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The HG Care Hub™ · For Workplaces

The HG Workplace Center™

Whether a woman keeps her job through Hyperemesis Gravidarum is usually decided in one conversation.
Hyperemesis Gravidarum is a serious pregnancy complication that can make work impossible for weeks or months at a time. Most employers want to help and simply do not know what the condition is or what good support looks like. This center exists to answer both — briefly, practically, and without asking you to become a clinician or a lawyer.
Human Resources Managers Employees
Before you begin
What this center is — and what it is not.
These resources are educational. THON is not a law firm and is not your employees' healthcare provider. Nothing here is legal advice, and nothing here replaces clinical judgment. Employment protections for pregnancy-related conditions vary considerably by jurisdiction — confirm your specific obligations with qualified employment counsel.
What we can offer is the part most employers are actually missing: a clear explanation of the condition, and practical tools for the conversations, the accommodations, and the return to work. Compassion is not a compliance exercise. It is mostly a matter of knowing what to say and writing things down.
Educational • Practical • Not Legal or Medical Advice
Understanding the condition
Ten minutes of understanding prevents most of what goes wrong.
Hyperemesis Gravidarum involves persistent, severe vomiting, dehydration, weight loss, and an inability to keep down food or fluids. It affects an estimated 0.3 to 3 percent of pregnancies, frequently requires medication, and often requires intravenous fluids or hospital admission. It is understood to be biologically driven — it is not caused by stress, attitude, or anything the employee is doing wrong, and it cannot be managed by determination.
It is not
Morning sickness
It does not reliably end at twelve weeks. For a significant number of women it continues throughout pregnancy.
It is not
A question of resilience
She is not coping badly with a normal pregnancy. She is coping with a medical condition most people never face.
It is not
Schedulable
Vomiting episodes and dehydration cannot be planned around. Absence will be unpredictable, and that is the condition, not a choice.
What you may observe
What is likely happening
Sudden, unpredictable absence
Vomiting episodes and dehydration are not schedulable.
Frequent, lengthy bathroom breaks
Continuous nausea and vomiting through the working day.
Visible weight loss and exhaustion
Sustained inability to retain nutrition and fluids.
Difficulty concentrating or remembering
Dehydration, malnutrition, sleep loss, and medication effects.
Sensitivity to smells, food, or lighting
Common and powerful triggers for vomiting — often the easiest thing to fix.
Repeated medical appointments
IV hydration, monitoring, and treatment adjustments.
Download the full briefing — Understanding HG at Work →
01
Human Resources
Process, documentation & policy
Most accommodation processes were built for stable conditions. HG is not one.

Severity fluctuates week to week. Episodes cannot be scheduled. And the employee is often at her most depleted at exactly the moment your process asks her to advocate for herself, gather documentation, and be persuasive about how ill she is. A process designed for a fixed impairment will fail her — and it will fail you, because the usual outcome is a quiet resignation within the year.

Treat HG as a fluctuating, episodic condition with a living plan and a scheduled review, rather than a single request to be decided once and filed.

Say this first
"Your job is safe while we work this out."
It is the single highest-value sentence in the entire process, and it costs nothing. Put it in writing on the day she discloses.
Practical guidance — the process in order
01Acknowledge within one business day. Confirm receipt, confirm confidentiality, and confirm her role is not at risk while this is resolved.
02Ask about function, not diagnosis. Which tasks are affected, what would help, what has already stopped working. You do not need clinical detail in order to act.
03Request documentation once, proportionately. One provider note confirming a pregnancy-related condition and recommended adjustments. Never a note per absence.
04Put interim accommodations in place immediately. Do not wait for paperwork to close. Early measures prevent avoidable absence and escalation.
05Write the plan down and give her a copy. What was agreed, what was not possible and why, how to report absence, and the review date.
06Brief the manager on obligations, not diagnosis. They need to know what to do — not what she has.
07Review every two weeks. HG changes. An arrangement that worked in week nine may be unworkable in week fourteen.
08Begin leave and return planning early — while it is still calm enough to plan well.
Document this
·Functional limitations, described by her
·Accommodations agreed, with start dates
·Anything declined, with the business reason
·Absence reporting method agreed
·Pay and leave arrangements, in writing
·Who has been informed, and what they were told
Do not ask, do not require
·Diagnostic or treatment detail beyond function
·A doctor's note for each individual episode
·Proof of severity by comparison to other pregnancies
·Disclosure to colleagues
·Exhausting all sick leave before accommodation starts
·Confirmation she intends to return, as a condition of support
Downloadable resources for HR
Frequently asked — Human Resources
Can we ask for medical documentation?
Generally you may request proportionate documentation confirming a pregnancy-related condition and recommended adjustments. Requiring a note for each individual absence is disproportionate, and it produces exactly the outcome you are trying to avoid — she stops reporting and works through episodes instead.
She cannot give us a return date. What do we plan around?
Plan in two-week blocks with scheduled reviews. Waiting for certainty that will not arrive leaves both of you improvising, which is worse for the team than a provisional plan that gets revised.
Do we have to grant everything she asks for?
No. The reasonable expectation is a genuine, documented effort to find workable adjustments — including offering alternatives where a specific request is not operationally possible, and explaining why. Declining something is defensible. Not engaging is not.
Can HG-related absence affect her performance rating?
It should not. Exclude it from ratings, attendance triggers, and bonus calculations, and say so explicitly — otherwise she will assume the worst and work when she should be resting.
02
Managers
Conversations, workload & the team
You do not need to understand the medicine. You need to remove two fears.

