Preventing hyperemesis gravidarum (severe pregnancy sickness)

This post is about how I avoided horrific, debilitating pregnancy sickness this time around. Most people will have no interest here, but I would love to help other sufferers so please send them this post! This info is really hard to find and, in my experience, doctors and obstetricians do not have the answers and advice that sufferers need!


So, at 25 weeks pregnant and distinctly less sick that I was last time with full-blown Hyperemesis Gravidarum (HG), I'm ready to share the steps that I took to help avoid HG this time. 

Like most HG sufferers, my GP and Obstetrician had all told me that there was nothing I could do to ever prevent or lessen HG. On hearing that my mum had it for all her pregnancies, and that I had it with Ella, they gave me about a 90-100% chance of experiencing HG for all my pregnancies. Also like most HG mothers, this bought on feelings of panic and anxiety and a bit of post-traumatic stress when it came time to think about having another baby. I started freaking out and my desperate researching led me to a facebook group called Preventing Hyperemesis Gravidarum. And within that support group of desperate, determined and traumatised women was where I found all the answers that medical professionals had not been able to give me. I implemented all their suggested techniques based on their own experiences for what helped. There was gold here that I'd not come across anywhere else, and for the most part, it worked.

Here's the protocol I followed PRE-PREGNANCY:

As many months before pregnancy as possible (for me I had about 3 months of prep before conceiving, but use whatever length of time you have) I took the following:

1. Magnesium  
  • Liposomal Magnesium. This is a liquid and is the only form of magnesium that doesn't cause stomach upset. It was worth every cent. Side note - I slept AMAZINGLY once I started on this and even found it successfully treated and prevented my migraines which I normally rely on strong drugs for.
  •  I also purchased Ethical Nutrients Mega Mag magnesium tablets for once I was pregnant, knowing that I may not be able to stomach the taste of the liquid mag once pregnant. I was right.
  • Another note: I was advised to avoid magnesium oxide and magnesium citrate. It comes in heaps of forms and some are more bio-available than others. The ones above are good.

2. B vitamins
 The most important ones are:
  • B6, in the form of "P-5-P" is best. I got my P-5-P here.
  • B1 also known as thiamine.
  • B12 in the form of cobalamin NOT the synthetic form cyanocobalamin which many brands use and literally contains cyanide.
To get my these I took:
  • Biobalance bio-active B complex (this covered all the above forms)
  • An extra B1 supplement (I used Solgar brand. I could probably just have used the one above but wanted extra)
  • Extra folate - folic acid is compulsory for NZ preggos and I opted for the form 'folate' which is absorbed by more people. (It's complicated but see here about MTHFR gene mutation.)

3. For gut health - important.
  • Fermented Cod Liver Oil - "Blue Ice" from Green Pastures brand. Also comes in flavours and capsules. This is a superfood for your health and contains co-enzyme Q10 and vitamin K which are great for HG prep, apparently.
  • Eating fermented foods. I just bought a can of sauerkraut and forced myself to eat some most days.   
  • I also took L Glutamine occasionally as this is healing for the intestine. There are some theories that gut health is the root cause of many other problems, which can be the root cause of HG, so I was just trying to cover my bases here!

4. For the liver - also important.
Your liver is what processes your hormones and cleans your blood. I have ALWAYS mocked liver cleanses and such as it seems stupid to me - your liver's job is to clean you so why on earth is there this trend to 'cleanse' your liver?!! 
BUT, while I don't trust many 'liver cleanses' you find online I have come to realise the vital role of optimising our liver performance if you suffer from HG. We get HG because our bodies react to the excessive hormones of pregnancy - both oestrogen and Human Growth Hormone. If your liver can't keep up with processing and flushing them, you have more of these hormones in your system and therefore are more sick.

I took:
  • I attempted turmeric capsules and milk thistle capsules as these are both liver wonder foods. Most people can handle them but they made me feel really ill (constant cramps, wonky cycles, stomach upset etc) so I stopped.

5. Diet. 
I adopted a Paleo style diet that was grain free, sugar free, dairy free and refined-carb free. To be honest, once I had it going it was much easier than it sounds. The key for me was doing a grocery shop beforehand and making sure I had all the healthy alternatives I needed - I kept lots of nuts, seeds, a little dried fruit, and organic cocconut sugar on hand for emergencies! I found Danielle Walker's Against All Grain" cookbook and blog invaluable during this time. 

Again, these diets are something I was previously skeptical of (or more like, openly mocking) but after reading so many stories of people overcoming terrible conditions with it, and now my own experience of avoiding HG, I'm all for it!

6. Prayer.
I had done all this work but couldn't shake the feeling that some part of my prep was missing. One day some of the amazing women at our church offered to pray for me and, say what you like, but for me that the missing piece and made all the difference.

Also, not as important but I purchased some unscented shampoo and conditioner from Amazon!

