What is Hyperemesis Gravidarum (HG)?
Hyperemesis gravidarum (HG) is extreme nausea and vomiting during pregnancy. It affects roughly 2% of pregnancies and is much more severe than the (mild, or at least tolerable) nausea and vomiting that is often associated with early pregnancy.
It is caused by genetic factors and, untreated, it can be life threatening.
Because HG is uncommon, many doctors and midwives are not up to date with the most current information and treatment options. Given this, doing extra research on your own can expedite your pathway to wellness and protect your health, mental health, your pregnancy, and your pregnancy experience.
Though many pregnancy professionals aren’t truly up to date with HG, there ARE people who are. There is an incredible organization called The HER Foundation, and if you or a loved one has HG, their website can be a tremendous help. They offer the most current, unbiased, and evidence-based research available regarding HG and treatment options for HG.
If You Have HG:
If you have or think you have HG:
The first thing to do is learn about HG. Remember, many health professionals are not up to date with the most current info and treatment options. Recent advancements have been made, but you can only benefit from them if you know about them. Go to The HER Foundation and familiarize yourself with their site. On the site, you can find scales to rate your levels of severity, flow charts that outline treatment options and approaches, handouts you can bring to your midwife or doctor, online support groups, links to evidence-based studies, and more.
Determine 1) what level of severity you are experiencing and 2) where you are on the HELP scale.
Now, make sure you have a doctor or nurse who can help you through this. This should be someone who you feel comfortable with, who you can trust, who understands what HG is, and is compassionate about what you are going through. They do not have to be an expert in HG, but they do need to understand the seriousness of it and be willing to help you with the additional elements that having HG can add to pregnancy care.
If your current doctor doesn’t fit this, consider finding a different one. Having the right support is important. Though it can be hard to find someone you trust, the benefits can be immense.
The HER Foundation has a professional referral network on their website and also a list of questions you can use to interview potential doctors.
Become an established patient with your chosen doctor. Have the initial visit, do the lab work (it’s important to have baseline labs), and discuss treatment options. Create a plan with them or consult with someone who can help you create a plan that you can take back to your doctor (this can be done with a different health professional who specializes in HG).
Throughout your pregnancy, be honest about your symptoms. Insist on the care you need — at your doctor’s office, in the hospital, or with anyone else. Advocate for yourself. If someone isn’t helping, even if it’s your main doctor, do not be afraid to try someone else, consult with someone else, or even change doctors.
The Learning Curve
One of the craziest things about HG (for me, at least) is that it came on so fast. Like most people, I had never heard of HG. One minute I was soooo excited I was pregnant, and very soon after, I was not feeling well, then vomiting all day, then weak and bedridden. And then, I needed to get to a hospital for IV fluids. It was unexpected and crazy, and then it turned scary. :(
Given the context in which HG comes, (right while mentally and emotionally processing a pregnancy), it was really challenging to become so sick — so intensely and so quickly.
It took me a while to figure out what was going on and then to figure out what the heck HG is. It then took me a while to research HG and figure out what info was unbiased. Then, I had to research treatment options and wrestle with the pros and cons of each. Ultimately, I accepted that I did need medical help. What was also very challenging was that, by this time, I was already quite sick, depleted, and vulnerable. (Note: this was my particular journey, and everyone’s will be different.)
Looking back, one of the most stressful aspects of having HG was not knowing anything about it when it struck, and also not knowing anyone who knew anything about it. Being pregnant, I cared so deeply about what I put into my body and how that would impact my tiny developing baby; I didn’t want to make a mistake. This pressure combined with the intense nausea and vomiting caused me a lot of struggle.
Crucial Early Knowledge: Dehydration
An important side note about hydration: Dehydration is one of the biggest and most immediate risks (and consequences) of having HG. People with HG get dehydrated because of repeated vomiting and the inability to keep fluids down. Because becoming dehydrated can lead to much more serious problems rather quickly, especially if the vomiting doesn’t stop, it is crucial to be aware of hydration.
Hopefully your doctor can guide you, but in general, if you are unable to keep fluids down for more than12 hours, you likely need IV hydration. Without this, you can develop more serious problems rather quickly.
If you are in question, go to the ER or contact a mobile IV hydration company to come to your home. Being dehydrated also makes current HG symptoms worse, so if you are dehydrated, please get IV hydration as soon as you can.
Now What?
When you have all of the above in place, take a minute and place your hand on your heart. None of this is easy.
Having HG can be scary (and miserable), but if you learn what it is, how to treat it, how to manage it; if you stay hydrated and have a doctor who you trust, you can weather this storm.
When the above things are in place, it can be a good idea to check in with your mental, emotional, psychological, and even spiritual health.
All of this can feel scary, and thinking about how to manage it can feel overwhelming. Break it down into tiny pieces, and focus on just one step (or one minute) at a time.
Mental Health
Having HG can be overwhelming. This, alone, would be cause to give attention to mental and emotional health, but often, with HG, there’s more.
Having HG can strain other things, like finances and career because if one can’t work. It can strain relationships, friendships, family dynamics, health (obviously), and parenting relationships with other kids. Depending on how long you have HG (which varies for everyone and also depends on the treatments you try and how you respond to them), it can pose a risk to mental health. This is because it’s challenging, painful, can be isolating, and can go on for so long. If you have preexisting mental health issues, like anxiety, depression, or injuries from trauma, risk for mental health issues related to HG can be even higher.
After you’ve addressed the above areas for your physical health, it is a wonderful idea to consider your mental, emotional, and psychological health — even if it is preemptive.
If you have a therapist, determine if they can help you with this. If they can’t, consider connecting with a different therapist, just for this time period, who specializes in medical challenges or challenges during pregnancy can help you specifically with HG. You can still keep your other therapist. Working with a specialist for a specific struggle is common and can save you time.
If you don’t want or have the energy for therapy, there are other ways to get support. People who have been through HG offer consult for those with HG — or for family members who want to best help. Sometimes, the most needed support comes from family members, and a lot of benefit can come from family members consulting. Consulting can also help to bring family members onto the same page, increase cohesion and purpose, and reduce stress in a family system.
Mental health support will look different for everyone. A good therapist will listen to you, learn about your history, be in your corner, learn and understand what is most distressing, and help you navigate this challenge, within your unique circumstances. A good consultant will listen, learn about your situation, and help you identify what types of things can make the most positive difference given your unique situation. Whichever way you go, connecting with someone who truly understands HG and the mental health aspects of it can minimize damage.
In Conclusion
Having HG can be very challenging, in more than a few ways. Thankfully, there are others who have been through it and who very much want to help those who have it. Recent advancements have been made, and researching on your own can help you take advantage of them. Because HG can be so disruptive (and stressful!) and also happens right before another major life change, having the right doctor and investing into mental and emotional health can help you get through it as easily as possible, recover more quickly and more thoroughly, and help you get into in the best position as possible to begin the next chapter.
If you are looking for mental health or emotional support and you have HG or have a loved one with HG, I would love to be of service. I offer free initial consults for new clients.