Why Track Your Symptoms

When you are in the thick of pregnancy sickness, every day can blur into the next. You might feel too ill to think clearly, let alone recall exactly when your symptoms started getting worse, or how many times you were sick yesterday versus three days ago. This is completely understandable, and it is one of the reasons why keeping a symptom log can be so valuable.

Tracking your symptoms is not about adding another task to your already overwhelming day. It is about building a clear, honest picture of what you are going through, so that when you sit in front of your GP or midwife, you have something concrete to share. Too often, pregnancy sickness is minimised or dismissed. A written record makes it much harder for anyone to wave away what you are experiencing.

Benefits of Symptom Tracking

Better GP consultations. When you are feeling dreadful, it can be difficult to articulate just how bad things have been. You might downplay your symptoms because you are used to them, or because you feel pressure to be "coping." A symptom log removes the guesswork. You can hand your GP a clear record showing exactly how many hours of nausea you experienced, how often you vomited, what you managed to eat and drink, and how your mood has been affected. This gives your GP the evidence they need to offer appropriate treatment.

Identifying patterns. Are your symptoms worse in the morning or evening? Do certain foods trigger more vomiting? Does your nausea improve on days you manage to eat little and often? Are your worst days linked to stress, tiredness, or hormonal fluctuations? Without tracking, these patterns are almost impossible to see. With tracking, you may discover insights that help you manage your symptoms more effectively.

Monitoring severity over time. Pregnancy sickness can fluctuate. Some weeks may be worse than others. Tracking allows you to see whether your symptoms are stable, improving, or getting worse. This is particularly important if you are taking medication, as it helps your healthcare team assess whether your current treatment is working or needs adjusting.

Validating your experience. We want to say this clearly: your symptoms are real, they are significant, and you are not making a fuss. Sometimes, seeing your own experience written down in black and white can be validating in itself. If you have been told to "just get on with it" or that "everyone feels a bit sick in pregnancy," a detailed log is a powerful reminder, both to you and to others, that what you are going through is genuine and deserves proper care.

Supporting medication reviews. If you are already on anti-sickness medication, a symptom log helps your GP assess whether the medication is working. They can see the difference between your symptoms before and after starting treatment, or whether a dosage change has made any difference. This evidence-based approach leads to better treatment decisions.

Understanding PUQE Scoring

The Pregnancy-Unique Quantification of Emesis (PUQE) scoring system is a validated clinical tool used by healthcare professionals to assess the severity of nausea and vomiting in pregnancy. Understanding how it works can help you communicate with your medical team using the same language they use, and it gives a standardised way to measure how your symptoms change over time.

The PUQE score was developed by researchers specifically for pregnancy sickness because generic nausea scales did not capture the unique experience of NVP and HG. It is now widely used in clinical practice and research, and it is referenced in the RCOG (Royal College of Obstetricians and Gynaecologists) Green-top Guidelines for managing pregnancy sickness.

How PUQE Scoring Works

The original PUQE score assesses three key areas over the previous 12 to 24 hours:

• Hours of nausea per day — How many hours in the day did you feel nauseous? Rated from 1 (not at all) to 5 (all day)
• Number of vomiting episodes — How many times did you actually vomit? Rated from 1 (none) to 5 (seven or more times)
• Number of retching episodes — How many times did you retch or dry heave without actually vomiting? Rated from 1 (none) to 5 (seven or more times)

The three scores are added together for a total between 3 and 15. This total is then categorised:

Our symptom logger below uses a simplified adaptation of the PUQE system. It calculates an approximate severity indicator based on your nausea hours and vomiting episodes. This is not a formal clinical PUQE score, but it gives you and your GP a useful reference point for tracking changes over time.

Interactive Daily Symptom Logger

Use this form to log your symptoms each day. Your data is saved locally on your device only — it is never sent to any server, and no one can see it except you. You can log as often or as rarely as you need to.

Your Symptom History

Your logged entries appear below, sorted from most recent to oldest. All data is stored on your device only.

