About 8 weeks ago, I promised myself that if I survived, I would share what I’d consider to be one of the most cruel and debilitating things I’ve ever been through — my first trimester of pregnancy. In September, I found out I was pregnant, and I was shocked, but ecstatic. That week I went running a few times, as I normally would, and felt amazing — invincible, even. I pictured myself continuing to run through my pregnancy, eating healthy foods and doing everything I could to give this baby a healthy start in life. About 10 days later I was laying in a bathtub, wishing my life would end, and planning out ways to make that happen.
What people don’t tell you about pregnancy, or they downplay, or what they just don’t know…is that a small percentage of pregnant women will suffer from something called Hyperemesis Gravidarum. It is an extreme and crippling form of “morning sickness” that is difficult to imagine if you’ve never been through it. I’ve known plenty of women who have had mild or occasional nausea and vomiting in pregnancy, and even known a few who had HG, but had NO idea what kind of an impact it can have on your life. One horrible reason you probably haven’t heard about this (unless you’ve been through it or have a partner who has) is that women are culturally shamed into hiding their pregnancies until 12 or more weeks — when the window for miscarriage drops significantly. The logic being that if you DO have a miscarriage, you should quietly bear that burden on your own (more on that nonsense later).
Trying to describe HG now is a little difficult because the worst of it is behind me. Imagine you have food poisoning, or the worst stomach flu you’ve ever had, from the moment you open your eyes in the morning until you are finally able to close them at night (if you’re lucky and can sleep). For every waking moment, your entire body is overcome with violent nausea. Imagine that feeling lasting every day for 10 or more entire weeks of your life. Some women with HG, as was the case with me, vomit multiple times a day. I think my record was 10 or 11 times in one day — even when there was nothing left in my system to vomit, but I still stood over the toilet choking and gagging on my own bile. Others have nausea without vomiting, but please believe that neither scenario is “better”. For me, the nausea was actually more debilitating than the vomiting. And it just. Doesn’t. Go. Away. To make matters worse, while you are in the beginning stages of growing a new life inside you and your brain is telling you to nurture it, your body is telling you, quite violently, NOT to eat or drink anything. In a cruel trick of nature, a functional evolutionary trait has made pregnant women skeptical of all foods that may, centuries ago, have been harmful to the baby, and so you suddenly just can’t fathom the idea of eating anything. Meat, vegetables, dairy, fish, fruit…I didn’t want any of it, and if I had eaten a bite of any of it, it would have come right back up anyway. Smelling lettuce was enough to send me retching to the toilet. In my case, the WORST trigger was water. Yep, that’s right…the one thing that you have to have every day to sustain life literally made me throw up so violently that I quickly became dehydrated to the point of delusion. I couldn’t even look at water without gagging. My wrist veins were the size of sewing threads, my lips were constantly parched and peeling, my head ached (but you can’t take painkillers when pregnant), and I genuinely just wanted to die. The guilt was immense — I thought constantly about how badly this must be impacting the baby inside me, who was just trying to grow, and I thought about how badly I was failing that baby by not even being able to feed him. I didn’t leave the house for 14 or 15 days at a time…I stayed in bed crying, lay on the couch or just sat on the floor in the bathroom. (Thank God I was able to work from home.) Standing up made me dizzy. I didn’t care about the pregnancy, myself or waking up the next day. Not waking up was all I could fantasize about because it would mean the end of that feeling. I was genuinely losing my mind, and nobody close to me (not even my mother) had been through it. Even she seemed to think some of it was in my head.
