Imagine if one day, you woke up and were hit by a tsunami of nausea, and that day you could not stop vomiting and retching. You vomit 30, 50, 100 times in one 24-hour period. Movement causes nausea, stillness causes nausea, noise causes nausea, silence causes nausea, light causes nausea, darkness causes nausea. Imagine how dehydrated you’d become, how achy your muscles would be, how raw your throat would feel. Consider for a second how physically and mentally exhausting that experience would be. Now imagine that the following day is the same. The following weeks and months are variations of this scenario. So in addition to the concern about your physical integrity you are also unable to work, do chores, go out, or look after your children. Then add to this, you are pregnant and are deeply concerned for the wellbeing of the life growing inside.
15th of May is Hyperemesis Gravidarum (HG) awareness day and 101mothers have dedicated this week to this important issue. In addition to unrelenting and extreme pregnancy-related nausea and vomiting which prevents adequate intake of food (taken from helpher.org), if it is not properly managed it causes:
- loss of greater than 5% of pre-pregnancy body weight (usually over 10%)
- dehydration and production of ketones
- nutritional deficiencies
- metabolic imbalances
- difficulty with daily activities
Whilst most women (up to 80%) will experience some degree of nausea and vomiting during pregnancy, only around 1% will develop HG. HG is poorly understood and traditionally misconstrued as a bad case of morning sickness, which could be eased by a good batch of ginger biscuits. Comparing morning sickness to HG, is like comparing being mauled by a kitten to being mauled by a lion. And the ginger biscuits would be about as much use at fending off the lion.
This general lack of insight means that for most of the mothers who experience HG, it comes as a bolt from the blue. In a Guest Talk for 101mothers this week Nicola gave a first-hand account of this cruel condition (read here). The physical and psychological effects are staggering. In fact, HG is associated with Post Traumatic Stress Disorder (PTSD) amongst its survivors. And theoretically it makes complete sense too. When the prerequisite for PTSD is that “the person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others” and “the person’s response involved intense fear, helplessness, or horror”.
To my mind, if you plucked an exceptionally strong and healthy man off the street and somehow managed to make him vomit repeatedly for days and weeks and months on end, the dehydration, starvation, repeated muscle contraction, and oesophageal damage would be utterly, mind-bendingly, exhausting for him.
The lack of understanding and support can cause the woman with HG to feel ashamed, embarrassed, incompetent, and terribly lonely. Worst of all it can cause women to delay seeking help or not receive help when they manage to drag themselves to the doctors. Which is tragic because there are effective treatments, and the sooner that medication is started the more impact it has.
The correct support is essential. In a huge Norwegian study, immigrant women from Africa, Sri Lanka, and India were over 3 times more likely to experience HG than native Norwegians. The study controlled for maternal education, marital status and other demographics but could not find an explanation. But I could hazard a guess at the cause, these women were probably less likely to have social support or speak the language, so when HG fell upon them they took longer to receive the care that could have changed the course of their illness.
What can be done? If you are an average Joe Bloggs then the very least you can do is get clued up. That way you can show more compassion and understanding. There are practical ways you can support someone in need right now (read here). But also, donate, advocate, and volunteer. The women experiencing HG should not be carrying this burden alone.
If you experienced this once upon a nightmare ago, we hope you got all the care and support you needed, we hope you are not still feeling the scars of it now. But if you are, you have every right to be! It’s not too late to receive the emotional support you always deserved.
And if you yourself are experiencing this right now, as we speak, then help is available from HER Foundation and Pregnancy Sickness Support, they are wonderful organisations who can guide, advise, and support you during this difficult time. And please know, for what it’s worth, that 101mothers really cares about you. Things will get better, and even if you don’t feel it right now… we think you are truly amazing.