Weekly Pattern Analysis

Understanding your weekly patterns can reveal important trends. Are your symptoms getting better, worse, or staying the same? Is a particular day of the week consistently harder? Does your medication seem to be helping? The analysis below automatically updates based on your logged entries.

When reviewing your patterns, look for the following:

• Time-of-day patterns — Note whether your worst periods tend to be mornings, afternoons, or evenings (record this in the notes field)
• Food connections — Do certain foods consistently appear on better or worse days?
• Medication effectiveness — If you started or changed medication, can you see a before-and-after difference in your logs?
• Week-to-week trajectory — Is the overall trend improving as your pregnancy progresses?
• Mood and physical symptoms — Do your lowest mood days correspond with your worst physical symptoms?

Warning Signs That Need Immediate Attention

While tracking your symptoms, it is essential to know the red flags that indicate you need urgent medical help. Pregnancy sickness can escalate, and severe dehydration or malnutrition is dangerous for both you and your baby. Please do not wait for your next GP appointment if you experience any of the following.

• Unable to keep any fluids down for 12-24 hours. This puts you at serious risk of dehydration and you may need intravenous fluids.
• Very dark urine, or not passing urine for 8 or more hours. This is a key sign of significant dehydration that needs medical intervention.
• Severe dizziness, fainting, or feeling like you might collapse when standing. This suggests your blood pressure has dropped or you are significantly dehydrated.
• Blood in your vomit. Small streaks can sometimes occur from irritation but should always be assessed. Larger amounts need urgent attention.
• Severe abdominal or chest pain alongside vomiting. While some discomfort is normal, severe pain could indicate other conditions that need ruling out.
• Weight loss of more than 5% of your pre-pregnancy body weight. This is one of the diagnostic criteria for hyperemesis gravidarum and warrants medical review.
• A racing heart (palpitations) that does not settle. This can be a sign of dehydration, electrolyte imbalance, or other issues.
• Confusion, extreme drowsiness, or difficulty thinking clearly. These may indicate severe dehydration or nutritional deficiency.
• Fever above 38°C alongside vomiting. Vomiting with fever may indicate an infection rather than, or in addition to, pregnancy sickness.
• Feeling unable to cope, having dark or hopeless thoughts. Your mental health matters. If you are feeling desperate, please reach out to your GP, midwife, or call the Samaritans on 116 123.

How to Share Your Symptom Log with Your GP

Having a symptom log is valuable, but knowing how to present it to your GP makes it even more effective. Here are some practical tips for getting the most out of your appointment:

Use the GP Report feature. Click the "Generate GP Report" button above your history table. This creates a clean, formatted summary that is designed to be printed and taken to your appointment. It includes your symptom data, severity scores, a weekly summary, and space for your GP's notes.

Highlight your worst days. Before your appointment, look through your log and note the worst entries. Your GP needs to understand the full picture, including the very worst days, not just the average. It can be tempting to minimise when you are face to face, but your log gives an honest account.

Note what you have already tried. Your GP will want to know what you have tried and what has or has not helped. If your log shows you have tried ginger, dietary changes, acupressure bands, and they have not worked, that information supports the case for medication.

Be specific about impact. Numbers alone do not always convey the full picture. Use the notes field to record how your symptoms affect your daily life: "Could not leave the house," "Called in sick to work again," "Could not care for my toddler," "Spent the day crying." These details matter.

Bring a support person if you can. If you have a partner or family member who can accompany you, they can help advocate for you, especially if you are too unwell or emotional to push for the help you need. Show them your symptom log beforehand.

Know what to ask for. Based on your symptom severity, you might want to ask about anti-sickness medication, a medication change or dosage increase, a sick note for work, a referral to an obstetrician, or hospital admission for IV fluids if you are severely dehydrated. Our treatments page has detailed information about available medications.

