By Tahlia Hutchison – Mum and Co-Founder of Little & Brave Eco Nappies
As an HG survivor, and with our focus on Mums this month, I wanted to share my tips for supporting a Mum with Hyperemesis Gravidarum.
Hyperemesis, or HG, affects around 2%-3% of women and is a life altering, and at times life shattering, form of severe nausea and vomiting in pregnancy. This is not something you fix with a dry cracker or some ginger ale. For some women hyperemesis results in hospitalisation. For many others it means months and months of medication and daily, if not hourly, vomiting sessions.
To put it into perspective, HG is like having your worst Uni hangover, multiplied by 10, 24 hours a day for weeks and weeks on end (and no time-frame for when it might stop). In my case it has meant that I began vomiting before I had even missed a period, and the need for multiple IVs because the dehydration had become so bad.
As I work through HG pregnancy number three, I felt a real need to share what I have learned, in the hopes that it will help other women and families who are also managing this debilitating condition.
Tip 1: If you have not experienced HG, you truly cannot understand what a sufferer is going through. That doesn’t mean you can’t be supportive.
HG is not morning sickness. If you, or someone you know, experienced morning sickness you do not know what having HG is like. HG is morning sickness on steroids. To be diagnosed with HG you have to have lost at least 5% of your bodyweight. In most cases it requires medication to manage it. Hospitalization is common.
I write this because it used to drive me nuts when people said that they had morning sickness (or knew someone who had morning sickness) and then proceeded to say that eating a cracker before they hopped out of bed solved it. At worst I vomited 40 times in a single day. A cracker is not fixing that.
This does mean that you can’t help. In fact, one of the best things you can do for an HG sufferer is to help her. Take the kids for the day (or the weekend). Do a load of washing. Unpack the dishwasher. Bring food over for the rest of the family. Scrub the loo. Do a shopping run. All of these practical things reduce the amount of “stuff” she has to do (or she has to feel guilty about if she can’t do them) and allows her space to rest, or even better, to sleep.
Remind her that you love her, that she is awesome and that is she is a great Mum. Tell her often, when she is up for some conversation.
Tip 2: Ginger tea will not fix this (or whatever suggestion is on the tip of your tongue)
Unless you are asked for advice, please resist the urge to give it. This also includes any sentence that starts with: “Well, in my day…”
If a woman has HG she will have tried everything that you are about to suggest and then some. She will have done crackers, low fat, high protein, no meat, only carbs, every single tea and homeopathic remedy you can think of. She would have done all of these things because HG is relentless. She will have tried everything to make it go away. She would have done these things because she would have been scared of taking medication while pregnant. Trust me, if you can think of it, she has tried it.
Instead of telling, ask “What can I do to help you?”
Tip 3: Set aside a toilet
There is nothing worse than power chucking into dirty loo, or walking into one after someone has pooped in there. If she is able to get out of bed and you have more than one toilet, designate one for her use only. No exceptions. If you don’t have a second toilet, make sure that everyone (including guests) know that the toilet must be cleaned after use and invest in a deodorising spray with no perfume.
Tip 4: Identify her triggers and eliminate, or at the very least minimise, them
There are some fairly common triggers for HG sufferers. These include: strong smells (think foods, perfumes, colognes etc), car travel, stress and tiredness. The good thing is these are also easy to eliminate. If onions being cooked make her vomit, don’t cook them. If travelling in a car makes her vomit, then do the errands for her. If she must travel, time it around her medication and keep containers and bags in the car for her to vomit into. Take responsibility for the child care and housework so that she can rest. Let her go to bed early and sleep in until the very last minute. Eliminate sources of stress. This includes the very real feelings of guilt that she will be experiencing.
Ask her often what her triggers are (they can change) and work to create an environment that is ‘trigger free’.
Yes, this may mean that you are doing more than your ‘fair share’. But remember, her job right now is growing your baby (and staying out of hospital).
Tip 5: Fizzy, sweet, and ice cold
In my experience, and chatting to other HG Mamas, fizzy, sweet, ice cold drinks are easier to keep down than plain water. I am not sure why, but plain water just made me vomit. I even knew one Mum whose sole source of liquid for a period of time was Coke. It was the only thing liquid that she didn’t throw up.
