Downloadable Resources & Printable Guides

Opening the Conversation

Start with a clear, factual summary. GPs see many patients and respond well to specific, measurable information:

• "I am currently [X] weeks pregnant. I am vomiting [X] times per day and experiencing constant nausea that prevents me from [eating/drinking/working/caring for my children]."
• "I have lost [X] kg/pounds since my sickness began. I am struggling to keep down fluids and I am concerned about dehydration."
• "My symptoms are significantly affecting my ability to function day to day. I would like to discuss treatment options."

Phrases That Work

If you feel dismissed or told that sickness is "normal," these phrases can help redirect the conversation:

• "I understand that some nausea is common in pregnancy, but what I am experiencing goes beyond that. I am unable to [specific impact]."
• "I have tried [list what you have already tried: ginger, small meals, wristbands, rest]. These have not been sufficient. I would like to discuss anti-emetic medication."
• "I am aware that medications such as cyclizine, prochlorperazine, and ondansetron are considered safe in pregnancy and are recommended by RCOG guidelines. Could we discuss whether any of these would be appropriate for me?"
• "I would like my ketones tested today, please."
• "Can you refer me to the Early Pregnancy Unit or arrange IV fluids if my oral intake continues to be inadequate?"
• "I would like this conversation and my symptoms documented in my medical notes."

Advocating for Yourself

You have the right to be taken seriously. If you feel your concerns are being minimised:

• "I do not feel my symptoms are being adequately managed. What else can we try?"
• "I would like a second opinion, please."
• "I have been reading the RCOG Green-top Guideline on hyperemesis gravidarum. It recommends a stepwise approach to anti-emetic treatment. Can we follow that pathway?"
• "I am struggling mentally as well as physically. The severity of this sickness is affecting my mental health."

Before You Leave the Appointment

• Confirm what medication has been prescribed, the dosage, and how often to take it.
• Ask: "If this medication does not help within [X] days, what is the next step?"
• Ask: "At what point should I go to A&E?"
• Request a fit note if you need time off work.
• Ask for a follow-up appointment in one to two weeks.

Essentials

• Maternity notes and any medication lists
• Photo ID and NHS number
• Phone and charger (long cable recommended)
• Headphones or earbuds
• Sick bags (hospital ones can be hard to find quickly)
• Current medications in original packaging

Comfort and Hygiene

• Unscented wet wipes (strong smells can trigger vomiting)
• Unscented lip balm (dehydration causes painful dry lips)
• Mouthwash (rinse after vomiting rather than brushing immediately)
• Dry shampoo (unscented if possible)
• Hair ties or a headband to keep hair back
• Loose, comfortable clothing (nothing tight at the waist)
• Warm socks and a light cardigan (hospitals are cold)
• Your own pillow and pillowcase (familiar smells can be comforting)
• Eye mask and earplugs (hospital wards are noisy and bright)

Food and Drink (If Tolerating Anything)

• Your current "safe" foods in sealed containers
• Ice lollies (ask a partner to bring these in)
• Straws (sipping is often easier than drinking)
• A refillable water bottle
• Mints or boiled sweets if tolerated

Emotional Support

• A comforting item: a photograph, a soft blanket, or a letter from a loved one
• A notebook and pen (for tracking symptoms, writing questions for doctors, or simply processing feelings)
• Printed list of key phone numbers (in case your phone battery dies)
• This resources page, printed, for reference

What Helps

• Believe her. The sickness is real, it is severe, and she is not exaggerating. This is the single most important thing you can do.
• Take over household tasks. Cooking, cleaning, laundry, shopping, childcare. Do not wait to be asked. Just do it.
• Keep her environment clean and smell-free. Take out the bins regularly. Cook when she is in another room or not at home. Use unscented products.
• Keep water, sick bowls, and her safe foods within her reach at all times. Replenish them without being asked.
• Attend GP and hospital appointments with her. She may be too unwell to advocate for herself. Be her voice if needed.
• Listen without trying to fix. Sometimes she needs to say "this is unbearable" and hear "I know, I'm sorry, I'm here" rather than solutions.
• Protect her from unhelpful comments from well-meaning family and friends. Be her gatekeeper.
• Acknowledge what she is going through. Say: "You are doing an incredible job. This is not your fault."

What to Avoid

• Do not suggest ginger, crackers, or positive thinking as cures.
• Do not compare her to other pregnant women or say "my mum was fine."
• Do not imply she could try harder, eat more, or "push through."
• Do not cook strong-smelling foods without warning or use heavily scented products.
• Do not express frustration about the impact on your life in her presence. Your feelings are valid, but find a separate outlet -- a friend, a helpline, or our partners page.
• Do not minimise. "It's just morning sickness" is the most damaging phrase she can hear.

