The awful reality of extreme morning sickness
It was world news when Kate Middleton was hospitalised with hyperemesis gravidarum. This is what it’s like to live with extreme morning sickness.
When Caitlin Kay-Smith was pregnant with her first child, she was excited by the onset of morning sickness.
It was the first physical sign she was really having a baby, the founder of Hyperemesis Australia recalls.
But after two weeks of vomiting at least 10 times a day and constant nausea, Caitlin realised something was seriously wrong.
That something turned out to be hyperemesis gravidarum, a condition that would cripple her for the remainder of her pregnancy and lead to her losing 15kg.
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What is hyperemesis gravidarum?
GP Dr Angela Rassi, of Sydney Perinatal Doctors, has also experienced the severe and persistent nausea and vomiting associated with hyperemesis gravidarum.
There are also symptoms of dehydration, such as a rapid heart rate or feeling dizzy, along with weight loss, poor appetite, difficulty keeping food down and low mood.
“The debilitating nature of this disease cannot be overstated – it affects every aspect of women’s lives,” Dr Rassi says.
The cause isn’t completely clear but is thought to be due to hormones changing during your pregnancy.
While hyperemesis gravidarum is quite rare, impacting around 0.5 to 2 per cent of pregnancies, it’s more likely in twin or multiple pregnancies or if hyperemesis gravidarum runs in your family.
The debilitating nature of this disease cannot be overstated – it affects every aspect of women’s lives.
Is it hyperemesis gravidarum or morning sickness?
While often described as severe morning sickness, hyperemesis gravidarum is a different condition.
Morning sickness is far more common, with up to eight in 10 women experiencing symptoms including nausea and vomiting during pregnancy.
Considered a normal, harmless condition of pregnancy, the nausea and vomiting associated with morning sickness does not cause dehydration and it usually improves by the end of the first three months.
When is hyperemesis gravidarum likely to be an issue?
Dr Rassi says the experience of hyperemesis gravidarum is different for everyone.
Some women experience a rapid onset very early on in pregnancy, while symptoms arrive more gradually for others.
Generally, she says, hyperemesis gravidarum starts before the 10-week mark and stops between 16 and 20 weeks – but for some women it can last the entire pregnancy.
If you suffer hyperemesis gravidarum, the chances of experiencing it with future pregnancies unfortunately increases.
‘I could barely move without vomiting’
After only having moderate morning sickness with her first pregnancy, Dr Rassi had hyperemesis gravidarum second time round.
“I woke up one morning at five weeks pregnant and could barely move without vomiting,” she recalls.
Constant vomiting for the next 11 weeks meant Dr Rassi couldn’t work or care for her toddler, and her mental health took a beating.
“I was completely miserable and was crying daily but had no tears because I was so dehydrated,” she says.
Cailtin’s ‘absolutely unbearable’ nausea
Caitlin and her husband moved in with her parents so she would have around-the-clock care.
The nausea was “just absolutely unbearable”, she recalls.
“I used to joke with one of the doctors who was looking after me, ‘Can you put me in a coma until the end of the pregnancy? I can’t live like this’.”
While every midwife or doctor told her that “at least the baby’s healthy”, Caitlin felt her own physical and mental struggles were largely ignored.
She says some doctors suggested she was trying to bring on a miscarriage, while another claimed she was bulimic.
Many were just unfamiliar with hyperemesis gravidarum.
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What Caitlin did for her second pregnancy
When she became pregnant a second time, Caitlin says she took a far more proactive approach, which really helped her mentally.
“I started medication as soon as I found out I was pregnant,” she says.
“I was getting fluid three times a week – sort of like a preemptive thing – so I never slipped into dehydration,” she says.
“So even though I was still physically sick and I was still vomiting and I was still constantly nauseous, there were steps in place to prevent it from spiralling.”
What to do if you have hyperemesis gravidarum symptoms
If you suspect you have hyperemesis gravidarum, Dr Rassi recommends first seeking out a GP with a special interest in pregnancy, or an obstetrician.
“They can assess the severity of the symptoms, examine and investigate for any complications and provide advice on lifestyle strategies and medications which can help to manage the symptoms,” she says.
Written by Larissa Ham.
