8 Myths of Hyperemesis Gravidarum
Pregnancy is a strange phase of life… it seems that as soon as you get that little blue line everyone and his dog has nonsense advice and ludicrous old wives tales about the condition you’re in… from whether your bump “looks like” a boy or a girl to advice about not raising your arms above your head or the cord will wrap around the babies neck…
And if you are unlucky enough to get a pregnancy related condition then your experience really does become public property for anyone and everyone to know best about!
And that‘s how it is with hyperemesis gravidarum, a serious and complex condition which everyone, except the doctors, seem to be experts on!
So, I'm here to do some myth busting about HG and get some of the facts out there instead...
Myth 1: Pregnancy isn't an illness
Correct, pregnancy itself isn’t an illness but there are numerous illnesses which can be caused by pregnancy. Hyperemesis Gravidarum is just one of them. Other illnesses which are caused by pregnancy include Gestational Diabetes, Molar Pregnancy, Ectopic Pregnancy, Symphysis Pubis Dysfunction, Eclampsia, Anaemia, Obstetric Cholestasis and Acute Fatty Liver of pregnancy. Most of those, including hyperemesis can be life threatening.
Myth 2: You'll be fine at 12 weeks
Whilst this is true for regular morning sickness as experienced by 80% of pregnant women during normal and healthy pregnancies, it is not true for women with hyperemesis gravidarum, which is rarely over much before 20 weeks. Many women, even if they see an improvement around 20 weeks, will still be experiencing symptoms by the time they give birth. It’s unhelpful and unfair to harp on about how much better she’ll be at 12 weeks and it will only increase her feelings that no one believes her and they all just think she’s got morning sickness. Much better to look ahead to what support you can offer over the coming months.
Myth 3: The baby will be just fine or it's a good sign
When it comes to regular morning sickness there is a slight correlation between experiencing symptoms and having a reduced chance of an early miscarriage. But we’re talking about a reduced risk… not a dead cert for a healthy baby! Given that 1 in 5 pregnancies end in miscarriage, even if having pregnancy sickness halved that risk (which it doesn’t!) you would still have a 1 in 10 risk! Now when it comes to hyperemesis gravidarum, unless it is effectively managed and treated then there is an increased risk of miscarriage due to the dehydration and malnutrition which characterise the condition. On top of this there is a very high, 1 in 10 chance that the baby will be lost to a therapeutic termination as severe symptoms put the mother's health, family and home at risk.
If HG is poorly managed as the pregnancy progresses there is an increased risk for the baby of placental problems, inter-uterine growth restriction and even death. Plus there is increasing evidence that malnutrition and dehydration can have a long term impact on normal infant development.
So basically… No the baby will not always be fine!
Myth 4: If you don't think about being sick you won't be
And if you don’t think about your diabetes you can eat all the cake you want!! Hyperemesis gravidarum is not a psychological condition; it is biological. We don’t fully understand the mechanism at play but it involves genetics, prostaglandin E2 and hCG and the complex relationships they have on other things like thyroid and digestion. This myth is particularly tenacious and dangerous as it is used as an excuse to leave women without necessary treatment and to treat them cruelly.
Myth 5: It's only 9 months, you'll be fine when the baby comes out
Sadly for many women HG doesn’t end when the baby is born, particularly if their condition has been poorly managed and anyway, 9 months is a hell of a long time to be sick all day every day. Many women are left with long term problems with their oesophagus and digestive system, torn muscles and other physical scars. Many more women are left with emotional scars as HG has robbed them of their physical and mental health. I’ve written more on that here with details of where to get help. It’s particularly poignant this week as the HG Community lost a member to a terminal mental illness.
Myth 6: It must be a new thing as it wasn't around in my day!
Often heard from generations above ours and from older midwives particularly, this is utter nonsense! There are Egyptian records indicating hyperemesis as far back as 4,000 years years ago. Hippocrates wrote of the condition a Roman physician documented it in the early second century. Until early last century it was considered a biologically based illness to be taken seriously as it was the leading cause of death in early pregnancy.
So no, it’s not new and it’s not just fashionable now… women have always suffered it and until a complete cure is determined they will continue to suffer it, but hopefully with greater awareness about treatments and support they will suffer less severely and not think they need to just put up in silence with it.
Myth 7: You can't take medication because it will harm your baby
About 50 years ago a drug was marketed as a cure all for pregnancy ailments, from insomnia to sickness. It was called Thalidomide and sadly it caused devastating harm to the growing foetus if taken between days 35-50 of pregnancy. At the time doctors did not believe that things the mother ingested would have an impact on the foetus and it was this drug that made everyone realise that it in fact does matter if mums smoke, drink, take drugs and so on while pregnant. Since then there has been a big black cloud over taking anything during pregnancy and the stigma is so strong that many doctors still advise terminating a healthy baby rather than risk prescribing drugs which a quick search for evidence would show is safe and effective. So you see the tragedy of Thalidomide is far from over. The drug is still claiming infant’s lives and causing devastation to families, not just affected by HG but all sorts of conditions which can be safely treated in pregnancy but are not, out of fear. For more information about the safe and effective treatments for HG please see the Pregnancy Sickness Support website.
Myth 8: Ginger helps hyperemesis gravidarum
Now I’m not going to get into a debate about whether or not ginger helps morning sickness… I’m not talking about morning sickness, or even moderate pregnancy sickness… I’m talking about hyperemesis gravidarum. And guess what – Ginger does diddly squat to help it! In fact, recent research I’ve done with a colleague actually showed it caused significant harm, not just by making symptoms a lot worse and causing pain to vomit but by alienating those who suggest it and adding to the woman’s isolation and feelings of being utterly misunderstood. When it’s suggested by a doctor or midwife then it’s been found to utterly destroy the patient’s confidence in their professional abilities… so just don’t suggest ginger!
If you like my blog and appreciate the work I do to raise awareness for hyperemesis then please could you click on this link and nominate me for the Outstanding Contribution category at the MAD Blog Awards. Nominations close on Monday 20th July 2015, so do it quick. Thanks x