When to Seek Emergency Help (Call 111 or Go to A&E)

• She has not kept any fluids down for more than 12 hours.
• Her urine is very dark or she has not urinated for 8+ hours.
• She is dizzy, confused, or fainting.
• She has blood in her vomit.
• She is expressing thoughts of self-harm or despair.
• She has a high temperature alongside vomiting (possible infection).

Week beginning: ________________   Weeks pregnant: ________________

Nausea scale: 1 = mild, barely noticeable. 5 = constant and debilitating but not vomiting. 10 = the worst you have experienced, unable to function at all.

Urine colour guide: Pale straw = well hydrated. Dark yellow/amber = dehydrated. Brown or very dark = seek medical attention urgently.

Weekly summary for GP: Total vomiting episodes: _____ | Weight this week: _____ | Ketones (if tested): _____

Questions to Ask Your GP About Medication

• "What are the possible side effects, and what should I do if I experience them?"
• "Can I take this medication alongside [other medication]?"
• "If this does not work, what is the next option we can try?"
• "Should I take this with food or on an empty stomach?"
• "Is there an alternative form (liquid, dissolvable, injection) if I cannot keep tablets down?"
• "How long should I wait before deciding this medication is not working?"
• "Is it safe to combine two anti-emetics if one is not sufficient on its own?"

Phased Return Schedule

Adjust this schedule to suit your situation. Some women need a longer phased return, and that is completely reasonable.

Ongoing Reasonable Adjustments to Request

• Flexible start and finish times to accommodate fluctuating symptoms.
• Option to work from home on difficult days.
• Desk located near toilet facilities.
• Access to fresh air and the ability to step away when needed.
• Regular breaks for eating, drinking, and taking medication.
• Exemption from duties involving strong smells, excessive heat, or prolonged standing.
• Understanding that symptoms may return or worsen unpredictably.
• Continued recording of any sickness absence as pregnancy-related (not counted in absence management procedures).

Review Process

Schedule a review meeting with your manager at the end of each week of your phased return. Use this to discuss:

• How you are managing the current workload and hours.
• Whether any adjustments need to be changed or extended.
• Any concerns or challenges you have encountered.
• Confirmation of the plan for the following week.

Severe When Very Little Stays Down

Focus on hydration and tiny amounts of anything tolerated. No pressure to eat "properly."

• Ice chips or ice cubes made from diluted squash
• Ice lollies (shop-bought or homemade from juice/squash)
• Tiny sips of flat lemonade through a straw
• Jelly (ready-made pots are convenient)
• A single plain cracker or breadstick
• A spoonful of yoghurt
• Watermelon cubes (high water content)
• Frozen grapes
• A boiled sweet held in the mouth

Moderate When Some Food Stays Down

Small amounts, frequently. Cold foods are often better tolerated because they have less smell.

• Plain toast or bread (white is often easier)
• Marmite on toast (if the smell does not trigger nausea)
• Plain crisps, especially salt and vinegar or ready salted
• Plain pasta with a tiny amount of butter
• Rice cakes
• Cereal with cold milk
• Plain biscuits (Rich Tea, digestives)
• Cheese sandwiches (cold)
• Tinned peaches or pears
• Mashed potato (made plainly)
• Apple slices
• Cold pizza (many women report this as a safe food)

Mild When You Can Manage Small Meals

Gentle, plain meals. Avoid greasy, spicy, or heavily flavoured foods if they trigger nausea.

• Jacket potato with beans or cheese
• Plain chicken with rice
• Soup (lukewarm rather than hot reduces smell)
• Scrambled eggs on toast
• Pasta with a simple tomato sauce
• Fish fingers and chips
• Beans on toast
• A small portion of shepherd's pie or cottage pie
• Sandwiches with mild fillings
• Porridge (if tolerated)
• Fruit smoothie (made with banana, yoghurt, and milk)

Week beginning: ________________   Weeks pregnant: ________________

Mood scale: 1 = deeply low, struggling to cope. 5 = managing but finding it difficult. 10 = feeling positive and hopeful.

Anxiety scale: 1 = calm. 5 = moderately anxious. 10 = overwhelming anxiety or panic.

Weekly Reflection

• One thing I managed this week that I am proud of: ________________________________
• Something that helped me feel better (even briefly): ________________________________
• Something I need more help with: ________________________________
• A kind thing someone did for me: ________________________________

Support Contacts