The Mental Health Impact of Hyperemesis Gravidarum (HG)
Photo by Acton Crawford on Unsplash
Share
Hyperemesis Gravidarum (HG) is often described as a severe form of morning sickness, but that description hardly does this illness justice. HG is a debilitating pregnancy condition characterised by relentless nausea, vomiting, dehydration, and profound physical depletion.
But HG doesn’t only affect the body. Living with severe and prolonged illness during pregnancy can also have a profound impact on mental health, leaving many women feeling isolated, frightened, traumatised, or simply in survival mode. Many women describe not only the physical suffering of HG, but also the distress of feeling misunderstood or dismissed while enduring it.
Understanding the relationship between HG and maternal mental health is essential to improving the recognition, support, and care women receive during pregnancy and beyond.
What is Hyperemesis Gravidarum (HG)?
Hyperemesis Gravidarum is a severe and debilitating pregnancy illness affecting approximately 1 in 100 pregnancies. Unlike nausea and vomiting in pregnancy (NVP), commonly referred to as “morning sickness”, HG is characterised by persistent and severe nausea, frequent vomiting, dehydration, significant weight loss, and nutritional deficiencies.
In your words.
“I don’t even know really how to describe HG. I mean, it’s been many years now and I still don’t quite think I have the words. And so what I’ve landed on is that it feels like you’ve been poisoned - that’s the closest thing I can come to understand what that feeling is like, because it’s not just the excessive vomiting and nausea. There’s also just something inside you that it’s like your body is trying to rid, but it’s not going away and nothing can alleviate it...”
For some women, symptoms improve after the first trimester. For others, HG continues throughout pregnancy.
But HG affects far more than physical health alone. The illness can disrupt every aspect of a woman’s life — including work, relationships, parenting, identity, and overall wellbeing.
Living with severe and prolonged illness during pregnancy can have a profound impact on both mental and emotional wellbeing.
The Psychological Impact of HG
When a person is severely unwell for weeks or months during pregnancy, it is understandable that their mental health may also suffer. The relentless nature of HG can leave women feeling trapped in a cycle of illness with little relief and no clear end in sight.
In your words.
“I went through my first pregnancy not quite understanding what was happening to me because I'd never met anyone with HG before. I'd never heard the word ‘hyperemesis’ before. And so every GP I saw, every midwife I saw, family, friends, everyone just called it ‘morning sickness.’
And so I really thought that something was wrong with me the whole time.”
Alongside the physical symptoms, many women with HG experience:
chronic exhaustion and sleep disruption
anxiety, low mood, or hopelessness
social isolation
fear about the pregnancy
difficulty caring for themselves or their family
a loss of independence and normal functioning
For many women, HG affects every aspect of daily life. The inability to work, parent as usual, eat normally, or participate in everyday activities can be emotionally distressing and deeply isolating.
Many women with HG also describe feeling misunderstood or minimised. Because nausea and vomiting (NVP) are so commonly associated with pregnancy, sufferers may hear comments such as:
“Everyone gets morning sickness.”
“As long as the baby is healthy.”
“Have you tried ginger?”
Although often well-intentioned, these responses can leave women feeling dismissed and alone in the severity of their experience.
In your words.
“He made a comment at the dinner table like, ‘That's not my daughter. She's a shell of who she was.’ And I heard him, and it was validating to hear someone else recognise that: yeah, I'm not okay. But what do you do in that situation when the cause of not being okay is the pregnancy?”
Research consistently shows higher rates of anxiety, depression, and trauma symptoms among women with HG. These psychological effects develop in the context of prolonged illness, physical depletion, isolation, hospitalisation, uncertainty, fear for their own or their baby’s wellbeing, loss of functioning, and feeling misunderstood or inadequately supported during pregnancy.
HG is not simply “bad morning sickness.” It is a serious pregnancy illness that can have significant psychological consequences.
HG and Depression
Research consistently shows higher rates of depression among women experiencing HG.
In your words.
“I'm on my hands and knees and I start vomiting again. And I burst into tears at this point…
That night I immediately was thinking about having an abortion: ‘I need to terminate this pregnancy. That's what will make this sickness go away. That is why I am unwell. I can't even take care of my son. We can't do this.’
I knew what doctor to see. I knew all the right things to say. I'd been offered a termination early on in that pregnancy. So I was like, ‘I'm just going to go back there and I'm just going to do it. I'm not going to tell anyone, and I'm just going to tell people I miscarried.’
It was a very, probably still to this day, the darkest day of my life.”
