Hyperemesis Gravidarum

20140607_140226Before having children, I thought pregnancy would be a beautiful experience. After having children, I knew it could be a challenging and sometimes ugly mess that happened to involve the beauty of new life. I had three typical pregnancies where I enjoyed kicks and a growing belly while brushing off the unpleasant nausea, fatigue and heartburn. Then I discovered we were having our fourth child and within days I felt sicker than I had ever felt before, pregnant or not. My midwife offered a prescription, Zofran, which helped me keep a little down, but I still was far from well. Within a few weeks, after a second ER visit, a compassionate and helpful emergency room doctor diagnosed me with hyperemsis gravidarum. Little did I realize just how much of an impact that diagnosis would have.

You might be wondering what exactly hyperemesis gravidarum (HG) is. The Her Foundation explains it as unrelenting nausea and/or vomiting that leads to a loss greater than 5% of pre-pregnancy weight, symptoms that interfere with daily activities, and dehydration leading to the production of ketones. HG affects 0.5-2% of pregnancies. If you speak to a woman and her family that have experienced HG the definition is longer, harder and life altering. HG takes good things, gives bad things and ultimately changes families.

Hyperemesis gravidarum takes away the ability to stay hydrated, a very basic need for physical and even emotional wellbeing. It takes away the ability to eat and keep food down. It can take away teeth, time with children, jobs, finances, homes and sometimes it can even take away a baby. Untreated or under treated HG can lead to miscarriage and in 10% of HG pregnancies, termination because women are not always given proper treatment. For many families it even takes away future plans for more children.

Hyperemesis gravidarum gives unrelenting nausea, phantom odors, scars from IVs and PICC lines, broken relationships, crushed spirits, guilt, debt, medical bills, dizziness and vertigo, and unpleasant side effects from medication. Many women with HG suffer from depression, anxiety and even PTSD, all of which may linger well after the physical symptoms are gone. Weight, nutrition, gastric and food issues can last well beyond the postpartum period for some women.

For me, HG was something that unexpectedly arrived 5.5 weeks into my pregnancy, got slightly manageable around 33 weeks, and left me unwell until after delivery. I had unrelenting nausea and motion sickness that made me feel sick, not pregnant. Even after hearing a heartbeat, seeing an ultrasound and even feeling kicks, I could not feel pregnant, I just felt sick. It meant laying on my couch watching my children grow and change but being too sick to be a part of it. It meant turning away clients and work even when bills were piling up. It changed our plans as we pulled our house off the market because I was too sick to leave the house for showings. It meant loving IVs because it was the only thing that could bring relief. My favorite part of Christmas was sitting in an ER room with a warm blanket, IV fluids and IV strength medication. Sadly, my only other memories from that Christmas are pieced together from pictures.

I would not wish HG on anyone, ever, but I am thankful for the lessons it taught me. I learned to truly appreciate life. I remember being two weeks postpartum and being grateful I could do the dishes. During my HG’s peak I was unable to even enter my kitchen and opening the fridge brought tears to my eyes. I learned to appreciate modern medicine, to find balance and to never judge how a person chooses to treat an ailment because we can never truly know how another person is feeling. I learned to appreciate health. I have never been the healthiest person in the world and I have always struggled with fatigue, but I can walk, I can eat and I can be an active participant in my family and community and that is an amazing thing!

Hyperemesis gravidarum only impacts a small number of pregnancies but for the families it touches it is life altering. You might be wondering what you should do, after all you are not likely to suffer from it. Spread awareness, a simple act with huge impact. If HG becomes a household word, a term every healthcare provider knows then fewer women will be left to suffer with inadequate treatment and support. I am extremely fortunate and thankful that I had heard of it before, that my midwife took me seriously when I said I could not eat and that the ER doctors treated me without question. Unfortunately that is not the case for many women that suffer with HG. Some are never prescribed medication even after losing over 10% of their body weight, some fight for necessary fluids and some are erroneously told termination is their only choice. Share this article, visit and share the HER Foundation, Beyond Morning Sickness and The HG Warriors websites.

Maria Silver Pyanov, CPD, CCE(BWI) is a mother of four, a postpartum doula and a childbirth educator in the greater Philadelphia area. Her pregnancy journey was shared in a recent Parent Trip article in the Philadelphia Inquirer which can be found here. You can learn more about Maria and her pregnancy services by visiting the Flexible Doula Care and Childbirth Education website.