The Reality of Hyperemesis Gravidarum
Updated: Apr 20, 2021
Sitting on the bathroom floor in pee after throwing up is just one part of my experience with Hyperemesis Gravidarum, but it is one of my most vivid memories. Probably because it happened so often.
Anyone who has experienced morning sickness knows that at any level it is unpleasant. Trying to brush your teeth in the morning without throwing up in the sink. Catching a whiff of eggs cooking sending you to toilet to vomit. Feeling hungry and nauseous at the same time. Getting sick at work but not wanting anyone to find out. Many women experience this, and I don't want to downplay their hardship. It is very difficult. I hope some of what I have to say can help any mother experiencing morning sickness.
Hyperemesis gravidarum (HG) is more than morning sickness. It is a condition in which a pregnant woman is constantly extremely sick with nausea and vomiting. It can be debilitating. Without treatment, HG is usually marked by weight loss and dehydration. Read more here if you aren't sure if you are experiencing very bad morning sickness or HG. And, for information from the American Pregnancy Association click here. Of course, even within this diagnosis there are ranges of symptoms. I have read about women who experienced the condition their entire pregnancy and even required feeding tubes. I experienced HG my last pregnancy, and I thought it may be helpful to expectant mothers if I shared my reality with this very extreme form of morning sickness.
My first two pregnancies, I did experience pretty severe morning sickness and I threw up one to two times a day starting about 6 weeks to around 20 or so weeks. But, I did function. I could go to a store and shop, I just may have thrown up in the parking lot or in the car on the way home. This last pregnancy, I could not take care of my kids. I could not drive. I could not scroll through my phone without vomiting. It was like perpetual motion sickness, as if I had just stepped off a rollercoaster...but all day. Dizziness, nausea, vomiting. ALL DAY LONG. It started out bad in the morning and got worse and worse throughout the day. By night, I would usually cry myself to sleep. I had constant headaches, likely from being dehydrated. And, it was so difficult to take any medication for the headache because I would have to hold it down. On top of that I was getting very depressed because I felt guilty I could not care for my kids. I felt guilty I had to take medication while pregnant just to keep food down, and I could hardly ever keep a prenatal vitamin down. I had little communication with others because I couldn't even look at my phone. I would ask my husband to read me my Facebook and my emails every few days. I felt gross because I was throwing up all the time and because I was constantly either having to wear depends or would pee on the floor as I threw up. Yes, I just admitted that publicly. (Remember I also had birthed two kids previously.)
How did I get through it physically and emotionally?
Disclaimer: This is only the story about how I got through HG. Always consult your doctor about what is right for you. I am not a doctor or any type of medical provider. Also, as background, I was always dehydrated at some level but I was never hospitalized. The nurses would tell me my blood pressure was on the low side, they could see my lips were chapped etc., but never to the point they felt I needed to be hospitalized. Always keep communication with your doctor. If you feel you need IV fluids never hesitate to contact your medical providers. I have had IV fluids in urgent care and there were probably times I needed to go and didn't because I couldn't withstand a car ride. This is not a one size fits all situation, what works for one person may make another worse. Always talk to your medical provider before trying anything and discuss all aspects of your care.
1) I limited my movement. Walking from my bedroom to the kitchen or living room really made me feel sick. Rarely, was I able to leave the house. I spent most of my day sitting in a recliner with my head straight forward, trying not to move. (Of course, I did move back and forth to the bathroom and stretched my legs when possible...you don't want to form blood clots.) For a long time, I couldn't even watch tv. Seeing the movement on the screen made me sick. I could only listen. Usually, on days my husband had work, my mom would come and pick up the kids in the morning. She would have to help my 2 year old with his diapers because just thinking about changing his diaper was unbearable to me. (Potty training had to come to a complete halt at that point because I was not capable...another thing I felt guilty about.) My husband would usually pick the kids up from her house on the way home from work.
2) I tried to figure out my triggers and avoid them. There were some food and drinks I knew would make me throw up. For example...WATER. I could not drink plain water, every single time I would take more than a tiny sip it would come back up. So I drank carbonated water and very slowly. Tiny, tiny sips. I also sucked on tiny tiny pieces of ice. I wished I could tolerate popsicles but...NO. They made me feel better in my first two pregnancies but not this one! And anything that is supposed to be eaten cold does not feel good coming back up.