She walks into that conversation carrying two fears: that she will not be believed, and that her job is at risk. Address both in the first minute and everything after it becomes straightforward. Leave either one unaddressed and no accommodation you offer will land.

Most managers get this wrong not through unkindness but through reflex — reaching for remedies, comparisons, or reassurance about the baby. What she needs is far simpler and entirely within your gift: belief, one concrete adjustment, and a date in the calendar.

Close with three commitments
01One adjustment starting immediately — not pending approval.
02One agreed way to report a bad day: a single text, no justification.
03A next check-in, in the calendar before she leaves the room.
How to open
"Thank you for telling me. I have read about Hyperemesis Gravidarum — I understand it is a serious medical condition, not typical pregnancy sickness."
"Your job is not at risk. I want to work out how to support you."
"I do not need medical details. I would like to understand which parts of the work are hard right now."
"Nothing you say here goes further without your agreement."
Five questions worth asking
01Which parts of your role are hardest at the moment?
02What times of day are worst for you?
03What would make the biggest difference this week?
04How should we handle absence so you are not explaining every time?
05What would you like colleagues to be told, and by whom?
What not to say
Avoid
Try instead
"Have you tried ginger or smaller meals?"
"I am not going to offer remedies. Tell me what you need at work."
"My wife had morning sickness and managed fine."
"I have not seen this before. Help me understand what it is like."
"Let me know if it gets worse."
"Let us set a check-in for Friday, so you do not have to raise it."
"We will need a note for each absence."
"One note from your provider is enough. Text me on bad days, no explanation needed."
"Are you still planning to come back?"
"Whatever happens, your role is here. We will plan it when you are ready."
Downloadable resources for managers
Frequently asked — Managers
She keeps apologizing and working through it. What should I do?
Tell her explicitly to stop, in writing. Working through HG episodes leads to worse outcomes and longer absence. If she believes resting will count against her, she will not rest — so remove that belief directly rather than waiting for her to relax into it.
The team is covering extra work and resenting it.
That is yours to manage, not hers. Redistribute formally rather than informally, acknowledge the additional load openly, and do not allow her situation to become a subject of team discussion. Resentment grows fastest where the reallocation was never named.
What do I tell colleagues?
Only what she has approved — usually that arrangements have temporarily changed. Her diagnosis is not team information, and you should agree the exact wording with her rather than improvising when asked.
What if I have already handled this badly?
Say so, plainly, and change what you do next. Employees remember whether you tried, not whether you were flawless from the start. A manager who corrects course is more trusted than one who was never tested.
03
Employees
Disclosing, asking & protecting yourself
You should not have to be articulate about being this ill.

Asking for accommodation while severely dehydrated, exhausted, and unable to keep food down is an unreasonable thing to expect of anyone — and yet it is what most workplaces require. So prepare on paper, on a better day, and let the page do the explaining when the day comes.

You do not owe anyone a diagnosis, a prognosis, or proof that you are trying hard enough. What helps is being concrete about what the work requires and what you can currently do. And you are allowed to bring someone with you.