P.S how daunting does this look!? I ordered so may supplements before figuring out those that I really needed and were best (listed above).

OKAY, Now for PART 2, once you are pregnant!

 1. Drop all liver cleanse supplements over ovulation and then once you are pregnant. Most of them are not safe for pregnancy.

2. Magnesium - continue taking in whatever form you can stomach. I bought a magnesium spray that you can spray directly to the skin and is them absorbed into the bloodstream. It works immediately to counteract nausea and is great if swallowing is tough.

3. B vitamins - continue taking. Make sure you have enough B6 (in form P-5-P) and even take this separately if you can.

4. Fermented food, probiotics - continue taking for as long as you can stomach it.

5. DOXYLAMINE SUCCINATE - (known under brand names 'Diclegis'. 'Unisom', 'Restavit' and 'Diclectin' depending where you live.) this is an anti-histamine that combats nausea IF you begin taking it from the time of a positive pregnancy test. Obviously a doctor can't prescribe you something before you even have symptoms, but this needs to be taken BEFORE the nausea begins. It builds up in your system and for many people, like me, successfully prevents the nauea taking over. You can't get doxyamine in New Zealand but there is an easy solution - buy it on Amazon. The cheapest brand I found is called "Kirklands Sleep Aid". Yes, it's also used as a sleeping pill and will make you drowsy the first week until you adapt. But IT'S WORTH IT. I was on ondansetron throughout my entire pregnancy with Ella and it stopped me vomiting as much, but didn't lower the debilitating nausea. It also has hideous side effects. For me, I have only needed doxylamine to combat nausea and vomiting this time.

6. Eat what you can. By week 6-7 I ditched the diet and ate carbs every 40 mins as that was the only thing that (combined with the supplements and doxylamine) quelled the nausea I was experiencing. 

From there on I've had a completely different pregnancy to my HG hell when pregnant with Ella. I haven't had to put my 2 yr old into full-time care, and I've been able to do normal activities.
I avoided cooking and preparing food for the first 20 weeks as that made me feel super queasy, but now at 25 weeks I can handle being in the kitchen again. My quality of life has been retained and I feel so lucky!

If you know someone who has suffered Hyperemesis or severe morning sickness please forward them here because this info is REALLY HARD TO FIND outside of the facebook support group/s. And get them to join the FB group 'Preventing Hyperemesis Gravidarum' too because it's filled with advice and empathy from hundreds of us experiencing the same thing.

Would I do anything different in a future pregnancy?
Since this experience I've heard positive things about
1) Continuing with a low-carb diet throughout the pregnancy and eating/drinking heaps of protein. I DID notice that after sugary foods I felt nauseated, but at the same time, the thought of eating low-GI foods like kumara (sweet potato) or any type of meat was also nauseating. I think *IF* I ever had another baby I would attempt to include more protein shakes. In my first pregnancy, I lived (literally) of "Up'n'Go" drinks for several weeks at a time when I could not ingest any other thing. They kept me alive and in hindsight it could be the amount of protein? Not sure.
2) Continuing with fermented foods e.g. sauerkraut through the pregnancy. I've heard people swear this helps, I just couldn't bring myself to do it.
3) Using the supplement L.Carnitine.
4) I've also seen that CoQ10 is available as a straight supplement here, if that's easier than the fermented cod liver oil. This is my favourite health brand.


  1. This is so great Amy! Will be use to pass along to any women I come across at work. Also really interested that you could get the doxylamine from the US, no problems with customs? I think it is available in NZ but hard to find (I had to look it up on Medsafe website to check!). So glad you're feeling much better this time round x

  2. Hi, Amy! I saw your article posted in the Preventing HG Facebook Group, and popped over to check it out. THANK YOU!! I am planning to incorporate your suggestions into my own pre-conception protocol. I have usually focused on diet rather than supplements, because I find supplement selection so overwhelming. I really appreciate that you took the time to list out and photograph your supplements - that is super-helpful. Congratulations on a non-HG pregnancy!! I will plan to link your article from my own blog soon.


  3. Thank you for this. During the 3rd trimester of my 3rd HG pregnancy I noticed a huge difference in my energy levels and nausea by removing grains from my diet.

  4. I stumbled upon this post while searching the internet on how to prevent HG in my next pregnancy. Your post reminds me of my first pregnancy, nearly everything you describe happened to me and more. I had a ruptured esophagus, and looked anorexic towards the end of my pregnancy. I had to work really hard to keep food down in my second pregnancy. I would eat and then chew gums to distract myself. I would chew about 20-30 gums in a day. It helped distract my mind. I could not enjoy either of my pregnancies due to the nausea. I am looking forward to having one more baby before I give up. Thanks for writing this post! I have already requested to join the FB group that you mentioned. Wishing myself and other women out there good luck with their pregnancies! x


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