3) Small Meals I tried to eat small amounts throughout the day to keep my blood sugar stable. I have learned that helps most women with morning sickness. Also, I was determined to try and get some food to stay down, so I never gave up. The more chances I had to hold something down the better, and throwing up less food at a time is frankly more comfortable than a large meal.
4) Medication. My first pregnancy I refused medication and suffered because I had the luxury of not having to take care of any kids. My second pregnancy I was able to take a category A drug that actually worked well enough to keep me functioning. Well, that drug didn't help at ALL this time so I was forced to take a category B drug. For the most part, it limited my vomiting to a few times a day and I was able to hold enough food and fluids down so I didn't experience severe malnutrition, even though I felt terrible still. While reading about HG after the fact, there are more treatment options than were presented to me at the time. If you find yourself with HG, be sure your doctor is knowledgeable about the condition.
5) I had help. My mom and my husband worked very hard to make sure the kids were very well taken care of and tried to meet my sometimes impossible standards. If you need it, never be afraid to ask for help. HG is a serious condition and you must take care of yourself for your and your baby's health.
6) Suckers and gum. I sucked on suckers ALL DAY LONG. Just regular candy suckers. It seemed to help me get through the day. When I had less severe morning sickness in previous pregnancies I had every ginger product you can imagine...but this time it was a not effective in the least. If you have less severe morning sickness ginger is a common aid, and there are suckers that are designed to help nausea. Peppermint may also help. Sometimes I found momentary relief from gum.
7) Sea sickness bands. I have no idea if they helped but I tried every angle.
1) Even though 5 months or so is a long time to be sick, I knew there would be an end. I didn't know when it would end for me (which ended up being about 24-26 weeks, yet can last the entire pregnancy for some,) but I knew THERE WOULD BE AN END even if that end wasn't until the baby was born.
2) Even though I felt guilty my kids weren't getting all the attention from me I wanted to give them, they weren't lacking any attention. My parents and my husband were meeting all their needs and I wasn't far away from the kids. I would still keep up with what was going on with my son in preschool, they still slept in the same room as me at night, and they weren't showing any signs of being upset.
3) I didn't have to worry about money. My employer happened to be father, who continued to pay me while I wasn't working, and my husband was able to take a fair amount of paid days off when my son had a field trip or I had a doctor's appointment. If you feel finances are factor, talk to your doctor about disability.
What I've learned
1) Don't feel guilty. All of the guilt I experienced did not help anyone. And, now when I ask my kids about that time, they hardly remember how sick I was. They remember getting Happy Meals with Grandma and Daddy bringing donuts to their school. They remember being excited about their baby brother. And...they have a few humorous anecdotes about mom peeing her pants.
2) Change doctors if you feel you aren't being listened to. The first doctor who told me I was experiencing HG was an urgent care doctor. I don't know if my OB doctor ever put that in my chart. She was primarily concerned about the numbers...my weight, the weight of the baby etc. (We did have one scare with my second pregnancy, when of course I was also puking everyday. My son was extra small at his anatomy scan and they were concerned the placenta wasn't attached correctly...even though I knew he was small because I couldn't hold much food down. She later said, well you're only 5'2 maybe he will be a smaller sized person. I should have known then she wasn't really hearing me. Don't worry, he was fine once my morning sickness subsided...he was born healthy at 8lbs 12 ounces and is not small for his age now.) It is important that your doctor is concerned about your symptoms and ability to function. Remember, almost all women experience some morning sickness and they are used to hearing complaining. You have to speak to them about all your symptoms so they can recognize you have a rarer case that is severe. Disclaimer: In all other respects, my OB was excellent. And, all my kids did arrive safely and they were healthy.
3) Depression is very common with HG. Speaking with someone who understands the condition can be beneficial, like a therapist. Or, a psychiatrist can speak to you about whether there are any safe medications they feel would be warranted. You may just need to hear from others who have a shared experience. Click here for a list of support resources. Also, be prepared you may be at increased risk for PPD/PPA.
4) The torture was certainly worth it for me. (Not that I WOULD EVER do it again!)
Look at this sweet little angel. And, he turned out just fine. He was born at 8lbs 14 ounces!