struggle

Sarah now supports women around the world, often meeting with them online because traveling can be difficult during severe nausea.

“I try to explore every possible option with each woman,” she says. “Even small things can make a difference.”

She also makes a point of speaking with husbands so they understand what their wives are experiencing.

“Support from the family is crucial,” she explains. “Sometimes the husband is the one who has to help arrange IV fluids or medical care.”

In one case, a woman told Sarah that her mother-in -law did not believe her symptoms were real.

“She said, ‘I went through pregnancy and so did my daughters. Everyone feels sick.’”

Sarah asked to speak with her directly and explained the medical facts.

“Once she understood there was a hormonal and genetic component, her entire attitude changed,” Sarah says.

Preparing for the Future

Sarah emphasizes that women who experienced hyperemesis in one pregnancy should seek guidance before becoming pregnant again.

“Research suggests that if you had hyperemesis once, there is a strong chance you will experience it again,” she explains.

That may sound discouraging, she admits. But preparation can make a significant difference.

Today Sarah herself is in her third pregnancy and still coping with hyperemesis.

“But this time I’m much more emotionally prepared,” she says. “I know what to expect, which treatments might help, and how to navigate the medical system.”

The challenges remain real.

“There are still days of crying, fainting, and dehydration,” she says.

“But with knowledge, support, and faith, I get back up again each time.”