Asking for accommodation is not asking for a favor. It is how a workplace designed around people is supposed to work.
Sentences that work
"I have Hyperemesis Gravidarum. It is a serious pregnancy complication, not morning sickness."
"I want to keep working. I need some adjustments to be able to."
"I would rather not discuss medical details, but I am happy to talk about what I can and cannot do."
"Could we write down what we agree, so neither of us has to remember it?"
Practical guidance — before you speak to them
01Decide who you tell first. Your manager if the relationship is good; HR if it is not, or if you want the process documented from the start.
02Ask for a private meeting at your best time of day. Thirty minutes. Not first thing, if mornings are worst.
03Write down what you want them to understand — three sentences is enough — and what specifically is hard about the work.
04Bring the employer briefing to leave with them. It is written to be forwarded, not argued with, so you are not the one educating them.
05Bring your tracker if you have one. Numbers are harder to dismiss than descriptions — and you should not have to argue about severity.
06Email a short summary afterwards. What was agreed, and when you will review it. Written records protect you.
Accommodations worth asking for
·A later or flexible start time
·Remote work, full or partial
·Rest breaks as needed, not fixed
·A private space to rest or be sick
·Relief from travel, driving, standing, or food duties
·Paid time for appointments and IV hydration
·A simple way to report a bad day
Questions to ask them
·What is the process, and how long will it take?
·What is paid, what is unpaid, and how does leave accrue?
·Who will know, and what exactly will they be told?
·Can we start something now, while paperwork is processed?
·When will we review this?
·Are my role and pay secure while this is in place?
Downloadable resources for employees
Frequently asked — Employees
Do I have to tell them I am pregnant?
You can generally request adjustments for a health condition without a full disclosure, but in practice most protections and accommodations for HG are tied to pregnancy — so disclosure usually strengthens your position. This is a personal decision, and it is worth getting advice specific to your jurisdiction before you make it.
How much medical detail do I owe them?
Very little. Employers generally need to understand functional impact and recommended adjustments, not your treatment history. "I would rather not go into the medical details, but here is what I can and cannot currently do" is a complete and reasonable answer.
What if they say no, or nothing happens?
Put the request in writing, so there is a record and a date. Escalate to HR if you started with your manager. Ask your provider for supporting documentation. If you are in a union, involve your representative. If you believe you are being treated unlawfully, seek advice from qualified employment counsel or your local labor authority — THON cannot advise on your legal position.
I feel guilty about the burden on my team.
Redistributing work during a medical condition is a management responsibility, not a personal debt you have incurred. Working through HG episodes to spare others tends to extend your illness and your absence — which serves nobody, least of all your team.
Download resources
Tools you can hold in your hand.
Every resource is print-ready, free to circulate internally, and written to be forwarded rather than argued with.
Human Resources
HR Accommodation Guide
All audiences
Understanding Hyperemesis Gravidarum
Managers
Supervisor Conversation Guide
Managers
Weekly Employee Check-In Template
HR & managers
Workplace Accommodation Worksheet
All audiences
Return-to-Work Planning Guide
Employees
Employee Conversation Planner
All audiences
Employer FAQ
See every resource in the HG Toolkit Library™ →
Related resources
Continue building a workplace that carries her.
Where are you on your journey?Eight stages — including "I am trying to keep working."→ Learn about Hyperemesis GravidarumThe condition in full — history, science, treatment, recovery.→ The Partner Journey™For the partner at home — the other half of getting through.→ The HG Toolkit Library™Every print-ready resource, organized by who needs it.→ The HG Knowledge Center™The full educational library, updated as guidance is published.→
What you can do today
Compassion at work is mostly a sequence of small, concrete acts.
Choose one and do it before you close this page. Every item below takes under thirty minutes.
Read the ten-minute briefingThen forward it to whoever else needs it.→ Prepare for the conversation properlyHow to open, what to ask, what never to say.→ Put one accommodation in place this weekDo not wait for the paperwork to close.→ Put a recurring check-in in the calendarTen minutes weekly, so she never has to raise it.→ Write down what you agreed, and send it to herIncluding the sentence: your job is safe.→ Share the FAQ with your leadership teamSo the next case does not start from zero.→
Creating a Supportive Workplace
Whether you are experiencing Hyperemesis Gravidarum, supporting someone you love, caring for a patient, or helping an employee navigate HG — support is available.
Your next step might be
Learn something newUnderstand the condition, the evidence, and what to expect.
Download a practical toolTrackers, checklists, planners — print-ready and free.
Connect with supportFind people and organizations who understand HG.
Explore workplace resourcesGuidance for HR, managers, and employees.
Support someone you lovePartner, family, and friend resources.
Prepare for your next appointmentQuestions written out, and a record to bring.
Continue your recovery journeyBecause recovery does not end at delivery.
Every HG journey is different, but no one should have to navigate it alone.
We are here to help you take your next step.
Community connections
Support doesn’t end here.
Explore trusted resources that can help you through every stage of the HG journey. As THON grows, this becomes a curated directory of community partners and support services — if you know of one that belongs here, we would like to hear from you.
Emotional SupportIn development→ Community OrganizationsIn development→ Financial AssistanceIn development→ Transportation ResourcesIn development→ Employer ResourcesAvailable now→ Partner ResourcesAvailable now→ Family ResourcesAvailable now→ Support GroupsIn development→ Healthcare ProvidersAvailable now→ Emergency Care InformationAvailable now→ Local Community PartnersIn development→ National OrganizationsIn development→
You are not alone.