This blog post is going to sound rather formal compared to my normal tone but that’s because it’s had to pass through the Plymouth University Ethics proccess and my research supervisor (yes, even this sentence!)… but the good news is my research survey is now ready for women to take part in if they want to!

Regular readers will know that I’m doing a Master's Degree in Clinical Research and for my research project I am exploring women’s experiences of receiving treatment for Hyperemesis Gravidarum (HG) in either a hospital ward environment or a Day Care unit setting. (By Day Care unit I mean any setting where you got fluids and went home the same day, even if that was just a chair in a waiting room or in A&E... I want to hear about it all).

If you have received treatment in either of these settings in the UK in the last 2 years then we would like to invite you to click the below link which will take you to further information at the start of the survey to see if you would like to take part in the research. Once you have read the information about the research there is a box to give informed consent and then it will take you to the survey. If you have any questions about the research then my contact details are on there to give me a call or email before, during or after you’ve taken part.

And please do give as much detail about your experience as possible!

TAKE ME TO THE SURVEY

Here is a commonly asked question, particularly on mediums like Facebook:

"My sister/friend/cousin/partner is suffering hyperemesis gravidarum. She had it in her last pregnancy and was in and out of hospital, on medication and so on. She’s already tried *insert any number of alternative therapies here* without success and I’m wondering what else I can suggest to her. Her mental health is suffering and I want to help."

Then below the post you’ll have a number of replies about homoeopathy, acupuncture, reflexology etc etc. Occasionally you’ll see a sensible suggestion from someone who has suffered about her needing actual medical treatment and hopefully a link to the Pregnancy Sickness Support website with mention of the helpline. And then someone will tag me…

Here is how I would advise a friend or relative of someone suffering HG:

Stop suggesting “alternative and complementary therapies”

When someone suggests things like homoeopathy, acupuncture etc I know they are just trying to help but to the woman suffering it sounds as though they really do not appreciate just how much they are suffering... you wouldn't suggest alternative therapies to mend a broken leg or cure diabetes or pre-eclampsia would you?

When you suggest an “alternative therapy”, no matter how gently you say it, the suggestion is loaded. This is what the woman you are suggesting it to is likely to be thinking:

“I know they are just trying to help but they really do not understand just how much I am suffering”

“They wouldn't suggest alternative therapies if I had a broken leg or diabetes or pre-eclampsia would they? They obviously don’t believe my condition is real”

“They don’t think I’m trying hard enough to get better… maybe they think I enjoy being this ill”

“They think I shouldn’t be taking medication… they don’t realise that I have no choice, that without it the baby and I could die. They just don’t believe me”

Don’t question the lifesaving medication she is taking

Yes in an ideal world we would all like to have natural hippy style pregnancies but this isn’t the ideal world… it’s the real world! In the real world there are all sorts of reason why women need to take medication in pregnancy. And thanks to modern medication women who would have previously died in pregnancy, or before they ever got the chance to be pregnant are able to reproduce. For example, women with asthma, diabetes, rheumatoid arthritis, lupus or Crohn’s disease are able to live normal lifespans and therefore reproduce. Women with cancer and kidney failure can carry to term and recover. Infertile women can reproduce, women survive obstetric emergencies, pre-eclampsia and all sorts of stuff. THANK YOU MODERN MEDICINE. But most relevant to this post is that it is now rare for women with HG to die (although not unheard of). That wasn't always the case and the chances are that 100 years ago your friend/relative would have dies early in the first pregnancy (having already tried ginger and homoeopathy as they were around back then when women died).

Don’t suggest them even as a “complement” to actual medication

There is just no need. She’ll have already looked them up online or had some other unhelpful person (possibly her midwife or GP) suggest them. And in fact, the process of getting to an appointment or having an alternative therapy practitioner around to the house to give a treatment, far from being the relaxing experience it would be when we feel well, can actually exacerbate the symptoms and lead to a downward spiral that leads her back to hospital.

Plus you’ll never get away from the unspoken implication that she should be doing more to help herself get better.

Be a practical support

Instead of trying to “fix her” just support her…

• Pop round and clean her house
• Look after her child
• Do the washing
• Wash the bed sheets
• Cook meals for her partner and kid
• Advocate for her with friends and at the doctors
• Support her to get help via Pregnancy Sickness Support
• Visit her in hospital
• Text her every morning and evening to let her know you are thinking of her and there to support her
• Buy her non-pregnancy magazines about something she is interested in
• Download her some audiobooks

Be a mental support

The absolute best thing you can do is just be there for her... don't make suggestions, just listen and be a practical help for her. HG is just something she has to battle through, medication can help but they're not a cure. Support and "being believed" is what she needs to get through it and stay sane. 

