Hyperemesis gravidarum. (hi-pur-em'i-sis grav-i-dar'um). It's a bit of a mouthful. It doesn't exactly roll off the tongue. Perhaps that's why it was little known and rarely talked about until the recent royal pregnancies brought it to our attention. Perhaps it just never caught on as a topic of conversation before now. Vomiting and exhaustion aren't the first things we usually discuss over tea and bourbons. Or maybe it's to do with the fact that we don't really talk about early pregnancy at all? These early weeks are the time when many women suffer the most during their pregnancies, and yet we often try to suffer in silence. Would it be so awful if our friends, family and colleagues knew? Why are we keeping it a secret? Who are we trying to protect? There is a taboo about miscarriage. It is a deeply personal event, but I think a woman can decide for herself whether she feels it should be kept private. I think many would agree that we need and deserve our community's support whether our pregnancies continue to term or not. The statistic often cited about one in four pregnancies ending in the first trimester actually includes a large proportion of losses which occur so early that the mother might not know she is even pregnant. By six weeks there is less than 10% likelihood of suffering a miscarriage and by eight weeks there is less than 2% chance.
There is a longstanding custom of secrecy surrounding the first three months and we have yet to break free from it. In times past, long before ultrasounds and pregnancy tests, the surest sign of pregnancy was the onset of foetal movements, beginning around four months. This was known as the quickening and it was a very significant moment. There may have been a lot at stake for a woman finding herself pregnant for a number of reasons, so it made sense to wait to be sure. But in the past a woman suffering from hyperemesis gravidarum (HG) may well have died from the illness and no one would have known the cause. It is thought that the author Charlotte Brontë might have been suffering from it when she died in 1855 after four months of pregnancy with intractable nausea and vomiting, apparently unable to tolerate food or water. Even today, with IV fluids and medication available to those lucky enough to receive it, some women are nevertheless so ill that they are forced to terminate their pregnancy.
I have been pregnant twice and both times I was completely debilitated by HG. I will never intentionally fall pregnant again, because the thought of it is so completely unbearable. I couldn't justify putting my family through it, knowing the effect it would have on us all. HG is not morning sickness. For me it's all day and all night. It's not being able to stand, speak or lift your head from your pillow. It's needing to eat every two hours otherwise you start shaking uncontrollably. It's feeling as though an iron fist is pressing deep into your stomach, forcing you to curl in on yourself. It's sleeping for 16 hours straight and then only having the energy to go to the toilet before crawling back to bed to sleep for another nine. It's missing your 18 week check because you simply could-not-get-to-the-phone to make the appointment, let alone get to the clinic. It's finally speaking to a midwife and being advised to eat ginger biscuits and get some rest. It's going to hospital and sobbing to the doctor on duty, asking for fluids and being told you're probably just a bit depressed. It's having to rely on others to look after your toddler and do everything else you would normally do in your daily life. It's feeling as though your unborn child is a parasite that might be killing you. It's wanting the baby anyway.
The first time I experienced HG was before the Duchess of Cambridge had had her first child, George and I had never heard of it before. I thought that perhaps I was just a bit feeble or that maybe I was somehow incompatible with my baby. I stayed at home for the first four months and after that I only worked occasionally because I was freelance and luckily I didn't have to hold down a job. My second pregnancy was much worse. I had a child to look after and my reserves may have been lower after two years of 24-hour parenting. Hyperemesis is often worse with each subsequent pregnancy, but I didn't know that at the time and I wasn't at all prepared. I felt like I had been overcome by a great tsunami. It took a long time to re-surface and start to see what was happening and how to stay afloat. I never received the care I needed because I had no way of accessing it while I was in such a state. The doctors and midwives I spoke to didn't recognise my condition because I wasn't vomiting much. A very small number of sufferers don't vomit, but the condition is no less severe in these cases. Eventually I found a pregnancy sickness support group and was able to research the symptoms and confirm my self-diagnosis, but it was really too little, too late. My experience of pregnancy was one of abject misery. But the tide is turning and with all the media coverage of Kate's pregnancy sickness, perhaps the next generation of HG sufferers can expect more understanding from their doctors, their families and their colleagues. Perhaps soon we will all be talking HG over tea and perhaps we will one day break the taboo of the first trimester altogether.
Pregnancy Sickness Support is a charity and support group specifically aimed at raising awareness and helping women and their families struggling to cope with this crippling condition. Visit their website for more information.
Trust Your Body, Trust Your Baby is Rosie Newman's debut book sharing everything she wishes she had known before becoming a mother.