Nausea and vomiting in pregnancy is one of the most commonly discussed symptoms in popular culture – nearly every pregnancy experience alludes to “morning sickness” – but what about when its morning, noon, night sickness?
1-2% of pregnancies meet the criteria for hyperemesis gravidarum, however the actual numbers of women experiencing moderate to severe nausea and vomiting in pregnancy, that impacts on their daily function, their quality of life, their mental and physical health and the wellbeing of their unborn child and their family is likely much higher, but not assessed appropriately by current diagnostic criteria. HG often results in significant weight loss in early pregnancy, dehydration and electrolyte disturbance and often requires medication or IV hydration in order to cope with the effects.
I never understood how debilitating nausea and vomiting in pregnancy could be until I experienced it for the first time myself. In my first pregnancy I lost 12kg in the first 16 weeks of pregnancy, my second pregnancy I lost 8kg and my third pregnancy my weight fluctuated throughout the first 25 weeks. While 70-80% of pregnancies involve some level of nausea and vomiting, many of these will resolve by 12 weeks – HG may persist until delivery, with it often persisting until mid-pregnancy at a minimum.
Commonly suggested strategies for managing nausea and vomiting in pregnancy such as vitamin B6, ginger, sour drinks, Fruit Tingles, may be helpful for some women, however the majority of women in the throes of even moderate nausea and vomiting in pregnancy will find that additional medical support is necessary.
There are safe and effective medications available for reducing your symptoms, however the reality for many is that the vomiting will not be prevented entirely. Three pregnancies, three different management strategies – some medications that worked in my first pregnancy didn’t work at all in my subsequent pregnancies.
Three Key Strategies for Managing HG:
- Advocate for yourself with health professionals.
Finding a supportive team to manage my subsequent pregnancies made a huge difference in my experience. I didn’t have to recurrently present to my GP to get the prescriptions I needed, and I knew that if I required hospital admission or hospital in the home services, I would have access to them in a timely manner. If you are struggling to access effective support, I would encourage you to follow up with Hyperemesis Australia – who provide a great number of resources and support services that make self-advocacy or advocacy for a loved one easier. You may also find it helpful to access the current guidelines for Management of Nausea and Vomiting in Pregnancy and Hyperemesis Gravidarum and print a copy to take to appointments with you.
2. Get your support system in place
Having supports and reasonable expectations in place in this season of your life is essential to your health and wellbeing. If you have supportive family or friends, consider sharing news of your pregnancy with them early and asking for their practical help where you feel comfortable (e.g. help with older children, meal prep for other members of your household). If you don’t have family or friends to help, consider taking this time to access support systems such as meal delivery services like Youfoodz, a house cleaner, or sending your laundry out if you can. And lower your expectations: your house is going to be a mess, you are going to eat what you can keep down and get some calories from, not what is nutritionally best.
3. Consider accessing early leave or sick leave.
If you have sick leave, use it. You are sick. Get a doctors’ letter confirming your condition, and apply for a flexible work agreement if necessary. Some employers that provide you with paid or unpaid maternity leave will allow you to take a portion of your time off during your pregnancy when you have a complicating condition, and hyperemesis falls into this category.
If you are suffering with HG, or have previously experienced a HG pregnancy and are planning another pregnancy – I would highly recommend Hyperemesis Australia as a resource to you.
The Natural Fertility Collective 