Please note, this blog reflects Karen’s experience. We recognise that HG is a spectrum condition and doesn’t look the same for everyone. If you are struggling with nausea and sickness in pregnancy, always consult your GP or midwife before taking any medications.
I have been pregnant twice, and both times I suffered with hyperemesis gravidarum (HG). It’s debilitating. And I want you to know that, if this is you too, I see you and I understand. Let me talk you through my pregnancies, and what my experience with HG was.
First time round, I didn’t have a clue, I thought that everyone felt like this. From the day I got that positive test, I was nauseous and I vomited. I continued to feel sick until the day my daughter was born. I went to the GP early on, who was very sympathetic and gave me cyclizine, but it wasn’t touching the nausea, so I just pushed on and tried to get over it. I was desperately trying to get to that second trimester, apparently that’s when you start to feel better. Not for me! I remember speaking to my midwife about 14 weeks pregnant and mentioning that I hadn’t been able to keep water down for the past two days. She frogmarched me into the maternity day care unit (for the first of many visits) and there I stayed until I was re-hydrated. Thankfully, that visit was managed with the anti-sickness jags and Lucozade. I can’t look at a bottle of orange Lucozade now without turning a bit green! My medication was adjusted and I left with a plan to get me eating and drinking again. I was surviving, certainly not thriving, but I was ok. The nausea was constant but the actual vomiting decreased with the medication.
This pottered on for a few weeks, until I had to move to a new doctor’s surgery due to a house move. I had letters from my old GP, my midwife and the hospital, all detailing what was wrong and what I needed. I will never forget handing them in to my new surgery, the receptionist opening the letters and saying ‘Well you won’t be getting those meds here! You’re just pregnant and feeling a bit sick.’ I left in tears. My repeat prescription wasn’t filled, I ran out of my medication and within the week I was back in hospital, dehydrated and exhausted. Thankfully, I met a wonderful consultant who advocated for me and, alongside my new midwife, sent a strong note to my GP surgery. I remember it was a Friday afternoon when I was discharged, and my midwife turned up at my house on the Saturday morning with an emergency prescription that she has picked up from the surgery and had filled for me. Again, I cried. It became a regular theme for me in pregnancy, crying and vomiting. Sometimes at the same time.
I plodded along, spending all of my spare time in bed. The nausea is so tiring, and so relentless. My mental health suffered the most about week 20, I felt like I had been feeling sick for so long and I was only at the halfway point. By this point I was resigned to this being my reality for my whole pregnancy, I had run out of hope that it would go away. Between 20 and 30 weeks was hard. At 30 weeks my midwife organised some hypnobirthing classes for me, and also some aromatherapy which was lovely and helped distract me and focus me on the end goal.
As I got closer to full term, I rallied a little and could see the light at the end of the tunnel. I was scheduled for a c-section at 38 weeks and I’ll never forget being weighed beforehand and the nurse doing a double take. I was exactly the same weight at 38 weeks pregnant as I had been before I got pregnant. It truly hit me in that moment, this is a proper illness, not just a bit of morning sickness. On the plus side, as soon as my daughter was born, I felt back to my normal self. I remember sitting in recovery, not bothered about the fact I couldn’t feel my legs or had a tummy full of stitches. I was just so thrilled to have a diet Coke and some salt and vinegar Pringles! My recovery was very food based as I savoured everything I couldn’t stomach over the past nine months.
My second pregnancy, I knew before I even took the test. That familiar nausea had crept up on me again and I just knew. But this time I was prepared, I knew what I needed and I had the confidence to advocate for myself. I got myself a GP appointment and went in with a list of medication, including a new one that I hadn’t been offered first time round (ondansetron, if you’re interested). I was advised not to start the ondansetron until 12 weeks, but the GP was wonderful and got me a good supply of cyclizine and prochlorperazine. I dug out my travel sickness bracelets, and went through my diary and cancelled anything non-urgent (anticipating the exhaustion). In post-covid times, I was extremely nervous about going to work (in a school), so spoke to my line manager and had my risk assessment done ASAP.
I got myself to 12 weeks and started ondansetron. Oh my goodness, for a week I felt wonderful! I could eat anything! And then the side effects kicked in… A tip for anyone on ondansetron, if you are offered lactulose, take it. The constipation was unreal, and back to hospital I went. I had much more time off work second time round, I think the first time I powered through, had strategically placed sick bowls and was always within sprinting distance of a bathroom. This time, I was signed off by my GP multiple times, and then for good from 28 weeks. I couldn’t do it. It was taking all my energy to function day to day, half of which was spent in the bathroom. When on the ondansetron, I rarely actually vomited, but the nausea was still there. I am often travel sick (I know, a grown adult!) and I likened it to how I feel when I’m on a boat. Shaky, like the floor is moving and constantly feeling like I want to throw up.
Again, my mental health suffered. HG is so underestimated by anyone who hasn’t had it, and I was in and out of hospital (thankfully only day visits) for hydration and checks on baby. My weight loss wasn’t quite so drastic this time, which I put down to the ondansetron. I had a few foods that I could tolerate in small doses and my sickness wrist bands were permanently welded to my wrists. I went to a wonderful local woman for pregnancy massage. I remember the weeks leading up to delivery, excitedly telling my midwife what I was going to eat first in the recovery ward! As predicted, as soon as I delivered, the nausea vanished. Like magic!
It’s a bizarre thing.
I think it’s important to take a quick minute to talk about how my HG affected others. My husband spent both pregnancies picking up everything I couldn’t do (including so much childcare second time round for our toddler), going to the shops in the middle of the night because I’d thought of something I might be able to eat, remembering my sick bowl anytime we went out a drive, collecting prescriptions, advocating for me when I couldn’t speak up for myself and generally cheering me on. Some weeks I needed him to sympathise, and some weeks I needed him to be a cheerleader. He kept an eye on my mental health, and would often spot I was struggling before I identified it myself. It’s so easy to drown in the relentless nature of HG, but he made sure I knew I wasn’t alone. And sometimes that’s all you need.
I wish I had answers for anyone suffering at the moment, but I don’t. I can offer some suggestions though, which I hope help.
- Don’t suffer in silence, speak to your midwife or GP. If they don’t listen, speak to another one. Someone will help you.
- Find some ‘safe’ foods and eat them (mine were dry wraps and frozen grapes). If you can’t, sip tepid water (sounds awful, but cold water was too harsh on my tummy). Ice lollies are good for hydration if you can cope with the taste.
- Try not to worry about baby, they will get the nutrients they need. Your body takes care of them first and you second, so even if you are looking a bit gaunt, baby will be just fine.
- Travel sickness wristbands can really help, they were a lifesaver for me.
- Keep an eye on your mental health. It is so draining knowing that it’s another day of feeling sick, and another, and another. Ask for a referral from your midwife to the mental health team if you need it.
- And a top tip for anyone who knows someone suffering with HG; don’t ask if they’ve tried ginger biscuits. We’ve all tried ginger biscuits. They don’t work. And we are more likely to chuck a ginger biscuit at you!
https://bnf.nice.org.uk/drugs/ondansetron/ (Please note, ondansetron should not be taken in the first 12 weeks of pregnancy due to small increased risk of cleft lip/palate in the baby)