A 2012 study (Hizli et al.) found that:
35.1% of pregnant women with HG experienced mild depression
26.0% experienced moderate depression
17.8% experienced severe depression
This was in stark contrast to approximately 5% of women without HG who experienced mild depression. The researchers concluded that the “depression risk was increased 76-fold in patients with HG.”
These statistics are significant, but behind every number is a woman attempting to navigate pregnancy while physically unwell and emotionally depleted.
For some women, the depression associated with HG may improve once symptoms resolve. For others, the psychological effects can persist long after pregnancy.
HG, Trauma, and Post-Traumatic Stress
For some women, HG is not only physically and emotionally distressing — it can also be traumatic.
In your words.
“I avoided anything that reminded me of being pregnant. My friends would tell me about their pregnancies and I wouldn't see them and I would feel physically unwell when they discussed it….
I would repeatedly pregnancy test myself. So if it’s day 26, I'm pregnancy testing because ‘where is my period?’
And then really easily triggered. So people would ask me, ‘Are you having any more kids?’ And I would fly off at them and feel angry for the whole day about that conversation, because how dare they?! They don't know what I've just been through and what that means!”
Research suggests that more than half of women experience post-traumatic stress symptoms following an HG pregnancy, with approximately 18% meeting the full criteria for post-traumatic stress syndrome (PTSS).
For many women, HG is accompanied by intense fear, helplessness, uncertainty, and a sense of being trapped in — or betrayed by — their bodies. The psychological impact is often further compounded by feeling dismissed or inadequately supported while severely unwell, and by struggling to have the seriousness of the illness recognised.
Following an HG pregnancy, some women experience:
intrusive memories of the pregnancy
heightened anxiety or hypervigilance
fear surrounding medical settings and/or future pregnancies
distress triggered by reminders of the experience
difficulty coming to terms with the pregnancy or birth experience
Some women may also grieve the loss of the pregnancy experience they had hoped for, particularly when much of pregnancy was overshadowed by illness and survival.
Recognising HG as a potentially traumatic experience is important. Compassion, validation, and appropriate psychological support can play an important role in recovery during pregnancy and beyond.
Why Lived Experience Matters
The emotional impact of HG should not be treated as secondary to the physical illness. Persistent illness, malnutrition, dehydration, isolation, and fear can significantly affect mental health, particularly when women feel unsupported or struggle to have the seriousness of their illness recognised.
Remember…
HG is not morning sickness. It is a serious pregnancy illness that can have profound psychological effects, even long after symptoms resolve.
Listening to women with lived experience of HG helps deepen understanding of the profound psychological and emotional impact this illness can have — both during pregnancy and long after symptoms resolve.
Even after the vomiting stops, recovery from HG is not always immediate. Some women continue to process trauma from the pregnancy experience, grief over the loss of an expected pregnancy experience, anxiety about future pregnancies, ongoing physical and emotional recovery, or lingering exhaustion and isolation. Recovery from both prolonged physical illness and psychological distress can take time. This does not mean you are weak, ungrateful, or “failing to move on.”
Feeling heard, believed, and cared for can make a significant difference to psychological wellbeing during an incredibly vulnerable time. Mental health support should be considered an important part of comprehensive HG care.
Support and Resources
For support, information, and lived experience resources:
Counsellors or psychologists with experience in pregnancy and postpartum mental health (ForWhen, COPE, and the Gidget Foundation Australia are great places to start)
Social workers or occupational therapists can help with practical concerns
YourGP, midwife, or obstetrician can screen for depression or anxiety and connect you with support
PANDA (1300 726 306) offer free, confidential emotional support
You, Me & HG podcast (https://www.youmeandhg.com.au/podcast)
Sources
HER Foundation. (2023). HG reality: Hyperemesis gravidarum survey findings and patient experiences. HER Foundation. https://www.hyperemesis.org/news/hg-reality-2023/
Hizli, D., Kamalak, Z., Kosus, A., Kosus, N., & Akkurt, G. (2012). Hyperemesis gravidarum and depression in pregnancy: Is there an association? Journal of Psychosomatic Obstetrics & Gynaecology, 33(4), 171–175. https://doi.org/10.3109/0167482X.2012.717129
NSW Health. (2024, July 19). Hyperemesis gravidarum. https://www.health.nsw.gov.au/kidsfamilies/MCFhealth/Factsheets/hyperemesis-gravidarum.pdf
This blog is informed by lived experience and is not intended as medical advice.
If you or someone you know needs support, Perinatal Stories Australia encourages you to reach out to Lifeline (13 11 14), 13YARN (13 19 76), or Suicide Callback Service (1300 659 467).
