Hyperemesis Gravidarum - Severe Pregnancy Sickness
Severe pregnancy sickness is a horrible thing
Hyperemesis gravidarum (HG) is the scientific term for severe pregnancy sickness and covers a spectrum of severity from really awful to absolutely dreadful.
Sure, I'd heard of morning sickness - being sick a couple of time in the morning for a few weeks in early pregnancy. I didn't realize you could have all-day-and-night sickness right up until the moment you gave birth. I do now.
I often see HG described as unusual or rare and then affecting around 1% of pregnancies. 1 in 100 pregnancies does not sound unusual to me. That's an awful lot of women. I actually know three other women who live within 0.5 mile of me that also experienced HG. It's one of those things that is invisible until you become a sufferer.
I'm also surprised by how little is known about HG. If men suffered then I'm sure we'd have an enormous amount of knowledge and a cure ...
In this lens I'll talk about my experience with severe pregnancy sickness in the hope that it helps others who find themselves in a similar situation and raise general awareness on the subject.
Book Recommendation for Morning Sickness
This is the book I found most useful during my pregnancy. Read on to find out why.
Here's the UK version Managing Morning Sickness
This was just what I needed to read to understand more about pregnancy sickness.
Morning Sickness on Amazon
A lot of the common morning sickness remedies did nothing for me. But some did help. I suspect this is highly individual and that you have to try things and see if they work for you.
First trimester sickness
At around 6 weeks I started feeling very sick. Then I started being sick. I was due to go on an overseas business trip at 7 weeks so I went to the doctor to see what he could suggest. He prescribed Gaviscon, a gloopy, pink remedy for heartburn and indigestion. I was skeptical, but what did I know? I dutifully collected the prescription went home, opened the bottle, the smell hit my nose and I was violently sick. It was clear that there was no way I was going to be able to swallow it.
I cancelled my business trip. It was clear that there was no way I was going to be any use to anyone in the state I was in. I went back to the doctor who took me more seriously this time and prescribed a strong anti-emetic. He didn't give me any advice on actually keep the tablets down ... it was a couple of days before I worked out how to do that, well most of the time. I think the medication made me a little less sick, maybe 6-8 times a day instead of a lot more. But it didn't make me feel any less sick.
Things got worse until all I could do was spend my days lying in a dark room. I couldn't work. I couldn't even look at a computer screen without being sick - any movement on the screen made me sick. I couldn't watch television, couldn't read a book. And I couldn't move without being sick. If I spent the evening downstairs I was guaranteed to be sick after I walked upstairs to bed. I spent a lot of time asleep.
At one point the doctor prescribed a different anti-emetic and I had the most horrendous 24hrs. I don't know if it was stopping the previous medication that had this effect (and this is what I would have been like without it) or whether the new medication made me worse. I wasn't in the mood to experiment, I started taking the original medication again.
I lived on whatever bland, starchy or just strange food I could best tolerate at the time. For several days I ate only potato triangles (a kind of salted potato snack). For a while I ate just plain pasta with nothing on it. At another point it was Chocolate HobNob biscuits. People asked me if the chocolate made me feel sick, Ha! I felt sick all the time, it made no difference. My partner would often cook me something bland for tea in the evening only to have it end up in the toilet half way though the meal.
I didn't feel pregnant at this point. Just ill. I didn't really acknowledge the pregnancy at all. Every time I hear anyone say 'pregnancy isn't an illness', my blood boils. For some of us it is most definitely an illness.
It was the first trimester, so everyone assured me that the sickness would go away when I got to 12 or 13 weeks. That was reassuring. Sure it was awful, but it was only for a few weeks.
Second trimester sickness
At the beginning of the second trimester I got to meet my midwife for the first time. By chance she had suffered from severe pregnancy sickness herself and actually had a few useful tips, and a lot of understanding. I wish I had been referred to the midwife earlier, but it's standard practice to wait until 11/12 weeks to increase the likelihood of a viable pregnancy. Not much help with managing early morning sickness.
My midwife was less confident that my sickness would magically vanish now I had entered the second trimester. She said it could go away, but hers had lasted much longer. This was useful information, it allowed me to mentally prepare for a longer stretch of sickness, rather that being continually disappointed that I wasn't feeling any better.
I did gradually improve during the second trimester, but didn't stop feeling sick, or being sick. My sickness was worse in the evening, so eventually at around 20 weeks I was able to return to work. I was fairly useless compared to normal, but I was able to do something vaguely constructive. Being at work posed it's own challenges. I could spot a smoker at 30 paces and would have to turn around to avoid them - I don't mean someone smoking, I mean someone who had smoked earlier in the day. There was no way I could get close to the canteen. And I had to ask people not to eat in my area. I took in plain bread rolls for lunch, biscuits to snack on and peppermint tea to drink.
Things reached a steady state and I did start to feel pregnant rather than just ill. I started looking forward to having a baby as well as looking forward to not being sick.
Third trimester sickness
By the third trimester, my sickness wasn't really improving, but I'd got a better understanding of how to control it. I had accepted that I couldn't eat anything resembling a healthy diet. I barely ate a vegetable the whole time I was pregnant. Occasionally I'd be overoptimistic about what I could eat with the inevitable consequences.
