Preconception experiences of women after hyperemesis gravidarum: a qualitative study

Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy with a high risk of recurrence in subsequent pregnancies. Little is known about how women with previous HG navigate the preconception period. To explore preconception experiences of women with previous HG. A descriptive qualitative study using semi-structured interviews was conducted with 41 women across Ireland who had experienced HG within the previous five years. Data were analysed using reflexive thematic analysis. Four themes were identified: [1] Anticipating pregnancy after HG , characterised by fear and recurrence expectation; [2] Pregnancy intentions and planning under the expectation of pregnancy sickness , where decisions were influenced by caregiving capacity, financial considerations, and partner perspectives; [3] Preconception preparation for HG , highlighting proactive pregnancy preparation; and [4] Preconception resources and support for HG , identifying psychological, practical, and peer-informed supports to improve pregnancy preparation. This study provides novel insights into the preconception experiences of women with previous HG. Fear of recurrence was evident, in addition to motivation to engage in preparatory health behaviours and contingency planning. Women frequently self-initiated support and relied on informal networks and private consultations, which highlight gaps in preconception care. HG impacts how women consider, plan and prepare for subsequent pregnancies. These findings highlight the need for preconception counselling to support women with previous HG, and guidance for women and their partners to better support with pregnancy planning, including physically, emotionally and financially.