She was only 25, a bright young salesgirl in a bustling Kochi clothing store. Every morning, she would steel herself before stepping out of the staff room, hoping the waves of nausea would spare her just long enough to greet customers with her usual smile. But by mid‑morning, she’d be leaning over the washbasin, exhausted, embarrassed, and frightened. Her colleagues whispered that it was “just morning sickness”, but she knew something wasn’t right. She couldn’t keep food down, felt dizzy all day, and had begun missing work. Eventually, she landed in the emergency department—dehydrated, drained, and desperate for relief.
Her story is far more common than we realise.
Pregnancy sickness—ranging from everyday nausea to the severe condition called hyperemesis gravidarum—affects women across India, often silently. And while families may dismiss it as a “normal part of pregnancy”, the truth is more nuanced, more human, and more deserving of understanding.
What exactly is pregnancy sickness?
Most pregnant women experience nausea and vomiting, usually starting between the 4th and 7th week. Despite the nickname 'morning sickness', it can strike at any hour. For 9 out of 10 women, it settles by around 20 weeks.
Scientists believe pregnancy hormones—especially a placenta‑produced hormone called GDF‑15—play a major role. Some women naturally produce higher levels of it, making them more prone to severe symptoms.
You’re more likely to experience pregnancy sickness if:
• you had it in a previous pregnancy
• you’re carrying twins or triplets
However, doctors also keep an eye out for other causes of vomiting, especially if symptoms start after 16 weeks or are accompanied by abdominal pain, fever, or urinary discomfort.
When it becomes severe: Hyperemesis Gravidarum
Hyperemesis gravidarum (HG) is the extreme end of pregnancy sickness. It affects up to 3 in 100 women, and it’s far more than 'feeling queasy'.
HG can make it impossible to eat or drink normally. Women may lose weight rapidly, feel faint, and become dehydrated. Signs of dehydration include:
• feeling unusually thirsty or dry
• passing very dark urine
• feeling drowsy or unwell
About 1 in 5 women with HG may need hospital care.
The emotional toll
Pregnancy sickness doesn’t just affect the body—it affects life.
Women often describe feeling:
• frustrated or helpless
• unable to work or manage household responsibilities
• socially withdrawn
• anxious or depressed
Support from family, friends, and health care professionals can make a world of difference. If the emotional strain feels overwhelming, speaking to a doctor or counsellor is important.
Does it harm the baby?
Mild to moderate nausea and vomiting do not harm the baby.
In severe cases or untreated HG, babies may have a slightly lower birthweight. Doctors may recommend growth scans later in pregnancy to ensure everything is progressing well.
Practical ways to manage symptoms at home
Many women can manage early symptoms with simple strategies:
• Eat small, frequent meals.
• Choose bland, easy‑to‑digest foods—rice, potatoes, toast, plain biscuits.
• Avoid strong smells or foods that trigger nausea.
• Sip fluids regularly, even if you can’t tolerate large amounts.
If symptoms interfere with daily life, it’s time to see a doctor.
When symptoms don’t settle
Your doctor may arrange a hospital assessment, which could include:
• a discussion about your symptoms, weight changes, and what you’re able to keep down
• checking your temperature, pulse, blood pressure, and hydration
• urine tests for infection
• blood tests
• an ultrasound scan (especially if you haven’t had one yet)
Hospital admission may be needed if you’re dehydrated, unable to keep fluids down, losing weight rapidly, or have abnormal test results.
What happens in hospital?
Treatment focuses on stabilising you and helping you recover:
• IV fluids to correct dehydration
• anti‑sickness medicines
• thiamine (vitamin B1) to prevent complications
• acid‑reducing medication
• compression stockings and sometimes heparin injections to reduce the risk of blood clots
• stopping iron tablets temporarily if they worsen nausea
Once symptoms improve, you’ll slowly return to eating and drinking normally.
Anti‑sickness medicines: What you may be offered
Doctors have several safe options for pregnancy:
• Doxylamine + pyridoxine (Vitamin B6) slow‑release tablets
• Cyclizine, prochlorperazine, chlorpromazine, promethazine
• Metoclopramide, domperidone, ondansetron (usually used if first‑line medicines don’t help)
In very severe cases, corticosteroids may be considered. They are reserved for women who haven’t responded to other treatments and have significant weight loss or dehydration.
Doctors weigh the benefits carefully, and for many women, steroids provide relief when nothing else works.
After discharge: What to expect
You’ll be sent home with anti‑sickness tablets. As you improve, you can reduce them gradually. If symptoms worsen again:
• pause solid food
• continue sipping fluids
• keep taking your prescribed medicines
If dehydration returns, contact your doctor immediately. Women who continue to have severe symptoms after 20 weeks may be offered additional scans to monitor the baby’s growth. Most importantly, remember: symptoms almost always improve after delivery.
Emotional support matters
Pregnancy sickness can be isolating. If you feel overwhelmed, anxious, or depressed, reach out to your healthcare team. Support may include counselling, peer groups, or community organisations. No woman should feel alone while navigating this.
Pregnancy sickness is common, but its impact is often underestimated. While most women experience mild symptoms that settle by mid‑pregnancy, a small but significant number face hyperemesis gravidarum—a severe condition that can disrupt daily life, work, and emotional wellbeing.
Safe and effective treatments are available, and hospital care may be needed for dehydration or severe symptoms. With timely medical support, practical strategies, and emotional care, women can navigate this challenging phase safely. Symptoms usually improve after childbirth, and recovery is the rule, not the exception.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
