What NOT to Say to Someone with HG and What to Say Instead

If a friend or family member has HG (hyperemesis gravidarum), you may not know what to say. They may not know what to say. You know they’re struggling. You want to help. But you should also know that the woman with HG (or anyone else going through a physical illness, mental trauma, or any other big change for that matter) is extra vulnerable right now. She may be lonely or depressed. She may have anxiety. She may be struggling with her own self-esteem. She’s probably trying really hard to be cheerful, but is secretly crabby because she feels awful a lot. She feels vulnerable. She may get defensive. And all of that is totally normal.

So how can you, as a friend, approach her? How does an outsider wade through all those eggshells?

Well I have a few tips from my own, personal experience.  These are all real-life examples.  But please know, this post is about love and communication.  I’m sharing these experiences, not to chastise anyone who said these things, but to encourage us to be open with each other.  I’m hoping that these anecdotes can help us to understand one another and communicate more effectively.  This post is written for people who aren’t struggling with HG, so it may seem like it’s all about you.  But that doesn’t mean the communication is one-sided.  Those with HG have a lot of processing to do, so that we can understand well-meaning comments through the lens of HG.  I truly love most of the people who made these comments to me.  And I was able to get over my own assumptions about all of these comments within a few days.  So don’t worry if you’ve made these comments to me or to another friend with HG.  The point of this post is to look into each other’s minds and communicate a little better next time.  So, without further ado, read on for the do’s and don’ts of talking to someone with HG:

1. Don’t ask how she’s feeling. I know you mean well.  I know this is such a basic question it just pops out.  But there is really no good way for someone with HG to answer this question.

Scenario 1: “How are you feeling?”

“Fine.” That was a lie. I hate answering with a lie.

Scenario 2: “How are you feeling?”

“A little better today!” This is true, but it often causes problems for the person with HG down the road. I’ll explain more in the next tip.

Scenario 3: “How are you feeling?”

“Awful.” While this is true, it puts you in an awkward position. You weren’t expecting that answer. What do you say next? Do you ask more about it? It puts me in an awkward position too. I don’t really want to talk about all the TMI things that make my day awful.

Instead say: “I know you’re probably still not feeling great. Let me know if you need anything.” It’s safe to assume she’s not feeling great. By not asking, she will know you care but won’t stress about what on Earth is the appropriate thing to say. And she’ll correct you once she’s getting better, so assume away and she’ll let you know when she’s in the clear.

2. Don’t say: “I thought you said you were feeling better.”

I’ve heard this dozens of times already. Yes, I said I was feeling better that day. Because that was a good day and I was feeling better. I ate a whole cup of food, I only vomited a few times, and I even got up the energy to leave the house for a few hours. For someone with HG, that is a phenomenal day. But I’m not the weatherman, and that wasn’t a forecast.

Honestly, hearing “I thought you said you were feeling better?” makes me feel like I’m on trial. The person asking the question is cross-examining me and they’re using my prior testimony to impeach me or something. In short, it feels pretty hostile. I know that’s me being defensive and vulnerable. But if your friend has HG, she’s probably feeling defensive and vulnerable too. So if a friend has HG, remember that there are good days and bad days. Lots of bad days will come after the days where she says she’s feeling a little better, so don’t be surprised or assume something is wrong when they do.

Instead say: “Bad day, huh? Well you’ve made it this far. Take it one day at a time.” When a friend felt better, and now feels awful again, all she needs is support. Trust me, she was secretly hoping that good day she had was an omen for good times to come. She probably got her hopes up that maybe the HG was finally over, especially if she’s between 12-20 weeks, when HG can sometimes subside IF it’s going to subside at all. And when she started vomiting again at 2 am or 5 am or whenever, she probably had those hopes dashed and had a good, pity-party cry. Don’t question her. Just let her know you’re there and that she’s going to make it.

3. Don’t tease her about her schedule.

If your friend is cancelling all her social engagements and is suddenly AWOL, or if she’s calling in sick to work way too much, or if she’s taking a million bathroom breaks, it’s probably related to the HG. So please don’t say “You finally left the house!” when she does get out.

I had a coworker tease me about my schedule and how often I was in the bathroom. “Even when you’re here in the office, you’re never here in your office!” He was just joking, but that was so hard to hear. First, I was furious. “Can’t I even go to the bathroom at work without being hounded?” Then, I was anxious. “I’ve missed so much. I’m going to get myself fired if I keep being sick.” Then, all of the sudden, I was just exhausted. Physically and emotionally. I closed my office door and cried. I went to my car and slept during lunch. I couldn’t pull it together. I left work early that day. And I felt like trash.