Start with sparkling water first and don’t be scared to try adding a water flavouring product like Vital Zing. If all she can keep down is lemonade, then that is what she gets. Keeping her hydrated is critical.
Tip 6: Keep plastic containers or plastic bags everywhere
Keep a plastic container in the car. Leave a bucket next to the bed. Think about keeping them handy so she doesn’t have to search for them. I don’t normally advocate for single use plastic bags, but having them in my handbag, and coat pockets has often meant not having to spew into a rubbish bin or on the footpath (which I have done too).
Tip 7: Remind her to pee before she vomits (if she is able to)
This will prevent her from peeing all over herself when she vomits. If it happens though, don’t let her feel embarrassed about it. Remind her that this is out of her control and that other women have experienced it too.
Tip 8: Educate yourself
During this pregnancy I began aggressive medical treatment before I had even missed my period. I started, because the power vomiting began at 3 weeks + 5 days. I also stopped all multivitamins, including those with iodine. This has been the absolute best pregnancy I have ever had. To put this into perspective the weight loss has been minimal and I only vomit, once or twice per day, and only if I eat after 3pm. I have been able to keep working. I have been able to look after my children. I could not do any of these things during my last pregnancy.
I only knew to start the medication early, because I had read a whole lot of research into HG.
Read everything that you can get your hands on. Join forums. Talk to other Mums and their partners who are managing HG. The more information you have to hand the better you will be able to advocate for your partner and your family.
Tip 8: Look for the signs of antenatal depression or anxiety
HG tends to work in cycles of relief and relapse. If she hasn’t quite got the medication right, it will be one long stretch of relapse. This can last for weeks.
There is also a horrendous amount of guilt that goes along with this condition. I worried constantly about hurting my baby because I was eating so little. I had to park my toddler on a tablet for long stretches because I physically could not get up to play with him. I felt terrible that I couldn’t help my husband with the housework, and I missed my friends and family terribly, because I was too sick to go anywhere. My last pregnancy was an incredibly lonely time. From my conversations with other HG Mamas, I know this is common.
HG is isolating. HG is soul destroying. It is not surprising than that it is common for HG sufferers to experience depression and anxiety because of it.
If you are worried about your partner’s mental health please talk to her, her midwife and doctor, and encourage her to talk to a counsellor as well.
Tip 10: If your partner (daughter, sister, friend) cannot advocate for herself, be someone who will.
If she is too sick to advocate for herself, you need to step in. Does she need an IV? Make sure she gets one. Is her medication regime not working? Talk to her health care provider. Has she been able to keep liquids down for the last 24 hours? Keep track and get her to hospital if she hasn’t.
There will be days when she is so dehydrated that she can’t think clearly. It is your job to be there to provide the support, and voice, that she needs.
BONUS TIP: Care for the caregiver too
If you partner is suffering from HG, the last thing she needs is for you to fall over! It is so critical that you take care of yourself as well. If you have other children, they will also need more from you, as you may be their sole source of support and comfort for a period of time. Reach out to your family and friends for support and help. This is likely to come in the form of child care (for older siblings) and helping out around the house, but all of these things will give you space to focus on caring for you.
It can also be easy to feel resentment, either towards your partner (who may be a shadow of her former self) or your new baby (who you might feel is doing this to your partner). These are normal feelings. It might be helpful for you as an individual, or you are a couple, to go and get counselling to work through this.
Finally, it is so critical to remember: HG is a MEDICAL CONDITION. It is worse for her than you can imagine. This condition is out of her control. She is doing everything she can to fix it. Don’t let her experience this alone – this is your pregnancy too.
And finally, hold onto the fact that this will pass. It will come to an end. Usually around 20 weeks (although it can be experienced until one or two weeks postpartum).
But right now, she needs you.
An important note to all: HG is a serious medical condition and should always be managed in conjunction with a Doctor and/or Midwife. Any changes to an HG sufferers’ diet or medication, should be done in conjunction with a doctor. This advice has been written based on a diagnosis of HG from a medical professional.