I found out I was pregnant about three months after suffering the loss of my first pregnancy. I was anxious and scared but welcomed the morning sickness. Everyone told me that morning sickness was a good sign that my pregnancy was progressing along. According to that sign, it was progressing but the further along we got, the worse I became. The realization came when I drank about 2 ounces of blue gatorade and close to 20 mins later I was begging for the car to be pulled over so that I could vomit at the gas station. It got to where even water wouldn’t stay down. This prompted a visit to my midwife, who kindly explained that some women suffer from Hyperemesis Gravidarum and some to the extreme of needing to be hospitalized.
What is HG
Hyperemesis gravidarum (HG) is a rare disorder characterized by severe and persistent nausea and vomiting during pregnancy that may necessitate hospitalization, as described by the National Organization for Rare Disorders. According to the HER Foundation, HG is the leading cause of hospitalization in early pregnancy, and is second only to preterm labor as the most common overall cause of hospitalization during pregnancy. I was excited to have a diagnoses because in my mind at that point, it could be treated. I could not have been more wrong. HG is rare and there is not enough research to know or understand where it comes from or why it happens. The way it affects each woman and each pregnancy varies.
Not Your Typical Morning Sickness
HG is not the typical morning sickness that you often hear about associated with pregnancy. HG is much more severe, at times causing hospitalization and even loss of pregnancy. As a two-time HG survivor, I would describe it as morning sickness on steroids. I, fortunately, never experienced being hospitalized for a period of time during either of my pregnancies. But did end up in the emergency room countless times needing IV fluids due to dehydration. The nausea and vomiting were so bad that it caused petechia around my eyes and often my throat would bleed. Weight loss to the tune of 40 pounds average during both pregnancies was overwhelming, especially when I should have been gaining weight.
It’s Not in Your Head
So many times I was told, “Try some ginger.” “Use SeaBands, they worked for me!” “Eat some saltines.” I wanted to scream in response. I was already being treated with anti-nausea meds that they use to treat cancer patients, and it only slightly helped. The comments became unrelenting. “Oh I have morning sickness too.” “I had it so bad for a couple weeks. Yours will go away soon.” Mine did not go away, either time, until I gave birth. I can remember thinking at one time, “Why am I even pregnant? This is utter hell.” Immediately guilt set in. This is when I began to search for more information on HG. The HER Foundation also says that nearly 20% of HG pregnancies are lost to therapeutic terminations, citing “no hope for relief.” This is heartbreaking and yet dare I say, I understand where these mommas come from. HG is relentless. It is 24/7 nausea so bad that it is difficult to move from the bed. Walking to the bathroom feels like a marathon, imagine caring for a family or working a job.
Even Royalty Can Suffer
Over the years, more awareness has come regarding HG. Her Royal Highness The Duchess of Cambridge Kate Middleton suffered HG with both pregnancies. Today is HG Awareness day and in honor of all the women and babies that have survived, I will leave you with this. If you know someone suffering with HG the best thing you can do is be there. Whatever you do, do not tell her;
1.“It must be in your head.” – I can promise you it is not. The suffering would be over if it was as simple as changing a thought.
2.“It will be over soon” – Delivery might be two days away but it will still feel like I lifetime.
3. “Eat some ginger.” – Ginger most likely will do nothing to stop the vomiting.
What a mommy who has HG needs more than anything is support. Send encouraging notes, donate towards research, offer to clean her home, watch her kids, cook her family dinner, and most of all love on her. When she finally makes it full term and gives birth, celebrate! Bring her the food that she has missed out on for the last 9 months. And remember that post traumatic stress after HG is a real thing. BE kind and most of all, simply walk alongside her and support her.
Often times I hear pregnant moms say “I don’t need to go to childbirth class I am going to use an epidural” and it is probably one of the biggest misconceptions about childbirth class that exist. Before the electronic era and wide spread use of pain medication for pain control, the common way expectant parents could learn about what was going to happen to them during birth was to attend a childbirth class. Over the years the childbirth education classes have seen a decline in attendance, yet a lot of people spend more time and resources researching how to remodel a bathroom or kitchen than learning about bringing a baby into the world.
Today offers a lot more options. With YouTube and the internet, one doesn’t even need to leave their home or put down their hand held device to get advice and information on giving birth. And it is true that babies will come into this world without their parents taking a class on “childbirth”, after all childbirth classes didn’t exist 100 plus years ago as we know them and babies still arrived. Fast forward to a very busy society where 80% to 90% of laboring patients use epidural and c-section rates are the highest they have ever been across the United States.
Learning from a childbirth expert what you can do to increase your chances of a positive birth experience is worth your time and money. Most hospitals offer some type of class, but it is also very popular to see other classes offered in the community. For those with busy schedules, private classes are the perfect option and are not as expensive as you might think. Most classes whether group or private should cover basic items like when to go to the hospital or birth center, stages and phases of labor, basic terminology, comfort measures, partner tips, interventions. Some classes include newborn care and breastfeeding. The hot topics usually are pain medications. In my 24 years of experience there are generally three types of thinking when approaching pain control;
1. I definitely want an epidural.
2. I will wait and see if I need one.
3. No thank you, I do not want one.
There is no right or wrong answer, only you can decide, but I also encourage you to stay open about options. For example if you are planning on an epidural learning about when the ideal time is to get an epidural can help you to decrease your chances of a C-section. Most moms don’t realize that the number one way to decrease their chances of a C-section is to wait until active labor to come to the hospital. We call this the 511 rule – contractions at least 5 minutes apart, lasting 1 minute long, for at least 1 hour. Also using a peanut ball decreases chances of surgery as well.
If you are planning on not having an epidural, have you thought about what it takes? Do you have good labor support? Have you thought about hiring a doula? Key to laboring without an epidural is movement, use of hydro therapy, access to many comfort measures, and understanding all the ins and outs of labor. Do you understand when an epidural can be beneficial? Yes, even for those “natural” mamas, sometimes interventions can be helpful in unique situations. Being prepared and not afraid makes a world of difference.
Birth planning and birth itself is not 100% black and white. The more you are educated and understand the value in good communication with your nurses, midwives and doctors the more satisfied you will be even if the need arises for a C-section.
Your childbirth educator is the expert that you can ask all kinds of questions to and bounce things off that you have read or heard.
It’s is your birth, and education is key!
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Kathy Bradley, CD, ICCE, IBCLC has been in the Maternal Health field for 29 years and has taught countess families. She taught for 14 years as the 2nd largest volume hospital in the US, located in Orlando.