Now….any logical person would assume that going to see a doctor would be a rational next step for someone so sick. Funnily enough, we did think of that! My wonderful partner, pretty early on, managed to get a very shaky and weak me out of the house and down to my doctor. Without going into too much detail, my doctor is easily close to 80 years old, a man, and of the mentality that suffering through pain is the best course of action for most ailments. I cried in his office as I told him that I was depressed and couldn’t go on like this. “Now, now…don’t be depressed,” he scoffed patronizingly down his nose at me. (“Don’t be depressed”? Is that actual medical advice?) My partner spoke on my behalf (I couldn’t muster the strength), telling him I had lost weight rapidly, wasn’t eating or drinking anything but the few bites of carbs or sips of juice I could manage a day, and begged him to give me the anti-nausea medication we had researched (widely available in hospitals and in the US) to make it possible for me to even stay hydrated and have a few bites of nutrition. He responded that I should eat some ginger and try eating a few dry biscuits. (Oh, thanks, I hadn’t thought of that!) Did he not understand how severe this was? Ginger and dry foods were the first things I turned to in the early days of this, because GOOGLE. The scent of ginger made me throw up, and dry foods had a similar effect. Nothing. Worked. He then spent about 10 minutes telling me about Thalidomide and how it caused serious birth defects in the babies of women who (and I quote) “weren’t willing to go through the nausea and just wanted to pop pills like candy”. (Umm, I’m sorry…didn’t doctors like you PRESCRIBE it to them?) Through a combination of subtle threats and a long series of back and forths with the hospital where I’m registered for birth and this dinosaur doctor, my partner eventually managed to wrangle me some anti-nausea medication (called Stemitil, for any women out there wondering), which a much younger doctor at the hospital told us is completely safe, tested to a level of confidence he felt good about, and is routinely given out at hospitals. I cried with happiness when we finally got our hands on it, but trust me that, thanks to that doctor, I also felt scared and guilty taking it for the first time. I felt that way until I realized that it did help to stop the vomiting (not the nausea, unfortunately). Some weeks later, I felt more reassured when I had an ultrasound and saw our little baby wiggling around, with a healthy heartbeat.
I’m typically a pretty upbeat person and now that I know what genuine (albeit temporary) depression feels like, I know that depression is not “normal” for me. Maybe that made it harder…literally everything about my body and psyche changed overnight, and there was nothing I could do about it. Hormones can be very scary. When you’re pregnant, your body produces something called human chorionic gonadotrophin (HCG). It’s the chemical that pregnancy tests pick up on, and that will definitively say if you are pregnant. People who aren’t pregnant have none of this in their system, except in rare cases where a tumour has grown. For a woman in week 6 of pregnancy, HCG levels can range from 1,080–56,500 mIU/ml. By week 8, it can soar to between 7, 650–229,000 mIU/ml. I know, through blood tests, that my HCG was in the 200,000s….extremely high, far higher than the average. This, medically, explains why I was as sick as I was.
Why am I writing all of this? It’s been cathartic, although it physically hurts me to think about how sick I was just weeks ago. While my appetite has taken another weird turn, at least I am now able to eat, I am staying well hydrated, gaining weight, and my mood is far better. (By about week 15, your HCG levels typically stabilize.) Along the way, it really hit me how shitty many women have it. I thought of the pregnant Syrian women I met in refugee camps earlier in the year and how any amount of HG could just have been the final straw in that scenario. In spite of location, I truly believe that if men could be pregnant, doctors’ attitudes towards HG would be much different, and there may even be a proper treatment plan in place for it beyond “hey, suck it up and eat some ginger.”
In the UK, a low estimate shows that over 1,000 women a year have abortions because of HG. Those are the ones that are reported. (You can read the harrowing experience of one such woman here.) I imagine that number is much higher, and I’m sure the physical and emotional suffering is much greater in other parts of the world. What a tragic thing it is to have to suffer alone and in silence, or even to end your pregnancy, because of stupid norms around when it’s socially acceptable to announce your pregnancy, and because the medical world doesn’t want to invest in finding treatment for something that only women go through. If you’ve made it this far in my rant, I hope you’ll join me in encouraging women to not be quiet about their pregnancies if they are hurting. Neither miscarriage nor HG is something to be ashamed of, and having people to talk to and share with makes it SO much better. If you’re pregnant and experiencing HG or depression, know that you’re not alone, it does get better, and there is NO shame in seeking proper medical treatment, including medication, to improve your quality of life.