I hadn’t even gone to the bathroom that morning to urinate. I went to throw up. Again. I had thrown up all morning at home (like every 15-30 min.). I’d thrown up in my car. (I keep a bucket and a towel in my car at all times now.) And I’d thrown up in the parking garage as soon as I got to work that morning. It took everything I had just to be there, then I ran to the bathroom to vomit again, and came back to an ill-timed joke. It was the straw that broke the camel’s back that day. Luckily, it was a Friday, so I had the whole weekend to process how freaked out I was by that one joke. Your friend is unbelievably sensitive right now. Combine pregnancy hormones with the grumps from feeling sick and exhausted all the time, then sprinkle on some self-esteem issues, depression, and/or isolation, and that’d be about right. Just avoid the teasing for now.

Instead say: If your friend is cancelling all her social engagements, calling in sick, or taking a million bathroom breaks, just ask if she needs anything. Maybe you can grab her a soda-water, or cover her shift for a few minutes, or drop off some new movie you liked for those nights she’s stuck at home.

4. Don’t comment on what she is able to eat.

The other night, a dear friend of the family saw me eating a bean burrito. And he said “I thought you couldn’t eat anything?” Again, it felt like I was being cross-examined. He sounded like he’d caught me doing something wrong.

While on meds, there are a few small windows most days when someone with HG feels up to eating something. Even on meds, there are some days she can’t eat anything. Without meds, that’s pretty much every day. Whatever type of day it is, if she wants to try and eat something, that’s good. Women with HG need to eat whenever they possibly can whenever they possibly can just to try and slow or stop the weight loss. Doctors advise women with HG to eat small meals all day, to snack in the night, and to eat even when you feel like it’ll probably come back up. So when a friend with HG is eating, it doesn’t mean the HG is over. It doesn’t even mean she’s feeling better.  But commenting on it makes her feel like she’s being judged for what and when and if she can eat.

Instead say: When a friend with HG is eating, we don’t really need to say anything at all. If we wanted to, you could ask if any foods help or what she eats most often now.

5. Don’t diagnose the cause of her HG.

I’m vegan. And so many friends have said “You’re so sick because you’re vegan.” And “have you tried eating meat?” To answer that question, yes. I was so desperate to feel better that I switched to eating meat almost daily for a couple months. Not only did I not feel better, I actually felt much worse. I was violently ill more often during that time period. I was more emotional. I was constipated on top of everything else (a side effect from the meds that is way worse when eating meat). So betraying all my values to try and feel better did not help at all and was so not worth it. #neveragain


Millions of women in the U.S. get HG and 99% of them eat meat. There’s no link whatsoever to veganism. In fact, some studies claim that morning sickness is actually caused by eating meat:

I’m proof those studies aren’t true either, since here I sit, a vegan with HG. But anecdotes aren’t evidence.

Your friend may have terrible eating habits, or chronic stress, or be obese, and you may be thinking that the HG must be related to those things. But we have to remember that there are skinny women with HG, fit women with HG, healthy women with HG, and totally zen women with HG. In reality, the cause of HG is unknown.

Whatever the cause, try to avoid saying that a friend’s HG is due to X reason. Like I mentioned above, your friend is already feeling vulnerable. You might just be trying to help. But a comment like “This is because you’re doing or did X.” sounds like you’re implying that she somehow is making herself this sick through her current or former choices. When people say that to me, it sounds like they’re blaming me for my being sick. And again, I feel defensive. And it totally wounds my self-esteem.

Instead say: We can just let the doctors and researchers figure out the “why” while we focus on the “how I can help.” 🙂

6. Don’t offer remedies unless you’re familiar with HG.

Your friend with HG has probably already Googled and tried every home remedy under the sun. She has a team of doctors already telling her what’s working for other women with HG (i.e. drugs like Zofran, Phenergan, & Diclegis).

Also, morning sickness remedies don’t usually work for HG. Like, at all. Plus, you are probably the 80th person to tell her to eat crackers before getting up, or small meals of protein throughout the day. Here’s the thing: you can’t really eat crackers when you wake up if you’re awakened by projectile vomiting at 3 am. And, with HG, you can eat all the small protein meals in the universe and you will still throw up every 15-30 minutes some days, no matter what you try to eat. Because HG is different from morning sickness, it requires different remedies.

Some suggestions are helpful. Pedialyte is used to treat dehydration, which makes it an awesome preventative suggestion for a woman with HG. For me, smelling or drinking peppermint can postpone vomiting for a little while, but it doesn’t totally prevent it. Soda water is sometimes nice when straight water is too hard on my stomach and won’t stay down. Um… besides that, it’s really just the drugs. Ginger, lemon drops, Preggie Pops, crackers, ginger ale, protein snacks, etc. do absolutely nothing to help.

Don’t feel like you have to offer suggestions or try to fix things. If you have experience with HG, then I’m sure your friend would love some advice. But if something helped your mild to moderate morning sickness, it probably won’t help your friend with HG.

Instead say: “Here, I brought you some Pedialyte. Call me when you run out, and I’ll bring some more.” 🙂

What do you think?  Has anyone said anything to you while you’re sick that you took the wrong way?  What would you like to say to someone with HG who is having a hard time with her reactions?  Tell me in the comments below!