Remember that, while pregnancy is not an illness, hyperemesis gravidarum is a very serious and debilitating illness which takes a massive physical and mental toll on the woman suffering. Relieve her feelings of guilt and failure by reminding her of that. Reaffirm that she has an illness and it’s okay to rest. Remind her that if you were ill she would be there to look after you, so she needs to just accept your help.

Help her to come to terms with the fact that for her this is what pregnancy is… a miserable battle yes, but one that she can survive and at the other end she will be stronger having survived. Suggest that when it’s over she can use her experience to help others, volunteering for PSS or raising money for research.

But if you are very worried about her mental health then please get her help. Most areas now have peri-natal mental health teams and it’s important that depression isn’t ignored. HG is strongly linked to depression, not as a cause of HG but a result of it. You can read more about that here.

Get her a thoughtful gift

It’s not the be all and end all but hey, who doesn’t like getting a little present now and then. How about some super comfy maternity pyjamas (seeing as she’s living in PJs at the moment!), or some slippers. I already mentioned audiobooks and they really are great. And obviously I’m going to suggest my books… Hyperemesis Gravidarum – The Definitive Guide and How to be an HG Hero, Helping children understand hyperemesis gravidarum. Or you can buy a pack which includes an HG calendar for ticking of the days. There is a section in the book specifically for family and friends to read.

Other practical gifts include: a nice drink bottle with a straw, ice lolly moulds, odour free products, a nice pillow… stuff like that.

Do not get the following: Smelly flowers, chocolates or any other food stuff, anything claiming to improve symptoms like acupressure bands, ginger capsules, hypnotherapy CDs, aromatherapy wrist roll on or “morning sickness lollies”. Unless she specifically asks for them... she'll say "thank you" but refer to above for what she'll be actually thinking!

I hope all that helps… please let me know what you think and if you are a sufferer is this the sort of stuff you would have liked your friends and relatives to know? Please comment below or on Facebook to let me know.

For further useful tips and info check out these links:

How to help a friend with hyperemesis gravidarum

10 tips to help a friend with hyperemesis gravidarum

What not to say to a woman with hyperemesis gravidarum

Information for partners and carers by Pregnancy Sickness Support

Information for family and friends by the HER Foundation

The results from the ginger survey I did at the start of the year have no been published in a peer reviewed midwifery journal for all to see. This means that whenever a healthcare professional looks up treatment for hyperemesis or does a literature review to see what treatments do and don’t have evidence for being safe and effective this piece of research will appear and blows the nonsense “ginger might help” papers out of the water. Yes it has flaws, it was an online survey of self selected participants and covered a long time period (in research terms). But it was over 500 participants who had all been admitted to hospital for HG and the results were close to unanimous… STOP SUGGESTING GINGER FOR HYPEREMESIS GRAVIDARUM

As mentioned before I’m launching a new research survey in the new year as part of my Master’s dissertation and it’s currently going through ethics approval. So far on my course I’ve written an assignment on how the historical stigma of HG still impact the care and treatment women receive today. I got 85% for it and it has been accepted for publication in MIDIRS next summer!

So now I’m going to ask you to support my work…

First of all, I’m absolutely thrilled to have been nominated for a Tommy’s award for “parent voice”. I’m currently on the long-list and to be shortlisted for it I need as many people as possible to email  Tommy’s with “Spewing Mummy” in the title bar and tell them why I should be shortlisted… do I represent your voice and the voice of the HG community? If so please tell them how. The email address to use is [email protected]

Second of all, most of you know that I don’t earn any money for the work I do, my role as Chairperson of Pregnancy Sickness Support is entirely voluntary and unpaid. I rarely get paid for publications and I generally self-fund things like attending healthcare conferences and teaching sessions. I do however earn a small amount each time I sell a book!

Please consider including my kids book as a stocking filler for your little ones this year, even if you’re not pregnant, it’s a good way of explaining what your went through during pregnancy and helping them to empathise with people when they are unwell.

Alternatively you can opt to donate copies of my books to PSS so that we can send them out for free to women who call our helpline (which I’ll be running over Christmas and New Year, again without any pay).

This movement needs your support. If you want to see more research like this reaching the healthcare professionals who treat you then we need your help. I understand that money is tight, particularly after an HG pregnancy with little ones at home and Christmas next week so if you really can’t manage to donate then please share posts and be sure to take part in my research next year to ensure your voice and experience is heard.

If you sign up to my blog mailing list you’ll get an email when I launch the research survey so you won’t miss out.

Finally, Happy Christmas everyone. For those of you pregnant now try to rest and stay hydrated and for those of you no longer pregnant… ENJOY! 

