When the morning sickness just won’t stop
Affecting up to three per cent of pregnant women globally, this condition has no cure and can even lead to hospitalisation and endanger the life of the mother and child.
Njeri Maina @njerimainar
Freddie Ngunju, a mother to a 16-month old toddler, knew right off the bat that something was wrong as everything smelt awful and almost anything could get her nauseated. Trouble did not start till the third month.
“Between months three and four, I started throwing up intensely and all day long. One day I threw up for three days straight.
And I mean non-stop, no breaks in between, just me and my puke bucket.
I was really hoping things would get better because I thought it was normal morning sickness.
I tried every remedy under the sun, crackers, peppermint, ginger, lemons, you name it, but they only made things worse.
After three days of no food or water, I realised nothing was working and that I could potentially be placing my baby in danger. So, my partner and I went to hospital,” she narrates.
On getting to the hospital, she was immediately put on intravenous fluids and told to stay overnight for observation as she was still throwing up.
She was given anti-nausea drugs but she threw them up too. She was diagnosed with hyperemesis gravidarum after several days of being on drip and observation.
“I was told that my condition affects very few women and that it would probably last until about month six then fade,” Freddie explains.
“Hyperemesis Gravidarum is a severe form of morning sickness that involves persistent nausea and vomiting.
This vomiting is so severe that it affects the quality of life of the pregnant woman and can affect her kidneys and the metabolic and electrolyte balance in her body.
The morning sickness could also manifest only with nausea and insomnia or heavy sleeping, and general body fatigue.
It might manifest differently in different people and in different pregnancies for the same mother,” Dr Alex Bosire explains.
Globally, hyperemesis gravidarum affects 0.5 to three per cent of all pregnant women.
The condition came to the spotlight when Duchess of Cambridge, Kate Middleton, shared her experience with it in all her three pregnancies such that she could not even honour her royal engagements.
While many liken hyperemesis to morning sickness, it is way more severe.
What causes hyperemesis and what is normally going on in the pregnant woman’s body on a physiological level?
“Hyperemesis gravidarum is suspected to be caused by the pregnancy hormones Human Chorionic Gonadotropin (HCG) hormone.
HCG is produced by growing placenta and we postulate that the more the hormone or the higher the body sensitivity to this hormone, then the more the related response.
This hormone can also then be associated with changes in functionality of the gut as well as the nervous system.
Evolutionary, nausea and vomiting caused by HCG could have been nature’s way of alerting us of the pregnancy thus protecting the mother from eating harmful foods and substances.
But excessive production of the same hormone is what causes hyperemesis gravidarum,” Dr Alex shares.
Commonly, hyperemesis gravidarum manifests in the first trimester and is usually more prevalent around week eight to eleven of pregnancy.
It rarely progresses past the 20-week mark. It also varies, in that some women will experience it with the second pregnancy, not the first while others experience it with all their pregnancies.
Commonly, those who experience it with the first pregnancy are, however likely to experience it in subsequent pregnancies.
It is, however, common with people pregnant with multiples as they have higher levels of HCG.
It is also found in pregnancy-associated growths such as choriocarcinoma (cancer in the uterus) and Hyatidiform mole (growth of an abnormal fertilised egg or an overgrowth of tissue from the placenta).
Hyperemesis is also more common in pregnancies in obese women and in first time mothers.
Dr Alex further explains the thyroid is suspected to also be at play in hyperemesis patients.
Therefore, it is important for all women with hyperemesis to get checked for thyroid hormone imbalance and if any of their muscles are affected.
Muscles are affected only if dehydration and electrolyte imbalance is severe, mainly because the muscles need fluid to remove toxins and a good electrolyte balance to be able to function.
“To prevent dehydration, I was on intravenous fluids and medicines for 90 per cent of my pregnancy.
I lost so much weight from poor nutrition and I could hardly work, let alone leave the house.
I got so weak that simple tasks such as walking to the toilet or showering seemed Herculean.
The bouts of throwing up would last weeks. The longest it lasted was three months straight, wherein I could take medicine and throw up daily,” the mother of one explains.
However, her hyperemesis did not disappear by month six and persisted till delivery time.
Even while she was in labour, she was vomiting and was, therefore too weak for natural birth.
However, it disappeared immediately she gave birth. She was able to eat and keep her food down.
Though she was still scared of vomiting after eating, she ate very little. At 38 weeks her son Leo was born completely healthy albeit slightly underweight.
While Freddie was lucky enough to give birth to a healthy baby boy, not all hyperemesis patients are so lucky.
In extreme cases, the foetus may be affected, which may result in a miscarriage.
In some severe cases, the mother is unable to provide nutrition for the foetus hence the foetus will not grow well due to lack of essential vitamins necessary for foetal development.
This can lead to foetal abnormalities, and babies may be born with low birth weights.
Mothers may suffer from general illness and malaise and may even risk death.
Where the mother’s life is at risk of death, doctors may advise for a termination.
Support groups
It is important to note that there is no cure for hyperemesis and, therefore the only way to deal with the condition is through proper management.
Dr Alex insists on the importance of seeking medical help as only then can one be advised on the care and interventions needed, which may range from prescription of ginger based products for mild cases, steroids to suppress nausea and hospitalisation for severe cases where vitamins and water are administered via drip.
He recommends taking small meals and drinks multiple times a day to keep both the expectant mother and the baby healthy.
He also emphasises the importance of remaining positive despite the vomiting bouts.
“Basically a positive pregnancy attitude counts for a lot when experiencing hyperemesis.
Counselling and therapy will help in reducing stress, which can worsen hyperemesis symptoms.
Reducing on sugary or overly oily or spicy foods will help prevent and reduce the effect of the condition.
High protein and carbohydrate meals are known to help with hyperemesis. Alternative medicine such as acupuncture at times help too,” he advises.
Freddie wholly agrees. She was on a bland diet with all food in the house having to be boiled.
She also subsisted on watery fruits such as apples and watermelons as they were a nice cross of food and water. She is grateful she had a partner to walk with her through it all.
“I knew that nothing could be done other than keep my baby safe. My part was just to endure the torture.
I am so grateful for the support I had through it all. I couldn’t have done it without my partner.
He was by my side through it all. He took care of me and encouraged me to keep pushing.
Had it not been for him, I would have considered termination,” she says, teary eyed.
She further explains the importance of online support groups and how such groups understood her and helped with tips, suggestions, and with moral support.
As to what she would advise other mothers going through the same, Freddie tells them to be brave.
“Surround yourself with other moms and couples who know the struggle of braving hyperemesis gravidarum.
No one understands what it is unless they experience it firsthand. Think about your baby.
That’s the reward at the end of the suffering. And it’s such a sweet feeling when you finally hold your baby for the first time.
No one deserves hyperemesis, but it’s all worth it in the end when you meet your blessing,” Freddie says in conclusion.
