Pregnancy is an exciting and enjoyable part of life for many women. Even morning sickness, an unpleasant but common side effect of pregnancy, is often taken in stride, seen as a right of passage and a reassurance that the pregnancy is progressing. However, for those who experience Hyperemesis Gravidarum, a severe form of morning sickness, wherein the vomiting and nausea become dangerous to mother and the developing child, pregnancy can be a nightmare; physically debilitating with long-term negative financial and emotional impacts.
The Duchess of Cambridge brought this condition to the spotlight when she was hospitalized with all three of her pregnancies. Here in Vancouver, BC Women’s Hospital has been caring for women suffering for quite some time. One such patient, Megan, was sent to BC Women’s for care in her ninth week of pregnancy.
Less than a week after receiving a positive pregnancy test, she could barely eat because of worsening, intense nausea. At six weeks pregnant, Megan was vomiting multiple times a day and could not keep food down. She was unable to make it to work or even get beyond the bathroom.
The nausea lasted beyond the typical time-frame of ‘morning’ sickness—she felt sick all day, every day. If she swallowed a few bites of cracker and some Gatorade without immediately vomiting, that was a good day.
Because Megan was missing work, she had to let her colleagues know she was pregnant earlier than she had hoped. They would often ask why she didn’t just come to work like other expecting colleagues whose morning sickness had never kept them away. “I don’t know if they truly believed I was being dramatic … but it felt that way. I was embarrassed.”
She called her midwife and was given Diclectin, a drug commonly prescribed to those dealing with morning sickness. “I was taking the maximum dose, I think I was taking 8 pills a day and it didn’t change anything.” She was frustrated, but the stigma attached to Hyperemesis kept her from reaching out again. Megan was offered numerous home remedies from her midwives, such as ginger capsules or acupuncture… but nothing worked.
For 3 weeks she was throwing up, up to 7 times a day, not eating anything, and had lost a considerable amount of weight. She was worried about her baby’s well-being but didn’t have the energy or mental will to call her health care team, only to be referred to home remedies again. It wasn’t until she went to her family doctor for an unrelated issue, that she finally got admitted to BC Women’s. A consulted obstetrician said she was so shrivelled and dehydrated that she looked like a raisin.
Senior Medical Director of Acute Perinatal Programs at BC Women’s Dr. Ellen Giesbrecht notes that this condition is difficult to diagnose since vomiting and nausea are so normalized in pregnancy. Women may not realize it is something more severe like Hyperemesis, and seek further treatment.
BC Women’s admitted Megan to hospital after seeing her weakened and dehydrated condition. She was put on a strong IV anti-nauseant medication and started on a detailed menu plan while in hospital. Once discharged, Megan started an oral anti-nauseant called Ondansetron, a medication often prescribed to patients suffering nausea due to chemotherapy.
On this medication, she was able to return to work and put back on the weight that she had lost… but it was not without side effects. Unfortunately (as with many suffering from Hyperemesis) her illness was not limited to the first trimester. Even up until 38 weeks gestation - 2 days before she gave birth, Megan had her safety net beside her, a bucket she carried whenever she felt nauseous… just in case. She had tried to wean off of the medication several times during the pregnancy, but the nausea and vomiting would come back every time.
A healthy baby girl, Alyvia, was born at BC Women’s Hospital on June 13th of 2017. Megan was happy to share that the delivery went really well… especially compared to her pregnancy. “If I could do delivery again, without the pregnancy, I definitely would!”
Megan is especially grateful to the doctors and nurses for their support and reassurance. Hyperemesis Gravidarum can be a very isolating condition, and many health-care professionals are dismissive. After giving birth, about the pregnancy itself, Megan still thought, “That was the most challenging 9 months of my life!”
Megan hopes that sharing her story will help more women reach out and speak honestly to their doctors about how they are feeling during pregnancy. “It can feel like defeat,” she says, “like already you are failing at motherhood” but Megan hopes that we can break down the stigma and reach a better understanding of the condition, and how to care for those suffering.
With further research and tested medication, health care professionals will be able to diagnose Hyperemesis Gravidarum earlier, offer appropriate medication, and ultimately allow other women like Megan the care they need to experience pregnancy as an enjoyable stage of life.
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