Hey Media! Its NOT Acute Morning Sickness
The Duchess of Cambridge is pregnant with her second child, and like the vast majority (80%) of women who have a history of hyperemesis gravidarum (pronounced hi-per-em-ee-sis gra-vi-dah-rum) she is suffering the condition again. My entire blog describes the misery of hyperemesis gravidarum and I wrote back in 2012 about how this might be for the Duchess so I won't rehash all that here.
What I would like to address is the appalling way the media are discussing the condition... Acute Morning Sickness! Or in fact during this morning's BBC Birmingham's radio interview they didn't even bother with “Acute” they just said she was having time off duties for morning sickness... which I promptly corrected.
“But we can't pronounce it... hyper... hyper... hyper what?” I've have numerous journalists and presenters say to me. What so because you can't pronounce it you'll just say she has something else instead? Great, that's like saying “Oh we can't say encephalitis so we'll just say so and so has a bit of a headache”.
Why is “Acute Morning Sickness” so incorrect when describing hyperemesis gravidarum?
The term Acute implies that it's a short lived condition. Hyperemesis is not short lived. It is incredibly rare to have improvement before 14 weeks (which is quite a long time when you're being sick constantly) and most women won't see any improvement before 20 week, that's 5 long months. But even for those who have improvement at 5 months, only 40% actually recover at that point. 60% are still having symptoms right up to delivery. And that doesn't even begin to address the long term physical and emotional problems women can experience.
So far from an Acute condition hyperemesis gravidarum is very much a prolonged and even chronic condition throughout pregnancy.
And then there is the “morning sickness” part of all this. Morning sickness is a cute, almost nostalgic term for a part of pregnancy which most women kind of look forward to... a bit of mild nausea and possibly the odd bout of vomiting for the first few weeks. Where the morning part comes from is a mystery to me as it can occur at any time of the day or night. However, it's a normal part of pregnancy and can be a sign of a healthy developing foetus (although that in itself isn't always true and it can increase the devastating impact for women who have felt sick for 8+ weeks only to discover at their scan that the baby is not viable).
So what should we call it? Well, the normal condition should be referred to as pregnancy sickness or nausea and vomiting of pregnancy because, like I say, it has nothing to do with the morning. And when it comes to the condition the Duchess has we should call it hyperemesis gravidarum – because that is what it is. If you really really don't want to call it that then you could at a push call it “very severe pregnancy sickness” or it's common abbreviation "HG", surely that's not hard to say?
But what harm does it do to misrepresent the Duchess's condition as Acute Morning Sickness?
The answer to that is A LOT! Belittling hyperemesis gravidarum to a normal, almost endearing, part of pregnancy does a lot of harm to those suffering what is in fact a serious and dangerous complication of pregnancy. It reduces the truth of the women's suffering, the lives ruined and the babies lost to the condition to a bit of fun, fixed by ginger!
When the media talk about morning sickness cures in the context of the Duchess of Cambridge's pregnancy it perpetuates the myths and old wives tales that prevent women receiving the treatment they need, it adds to the suffering and ultimately contributes to the loss of vast numbers of pregnancies every year.
So what can the media do to help?
Stop talking about morning sickness in relation to the Duchess of Cambridge because that is not what she has. Report on hyperemesis gravidarum because that is what she has. Stop getting doctors on TV who don't know about hyperemesis gravidarum to discuss morning sickness cures because you are causing harm.
It's appalling that registered doctors are seen to be speaking with authority about utter nonsense, like “ginger biscuits” (they are ginger flavoured... they don't actually contain any ginger!) or ginger tea. They've even stated that they try to avoid medication in early pregnancy and that every pregnancy is different, both in the context of hyperemesis gravidarum. Far from simply being untrue and non-evidenced base, both statements can cause significant harm to women with a history of hyperemesis who need to plan carefully for early medical intervention to manage the condition.
Hyperemesis gravidarum is an historically under recognised and marginalised condition for which women have had to fight at their most vulnerable and miserable time to get the treatment they need. That is despite the fact that it used to be the leading cause of death in early pregnancy and is still a massive cause of maternal morbidity and foetal loss.
It's time the media dropped the morning sickness nonsense and started to report on hyperemesis gravidarum, which the Duchess of Cambridge is suffering from. Let's address what does and doesn't help women suffering the condition, lets address the current poor state of care in the UK for HG and the fact that all women should be treated in their homes for it where possible, whether they are royal of not. Lets address the severity of this overlooked condition: speak to the women who nearly died from it (I know plenty of them); speak to the women who can't have a second child like the Duchess of Cambridge, because they don't have the medical or social support to face nine months of severe illness (I know plenty of them); speak to the women who lost their babies to this condition (I know plenty of them).
It's awful that Catherine is suffering, my heart aches for the awful situation she is going through and I hope she is getting the support and care she needs to survive this without the long term effects so many women experience. I really sincerely feel for her. However, this is an opportunity to improve the world for millions of normal women around the globe who also suffer this and don’t have access to proper care and treatment. Women who are faced with stigma and discrimination over the condition. Women who can't have more children because the condition could kill them.
Report it accurately and we could make the world a better place for all of these women. Report it badly, refer to it as morning sickness, perpetuate the myth that ginger cures it and you are hammering the nails in the coffins of the babies that have died from it and crushing any hope that women hold of their serious illness being recognised for what it is and helped.
So please British Media... journalists, presenters, celebrities, news desks, editors... it is NOT acute morning sickness... it is Hyperemesis Gravidarum.
For accurate information about hyperemesis gravidarum check out these links:
Pregnancy Sickness Support - National charity supporting women with the condition
Hyperemesis Education and Research Foundation - American charity supporting women with the condition
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