Christmas is a particularly tough time of year for women suffering hyperemesis gravidarum, especially if they already have little children. Guilt can be increased almost exponentially as visions of happy memories being created for Christmas craft activities with kiddies and songs around the Christmas tree are replaced with the grim reality of vomit bowls, consent nausea, pissy pants and general misery.

I’ve written previous years about “surviving” the festive period while chucking your guts up and trying to stay out of hospital and the tips and tricks in those posts still apply. But this year I want to focus on another way to survive this high pressured epitome of motherly perfection… keeping the damn thing in perspective!

This is one year, just one year of you and your children’s lives. If Christmas is not absolutely perfect then so what? They won’t remember come January. If you don’t bother to cook a nice meal then nothing really bad is going to happen. If your kids presents are loosely wrapped in old ASDA bags I doubt very much that they’ll notice. If you can only get them one or two small items online because money is so tight while you’re off sick then, actually, that’s okay… it’s still one or two more than a lot of other kids and they’ll probably grow up to be more rounded and compassionate individuals for the experience of working as a family team while mummy is sick.

Teaching children to be grateful for what we have instead of pinning after what we want is one of the greatest gifts you can give them. All they really want this Christmas is mummy to sit on the sofa for a while and play with their new toys. Keeping out of hospital is far more important than pushing yourself to wait on your family hand and foot and making yourself iller as a result. And what about what you want for Christmas? How about asking your partner and children to give you the gift of Christmas this year… ask them to do the house work and cooking over the festive period. Even small children can pull their weight by pushing the hoover around or tidying toys away.

Yes Christmas is “about the kids” but that shouldn't come at the cost of your health or sanity… which they need far more than an elf on a different shelf every day. Christmas is also about family and children are never too young to understand that they are part of a family who cares for each other and not a family in which the parents are slaves to their offspring. Bear in mind too that the baby you are carrying is part of the family too and that baby needs you to rest and look after yourself as much as you can so that it can have many more Christmas’s.

So here are some ideas for toning down Christmas and keeping it all in perspective:

• Shop online and keep gifts basic and few. The more toys you buy the more clearing up there is to do!!
• Explain to extended family that this year you are giving them the gift of a grandchild/niece/nephew to huge financial and physical expenditure on your part and that is plenty for one year!
• Don’t worry about cooking an all-out Turkey dinner. Buy ready-made stuff or cook a casserole in advance so you don’t have to do anything on Christmas day. Decide that you’ll do a fancy meal with all the trimmings next year.
• Stock up on DVDs or make a list of family films you want to watch and decide to have a “film based Christmas” this year.
• Stock up on “help yourself snacks” that the kids can plough into to reduce the “mum I’m hungry, what is there to eat” bombardment.
• Make your own Christmas gift list for the family to use over Christmas – Loading and unloading the dishwasher, hoovering, tidying their bedroom, emptying the bin. And ask partner and kids to ensure all these things are done without you for the duration of Christmas this year (To be fair, if you’re sick they ought to be doing this anyway for the duration but I’m trying to be realistic).

Remember that it’s only Christmas, it’s not as big a deal as everyone makes out it to be, it happens every year and if this year is really pants then it will make you appreciate next year all the more!

Oh and PS. Don’t forget to ask Santa for my books!

Woman: “Doctor, Doctor, I’m being sick 30 times a day, I haven’t drank for 3 days and passed out from it this morning”

Doctor: “Don’t worry that’s totally normal”

Woman: “Doctor, Doctor, I can’t stop being sick, please can I have some safe and effective anti-sickness medication?”

Doctor: “hmmm… Have you tried ginger?”

 

Woman: “Doctor, doctor, I’m so sick I’m going to lose my job and can’t pay my rent or look after my toddler, could I have a sick note so that my employer understands?”

Doctor: “Pull yourself together - You just need to battle through like everyone else does”

 

Woman: “Doctor, doctor, I’m still sick all day everyday and it’s been 16 weeks now”

Doctor: “No I’m sorry but you can’t be – it must be in your head”

 

Woman: “Doctor, doctor, I’ve got a serious condition called hyperemesis gravidarum. I’ve lost 2.5 stone and am throwing up blood, I’m scared but I desperately want this baby.

Doctor: “Hmmm… Why do you think you’re being sick?”

Woman: “because I have hyperemesis gravidarum!”

Doctor: “Yes but why are you being sick… do you really want this baby?”

 

Woman: “Doctor, doctor, I’m so depressed because I’ve been bed bound with hyperemesis for 5 months now, throwing up every day and nausea constantly… I’m lonely and miss my busy life going to work and seeing people, eating is torturous as food all tastes awful and comes back up anyway, I can’t wash my hair without vomiting and I haven’t left the house in weeks”

Doctor: “Well, you just need to snap out of it and stop being sick!”

 

... Except none of these are jokes....