I hadn't been able to face drinking tea up until this point. But one day I just fancied a cup of tea. It was weird, it didn't taste like tea at all. Most disappointing.
The last time I was sick was a couple of days before my waters broke. I felt sick right until the birth.
After the birth
Pretty much as soon as my son was born, I stopped feeling sick. I had a cup of tea in the delivery room and it tasted like tea! The food they served me tasted like food and I could eat it. Amazing!
Once I got home, family arrived and my sister-in-law (who had a newborn herself) provided a range of sandwiches from the supermarket. She asked me which one I wanted. I asked if we could cut them all up so I could have a little bit of each. Food has never tasted so amazing.
I felt so amazing once I'd given birth (well once I'd caught up on sleep - I was in labour for over 3 days ...) that I was on a complete high. It just felt so good to be able to do things. While my friends with newborns found things hard, I was just so glad not to be pregnant that having a newborn was easy in comparison.
My second pregnancy
I got pregnant again when my son was around a year old. This may seem crazy given my prior experience. Especially when I had read that hyperemesis gravidarum is is likely to reoccur in subsequent pregnancies. My rationale was that I knew I wanted a second child and if I was going to be that ill again then I wanted to get it over with as soon as possible.
I was sick with my second pregnancy, right the way through until the end. But it wasn't anywhere near as severe. I managed to work throughout (albeit at greatly reduced efficiency). If this had been my first pregnancy I would have considered it to be dreadful. But given my baseline, I was just grateful that it wasn't worse.
Just like the first time, all sickness evaporated instantly when I gave birth. And I was on an amazing high for weeks. Just as well, as my second son had dreadful reflux and projectile vomited after every feed. More sick. Just what I needed ;-)
After the births of my children, I often got a comment along the lines of 'it was all worth it, wasn't it'. This was well-meaning, but very irritating. If you mean, was I willing to endure severe sickness in pregnancy to have my children, well yes. But really, I'd rather sail through pregnancy like other women.
I would be willing to risk severe pregnancy sickness again, but their Dad doesn't want any more children (or pregnancies). If I had another pregnancy like my first it would be very hard on him and my two boys.
Things that didn't help me
I was given lots of advice during my pregnancies. Most of it didn't work. Here are a some examples:
- Ginger - ginger biscuits, ginger tea, ginger tablets, ginger sweets. No help whatsoever.
- Travel sickness wrist bands - did nothing except feel uncomfortable.
- Sniffing lemons - wasn't unpleasant, but I can't say it helped.
- Eating little and often - hmm well in the first trimester, I could only eat a little and then I was sick. Eating often just made me sick more often. (Admittedly this advice did help a little once I reached about 20 weeks.)
- Eating high protein foods like nuts, meat and eggs. I could barely be in the same room as these foods, much less eat them.
- Resting. Ha! I could do nothing but rest. I suppose you could say it helped because if I tried to do anything other than lie prone, I was sick.
Things that did help
There were things that made life a bit less dreadful:
- Eating ice cubes. My midwife suggested this and it certainly helped keep me hydrated.
- My partner waking me up at 6am with a drink of ice-cold water and my anti-nausea medication. I would take the tablets while still drowsy and drop straight back to sleep. If I tried taking the tablets later in the day I would be sick. This trick stopped me getting very dehydrated and kept me out of hospital
- Just sticking to the one food I could tolerate. Even if it meant eating the same food item for days in a row.
- Fresh air. Well this didn't help early on as any movement made me feel sick. But later on being outside did seem to make me feel a little less awful.
- Anti-nausea medication (cyclizine). Zofran seems to be common in the US but that isn't prescribed in the UK where I am. I do wonder whether it would have been better, but it wasn't given as an option.
Book Review: Managing Morning Sickness
Managing Morning Sickness - A Guide for Pregnant Women by Miriam Erick was my favourite book on the topic.
This had some useful suggestions, nothing that made a major physical difference to me, but then nothing did really. I liked the chapter title 'Alternative Remedies: Other Things Women Try' - it doesn't try to suggest that the suggestions have any validity, but if you've got that far through the book and nothing has worked, well hey anything is worth a try ;-)
But what this book did do was explain how morning sickness works (to the extent that it's understood) and tell stories of other people's experiences, some far worse than mine. This made me feel less isolated and helped me understand what was going on. I also really enjoyed the 'Historical and Cultural Perspectives' chapter, it was interesting to consider how women in other times and places had gone through a similar experience.
Then there was the 'Very Bad Morning Sickness and Pregnancy Outcomes' section. Made me realize it could be worse. In my case there was no serious risk to my health or that of my baby.
I found this book much more satisfying than those that just suggested remedies that didn't work anyway. Those books just left me feeling like a failure for not responding to the 'cures'.
Here's the UK link Managing Morning Sickness
If you're suffering at the moment, you have my sympathy.
If you were looking for specific information and didn't find it, then make a suggestion for a future topic.
Any feedback on this lens or sharing of experiences is welcome.