Hyperemesis gravidarum is a debilitating, serious, and rare form of morning sickness. While morning sickness affects an estimated 50 to 90% of pregnancies, hyperemesis gravidarum affects an estimated .5 to 2% of pregnancies. Hyperemesis can be potentially dangerous in the physical sense but is also extremely damaging mentally as well. Keep reading to learn more and to hear Deema’s personal story coping with HG.
What is Hyperemesis Gravidarum?
Hyperemesis gravidarum is the second leading cause of hospitalizations during pregnancy. In severe cases, hyperemesis gravidarum can even lead to maternal death. Hyperemesis gravidarum is more than the expected morning sickness. I would know, I suffered from HG with both of my pregnancies.
It is the main reason that I’m more than likely done having children. In many cases, nausea is an inevitable part of pregnancy. However, we know that typically, morning sickness subsides by fourteen weeks. HG does not.
Hyperemesis Gravidarum does require medical intervention. It is not to be taken lightly. Mothers suffering from HG are subjected to harmful rhetoric, often times from other women. It is not uncommon for HG moms to hear comments such as “Oh you’re taking medication? I just had to deal with my morning sickness.” I’ll say it again, HG is not morning sickness.
I’m not taking away from how debilitating morning sickness is for everyone. However, experiencing nausea and vomiting for a few weeks to a few months is vastly different than experiencing severe vomiting for the duration of your pregnancy. Keep reading below to learn more.
It appears that a genetic component plays a major factor, specifically with the presence of two gene’s. You can read more about the latest research results here!
Treatment for Hyperemesis Gravidarum
Treatment with medication is inevitable in dealing with HG. There are oral options along options for a pump, similar to an insulin pump, where anti-nausea medication such as Zofran are administered throughout the day. Along with that, comes the mommy-shamers. The experts that we all know and love (eye roll), armed with doctor google “citing” studies that are neither empirically based nor accurate.
In fact, UCLA conducted a study and cited that there is no evidence linking anti-nausea drugs to birth defects. You can read the full study here.
I had to take medication for the duration of both of my pregnancies. I had countless trips to the emergency department for IV fluids as well. My first experience with HG I was not equipped by any means. I cried the duration of my pregnancy and had to quit my job at five months pregnant. I did not know how to advocate for myself and did not know much about HG. It is difficult for me to reflect back on that time. I would get sick in between seeing patients at the practice that I was working at and would need to pull over on the way to and from work. Nearly every single day.
There were times that I was so dehydrated that nurses were unable to place an IV in my veins, leaving me with no other option other than going home.
The second time around was challenging for different reasons. I was able to cope ahead but also knew how bad the road ahead would be. Fortunately, my symptoms were not as severe and I intentionally selected on OB who was well versed on HG and treatment protocol. But then of course, Covid-19 happened.
HG comes with frequent appointments and my toddler was not allowed to attend my appointments. I had to arrange childcare for my toddler, safely get myself to the emergency department, only to be re-routed to the Covid floor for labor and delivery since vomiting is a symptom of covid. No visitors were allowed of course, and I had to risk exposure with every visit. However, I had no choice and I had to keep reminding myself of that. Otherwise the guilt would eat me alive.
Hyperemesis Gravidarum and emotional distress
Suffering from HG can feel traumatic. The moment that anyone asks me when we will have another child, I instantly feel symptoms of anxiety. I recall relaxing in bed after my toddler was asleep for the night and turning on Amy Schumer’s latest Netflix special. I was laughing along until she started to share her own battle with HG. I was so happy that a woman with a platform was being so honest with how miserable hyperemesis is. However, I had to turn it off halfway through because I started to feel sick to my stomach.
Here’s the thing. It’s not just the memory of the physical symptoms that send HG survivors to a state of panic. It’s the memories of their mental state. HG come with feelings of hopelessness, fear of death, and immense feelings of guilt. Both of my children were born small for gestational age due to intrauterine growth restriction. My second pregnancy was heavily monitored and ultimately I ended up needing to be induced three weeks early due to complications from the pregnancy.
Studies have shown that women who currently have HG or have had it in the past are at risk for emotional distress. A specific study showed that emotional distress was exhibited throughout the pregnancy and six months following the pregnancy. The good news is that the state of emotional distress had subsided for many of the women by eighteen months.
However you need to keep in mind that that means those suffering from hyperemesis gravidarum can expect to face emotional impact for up to a year and a half total, including the time of the pregnancy.
Feelings of guilt
Talk to any woman who has dealt with HG and she will tell you it was hands down the worst experience of her life. I know it was mine. I hated so much of my pregnancy. I don’t have many photos of myself being pregnant with my first child and I hate that. It’s the strangest feeling to love something so much with your whole being and simultaneously hate what they are doing to you.
There is a constant fear that you are harming your fetus. You cycle between forcing yourself to eat to please others around you who express that you will harm that baby if you don’t eat something. And projectile vomiting with no end in sight. You don’t know at which point you should seek medical help as this has become your norm. You feel guilt for crying in front of your other children. For vomiting in front of them. But your children are resilient. Remember that.
You cry for hours on end. You lay awake at night and think there’s no way you can last another six months like this. I found myself in the most ironic position of my life at the time. Here I was, a mental health professional and I was in the worst mental state of my life.
No one around me knew how to help. Close friends and family members would constantly ask me what I needed. What they could do for me. And I would say the same thing every time, “I just need this pregnancy to be over.” I begged everyone around me to just let me feel what I needed to feel and to listen to me. And listen they did.
I was convinced that I would not be able to bond with this baby. The only way for me to get through the pregnancy was for me to try and ignore it. Today I can tell you I love my children more than life itself. However I still stand firm in saying that I hate being pregnant. And that is okay.
How you can help women suffering from hyperemesis gravidarum
Please stop telling women dealing with HG how to feel. Do not inundate her with statements about how worth it this will be in the end. She knows that. Instead listen to her. Ask her how she is doing.
Allow her to be honest without fear or ridicule or judgement. Remind her that you know that she is the vessel carrying this life inside of her and that her health matters too, not just the health of the baby. If she’s not okay, the baby is not okay. Point blank period.
Statements such as “you’re going the hospital again?” Not. Helpful.
Remind her that she is a warrior and how lucky her future baby is to have such a strong and selfless mother. If she has other children, offer to look after them for a few hours so that she can sleep.
Many women who suffer from hyperemesis gravidarum opt to not get pregnant again in the future. This is a decision that is made between a woman and her partner. It is not anyone else’s place to judge or try to coax her into having any more children. Statements such as “but wasn’t it all worth it in the end,” are offensive. Please don’t do that.
To all of my hyperemesis warriors out there, you are amazing, strong and beautiful. You are doing one of the most selfless things that you could possibly do. You do not love your child any less just because you didn’t love your pregnancy as much as Becky from your mom group did. Don’t be afraid to reach out for help mama!
For more information on hyperemesis gravidarum:
Have more questions? Schedule a text or video chat consult with Deema here (maternal mental health specialist) or with Kate, Lauren or Natalie here (NICU RNs) and they can help answer any questions that you have!
**This post is educational and not meant to take the place of your provider.