Keeping a Food and Trigger Diary

Alongside your symptom log, keeping a note of your food intake and potential triggers can help you identify what makes your sickness better or worse. While pregnancy sickness is fundamentally hormonal and not caused by diet, certain foods and environmental factors can exacerbate or ease your symptoms.

What to Record

Use the "Foods Tolerated" and "Notes" fields in the symptom logger to capture this information. Over time, patterns may emerge that help you manage your days a little better.

• Foods you managed to eat — Even if it was just three crackers and half a glass of lemonade, write it down. On bad days, knowing what you have previously tolerated gives you options to try.
• Foods that triggered vomiting — If a particular food made things worse, note it so you can avoid it.
• Smells that triggered nausea — Cooking smells, perfume, petrol, certain rooms. Identifying triggers means you can try to avoid or minimise exposure.
• Times you ate — Some women find eating before getting out of bed helps. Others find eating small amounts every 1-2 hours prevents the empty stomach that worsens nausea.
• Temperature of food — Cold foods often have less smell and may be better tolerated than hot meals.
• Fluids — What you drank, how much, and whether you kept it down. Small sips of ice-cold water, flat lemonade, or ice lollies may work better than large drinks.

Remember, your food and trigger diary is a tool for you. There is no "right" way to eat during pregnancy sickness. If the only thing you can keep down is ice lollies and crisps, then that is what you eat. Survival eating is valid, and your baby will be fine. Speak to your GP or midwife about vitamin supplements if your diet is very restricted.

Emotional Wellbeing Tracking

Pregnancy sickness does not just affect your body. It affects your mind, your relationships, your sense of self, and your feelings about your pregnancy. The emotional impact of severe or prolonged sickness is often overlooked, but it is just as real and just as important as the physical symptoms.

The mood rating in our symptom logger is a simple but powerful tool. A pattern of consistently low mood scores is worth discussing with your GP or midwife, as pregnancy sickness can contribute to antenatal depression and anxiety. You are not being dramatic. You are not failing. Living with relentless nausea and vomiting is genuinely distressing, and it is completely normal to feel low, angry, resentful, or hopeless.

Feelings You Might Experience

All of the following are normal responses to pregnancy sickness. None of them make you a bad person or a bad mother:

• Guilt — For not enjoying your pregnancy, for not being able to care for existing children, for burdening your partner, for resenting the pregnancy. Guilt is almost universal among women with severe sickness. It does not mean you do not love your baby.
• Isolation — You may feel cut off from the world, unable to socialise, work, or participate in normal life. The loneliness of being housebound or bedbound with sickness is profound.
• Grief — For the pregnancy experience you imagined, for the weeks or months lost to illness, for the impact on your relationship and your life.
• Anxiety — About your baby's health, about whether the sickness will ever end, about money if you cannot work, about future pregnancies.
• Anger — At people who minimise your experience, at a healthcare system that sometimes fails women with pregnancy sickness, at the unfairness of it all.
• Regret or ambivalence — About the pregnancy itself. This is more common than anyone talks about, and it does not mean you do not want your baby. It means you are suffering, and you deserve compassion, not judgement.

Tips for Supporting Your Emotional Wellbeing

• Be gentle with yourself. Lower your expectations. Surviving is enough right now.
• Stay connected where you can, even if it is just a text message to a friend or an online forum.
• Accept help. Let people bring food, do housework, or look after older children.
• Limit social media if other people's "glowing pregnancy" posts are making you feel worse.
• Remind yourself that this is temporary, even if it does not feel that way right now.
• Consider speaking to a counsellor who understands perinatal mental health.
• Use the notes field in the tracker to express how you are feeling each day. Writing it down can help.

Read our detailed mental health guide for more support on the emotional impact of pregnancy sickness.

Printable Symptom Diary Template

If you prefer pen and paper, or if you want a backup alongside the digital tool, you can print the template below. It provides a structured format for one week of symptom tracking that you can fill in by hand and take to your GP appointment.

To print, click the button below or use your browser's print function (Ctrl+P or Cmd+P). The page is formatted so that the diary prints cleanly on A4 paper.