Could Scientists Be Close to a Potential Cure for Severe Morning Sickness?

Imagine that you have food poisoning and are lying miserably on the bathroom floor. The only thing that can possibly cheer you at that moment is the knowledge that this will soon be over, and you will be feeling better again.

Now, imagine what it would be like if you did not get better in a day or two. What if you had food poisoning for months—perhaps even nine months?

That is what it is like to have hyperemesis gravidarum (HG), otherwise known as “severe morning sickness,” during pregnancy. Unlike the normal nausea and vomiting of pregnancy, which is difficult but not incapacitating, HG threatens a pregnant woman’s ability to gain weight, remain hydrated, and perform basic daily duties. While definitions vary, the Hyperemesis Education and Research Foundation (HER) describes the condition as causing 

continuous nausea and multiple episodes of vomiting throughout the day with few if any symptom-free periods, especially during the first three months. This may lead to rapid and/or significant weight loss, dehydration, and electrolyte disturbances often requiring hospitalization. 

HER goes on to explain that “If not treated promptly, methodically, and adequately, these [symptoms] can lead to fetal loss, and irreversible renal, neurologic, and hepatic damage, or even death.” The condition may also cause suicidal ideation in mothers and sometimes even leads to otherwise unwanted abortions due to a mother’s extreme suffering and the potential danger to her own life. As this all-encompassing illness dramatically limits a mother’s ability to work and to care for herself and any already-born children, she may also experience antenatal or postpartum depression (or both), as well as PTSD.

Sadly, HG is not as rare as one might think: while only an estimated 1-3% of pregnant women are hospitalized each year due to the condition, another 8% or more of pregnant women are estimated to suffer from it at home, with or without medical treatment. Often, the condition causes lasting damage to these mothers, their families, and even their babies, perhaps even leading some couples to avoid having more children due to the high likelihood of experiencing HG again, as it did for me and my husband as well as another couple we know.

I experienced HG first-hand through four pregnancies. The first time it happened, I was told to drink flattened cola and eat crackers and ginger. Among HG survivors, this is called being “crackered,” and it means you need to get yourself a better doctor than the one who said this to you, STAT. I finally found such a doctor in my third pregnancy, when my new obstetrician looked at me over his desk and said, ‘You’re really not functioning, are you?” and pulled out his prescription pad. After that, I continued to suffer, but I stopped losing weight and the vomiting quieted down. 

Fortunately, in an important medical breakthrough, researchers announced this past December in the journal Nature that they have identified the hormone that usually causes HG. Researchers believe that this hormone, GDF15, triggers either more or less vomiting and nausea during pregnancy based on the hormone’s levels in the mother’s bloodstream before and then during pregnancy. The study concluded that fetal production of the hormone and maternal sensitivity both play a role in determining who has tolerable levels of morning sickness, who has none, and who develops HG. Although other factors (such as the presence of the bacterium H. pylori) have already been linked to HG in subsets of sufferers, GDF15 seems to be implicated in a majority of cases.

Moreover, while work on how to use this knowledge to prevent or treat HG is only just beginning, researchers speculate that sensitizing the mother to the hormone before she conceives, perhaps through the use of existing medicines containing the hormone, may be effective. Parents around the country should rejoice to hear this news, which seems poised to lead to a considerable reduction in the immense suffering of HG and the losses of health and children that go along with it. 

I have two daughters who may one day become mothers, and I pray frequently that they will be spared the sufferings of HG that I know so well. With this new light on the horizon in HG treatment, mothers like me should take heart—it seems that our prayers are be being answered.

Dixie Dillon Lane is an American historian and essayist living in Virginia. Her writing can be found at Hearth & Field, Current, and Front Porch Republic, among other publications, as well as at her newsletter, TheHollow.substack.com.