Analysis: Hyperemesis gravidarum (HG) is the medical name for severe sickness and vomiting during pregnancy, making it seem like a months-long battle for survival
By Zeinab El Dirani, RCSI
Pregnancy is viewed as a time of joy and anticipation, but it can feel like a relentless battle for survival for women suffering from Hyperemesis Gravidarum (HG). This is a severe condition characterised by persistent nausea and vomiting, affecting women's ability to eat and drink. For these women, every day is a struggle against dehydration, malnutrition, and extreme exhaustion.
Unlike the common 'morning sickness' that many expectant mothers experience, HG is a severe and debilitating condition that can persist throughout pregnancy. Women who have experienced HG describe it as one of the worst experiences of their lives. The relentless nausea and vomiting leave them physically and emotionally depleted, making even basic tasks, such as showering, brushing their teeth or getting out of bed, an immense struggle.
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From RTÉ Radio 1's Drivetime in 2021, Trish Lynch, who has suffered with hyperemesis gravidarum, and Dr. Peter Boylan, former Master of the National Maternity Hospital, discuss the condition
The impact of this condition doesn’t end with childbirth. The physical effects may end, but the impact on mental health persists. Many women suffer from post-traumatic stress disorder, severe anxiety, and an overwhelming fear of ever becoming pregnant again. The isolation and lack of understanding from society and even healthcare professionals add to their distress.
A condition that runs in families
HG affects 1 to 3% of pregnancies and is caused by a hormone called GDF15. There is also evidence of a genetic link to the condition; if a mother or sister has suffered from HG, a woman is significantly more likely to experience it herself. Even more concerning, women who have had HG once are at high risk of suffering from it again in future pregnancies, often with worsening symptoms.
But despite its severity, research into HG remains scarce, leaving many women without adequate treatment or support. A project at the Royal College of Surgeons in Ireland is determined to change this by understanding the long-term physical and mental health impacts of HG. Our aim to create a digital support toolkit to empower women and equip healthcare professionals in Ireland with better resources to manage this condition.
Women suffering from HG should not have to fight for recognition, treatment or financial support.
Research findings
We have conducted interviews with over 40 women across Ireland and are now working directly with women affected by HG to ensure their voices shape the solutions. When we launched a call for participants to take part in our interviews, over 130 women responded. Many had endured multiple HG pregnancies, each one more brutal than the last. Their willingness to participate highlights the urgency of this issue and the pressing need for meaningful research and action.
Our findings reveal a shocking lack of support for women after an HG pregnancy. While previous studies have explored medications to alleviate early pregnancy symptoms, the methodologies were often weak, and almost no research has addressed recovery from the long-term physical and psychological damage of HG. Women are being left to suffer in silence, navigating future pregnancies without adequate medical guidance or emotional support.
Beyond the physical and emotional toll, HG imposes a huge economic burden on women and families. Many women are too ill to work, placing their jobs and financial stability at risk. Caring for children while suffering from HG presented another significant challenge. Women reported being physically incapable of caring for their children, forcing them to rely on costly childcare services. Frequent hospital visits for IV fluids further strain finances, with long hours spent in overcrowded emergency departments waiting for treatment.
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From RTÉ Radio 1's Liveline, listeners suffering from Hyperemesis Gravidarum discuss the financial cost of the condition
The financial strain was exacerbated by the need for private medical consultations, as access to HG treatment in the public healthcare system remains inconsistent. The recent inclusion of Cariban, a medication used to treat nausea and vomiting of pregnancy, in the Drug Payment Scheme was a step forward, but access still depends on a doctor’s discretion, often delaying or limiting treatment. Women frequently reported feeling dismissed by healthcare providers, forcing them to seek costly private consultations to receive the care they needed.
One woman described the burden of managing HG:
"There are all these extra costs, the travel in and out of the hospital because you're not just going once every three months. You're going two or three times a week. You are trying to find foods that work for you that won’t make you sick. The medications are another burden. Even the extra 80 euros a month on the drug payment scheme for the medication is a big expense. I was also buying sick bags online, so I would have somewhere to vomit into when I was on the train or the bus or in the car or even in bed. Childcare is a massive one. I didn't think it would impact me that bad. My husband's job wasn’t great. They wouldn't let him take any time off or work from home, so we had to rely on friends"
Like many conditions that affect women only, HG remains underfunded and deprioritised. An equitable healthcare system must recognise the severity of HG and ensure that every woman has access to the care she needs, without financial barriers or systemic delays.
Women suffering from HG should not have to fight for recognition, treatment or financial support. By advancing research and ensuring that healthcare providers are equipped with the right resources, we can help ease the burden of HG and improve outcomes for both mothers and their babies.
The HG research project at RCSI is in collaboration with Hyperemesis Ireland, a national charity that provides essential support, information, and advocacy for women with HG
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Zeinab El Dirani is a SPHeRE doctoral candidate and a member of the Women's Health Research Network at RCSI. She is a Research Ireland awardee
The views expressed here are those of the author and do not represent or reflect the views of RTÉ. If you have been affected by issues raised in this article, support information is available online
