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Hyperemesis Gravidarum & Mental Health

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Today is World Mental Health Day 2021 and I thought I would just post about how much mental health can take a hammering with constant nausea and vomiting from both Hyperemesis Gravidarum and Gastroparesis.

During a HG Pregnancy

It is hardly a surprise that Hyperemesis Gravidarum can take a major toll on a woman’s mental health whilst she is suffering. The random and frequent nature of vomiting and constant nausea can leave the sufferer house bound, too worried to be far from the bathroom in case an episode of vomiting occurs whilst out. This can lead to feelings of isolation. Not being able to take part in social activities with friends and family..

The feeling of not being able to enjoy pregnancy got me down whilst I suffered HG. Women were meant to be ‘glowing’ and enjoying their pregnancies. I always felt like people thought I was ungrateful which couldn’t be further from the truth. I desperately wanted my baby but hated feeling so awful with no break from the 24/7 nausea. The only time I had respite was when I slept and even then if my stomach filled with bile/acid it would cause me to wake to vomit. This would cause disrupted sleep which would add to making my mood even lower.

Being always in hospital would make me anxious and low, I hated being away from my husband and children. This was even worst when covid hit and I wasn’t allowed any visitors.

Then there was the anxiety that this constant sickness would hurt my baby in some way. Would the malnutrition and dehydration cause physical or mental abnormalities in my unborn baby. How would it survive without nutrients. This is turn led to guilt. I would feel like it was my fault and that I was responsible for my husband and childrens worry about my health. The guilt of not being a proper mum (cooking their dinner, helping with homework etc). The guilt of what I may be doing to the baby I was carrying.

The guilt, misery and feeling sick 24/7 would leave me wishing that I had the guts to terminate the pregnancy or even worse, wishing I would miscarry. Then I would feel hideously guilty for daring to think like this. I have gone through several miscarriages and a stillbirth, of course I would never want this for my baby! I loved my baby, he/she kept me going through this hell. I didn’t really want them gone just the dreadful HG. But I hated myself for my sinister thoughts, there are women who would do anything for a healthy baby and there is me wishing mine away. But this is how hideous HG is. You feel that unwell that you have these awful thoughts, you are so desperate to be out of this horrific state that you get to wishing your precious baby away. But its not really wishing your baby away, its desperately wishing that feeling so awful will end. You feel so guilty at your thoughts you end up wishing you would die so that at least you could be out of the physical and mental suffering. I would think, at least if I died I would be away from feeling so terrible but I wouldn’t be guilty of wishing my own baby gone or wanting to terminate. I would even plan my suicide. Wondering what to do to cause the least damage to my husband and children. Desperately praying that the HG would just hurry up and take me so I didn’t have to do it myself!

Physically feeling so dreadful and low blood sugar leaves you irritable and angry that you are suffering and that people are getting on with their lives. You end up resenting those who have easier pregnancies, wishing people knew what it felt like. Your thoughts turn increasingly bitter and angry. All the while being so sad that you cant enjoy the pregnancy, and all the positive things that go with it, baby showers, gender reveals, getting excited over baby clothes. Instead you are either hunched over a bucket or the toilet or in bed praying for the nausea to just stop!

As the pregnancy continues and the symptoms of HG don’t subside your mood gets lower and you wonder how much more you can put up with. You worry that you wont bond with your baby. How can you love something that has brought you so much suffering? People don’t understand, they can comprehend sickness at the beginning of the pregnancy. In fact most pregnancies involve some nausea and vomiting. But this is a different level, and very few people can grasp just how bad it is. People think they know what its like, everyone has times of nausea and vomiting. But very few people truly know HG. To know HG you have to have suffered from it!

People grow tired of hearing your suffering/praying for you. Their patience ends, some even feel like you are exaggerating. You feel desperately alone with your suffering. And the biggest feelings of life being so totally unfair? All you can think is ‘Why me?’, what did I deserve to get this. All logical thoughts of genetics and hormone intolerances go out the window and you just feel bitter to everyone who isnt feeling just as horrid as you! HG is a vicious ball of misery!

After a HG Pregnancy

Sadly some women arent able to hold on and have to accept that they can no longer carry the pregnancy and are forced to terminate. This comes with its own feelings of loss and sadness. I have never terminated a pregnancy so cannot comprehend just how terrible it must feel to have to go through that. However having lost a twin to HG, you never get over the guilt of feeling, if my body could just have been stronger, would my baby still be here? It is hard to see that you did an incredible job and that life can be unnecessarily cruel. To go through HG and come out without a little bundle of joy is so hard. How can life/God be so awfully cruel and unfair?

After the HG has ended, people expect everything to be ok! You have your baby, for most people they no longer feel sick at all. So people just expect you to be happy and grateful! No one tells you that sometimes you don’t immediately bond with your new baby. Sometimes you don’t feel that immediate bliss. Sometimes you don’t feel better. Sometimes your struggle isnt over if you have postnatal complications after birth or if your child is born with health issues.

After your baby is born you are left with the aftermath of the pregnancy, you are left wondering why you had such an awful pregnancy and will it be the same if you have any more children. No one ever talks about the trauma that is left behind. The flashbacks and feelings of failure. The absolute paralysing fear you may get when you have a stomach upset and those feelings of panic that you might be pregnant.

Hyperemesis can leave you with long lasting depression and anxiety. You are far more likely to have postnatal mental health problems after going through a HG pregnancy but there is no support. You try to talk to your partner or friend and they cant understand. HG is in your past but people don’t realise that you have to deal with it and process what you went through. Going through HG, you have to take things  minute by minute, its not possible to deal with the emotional side until you are through the other side. But this is when people are least understanding. You have the role of mum, you don’t have time to deal with your own baggage as you are too busy looking after this demanding little baby..

One of my biggest struggle after I had given birth is knowing I wouldnt be able to have anymore children. We always wanted a big family, and had hoped for 4 children! But to have any more children would be too dangerous for me. It might be fatal next time. I also had so many health problems after I gave birth. These include, infertility from premature menopause, cPTSD (complex post traumatic stress disorder) and gastroparesis. I was left feeling very depressed that what should have been a happy time in my life was cruelly snatched away from me. To this day I still feel resentful at not having a good pregnancy, at having to spend most of my pregnancy in hospital, attached to tubes and drips! And I still battle with the feeling of great unfairness! As soon as I go anywhere near the hospital I get episodes of intense anxiety and panic and I get flashbacks of my times in hospital.

I have no answers for you dear reader! Im sorry I have no advice other than to take one day at a time. Going through HG is not a small feat! If you have gone through it, then you are incredible but be gentle with yourself and know its completely ok to not be ok!

 

***Its ok if you are grieving for the good pregnancy you didn’t have, you need to mourn it!
***Its ok to be sad that you did not get to experience the joyful pregnancy events, it is sad that you were too unwell to enjoy things
***its ok to be angry that this happened to you, its unfair!
***its ok that you didn’t feel bliss when you first saw/held you baby…the love will come!
***Its ok that you panic when you feel sick, it must bring back so many terrible memories
***Its ok to cry at all the things you missed out on when you were sick..you need to grieve the things you missed out on!
***its ok to resent other peoples pregnancies..life can be cruel, no one deserves to suffer! But remember just because you cant see them suffer, does not mean that they are having a good pregnancy
***Its ok if you became depressed or anxious after your baby was born…its is not a surprise you are struggling after everything you went through!
***Its ok if you did not recover from HG after the birth…it takes different people different times to recover. Take things slow and be kind to yourself!

Do
– Seek help…you don’t deserve to suffer, your mental health is just as important as your physical help..whether you look in to hypnosis or counselling…get professional help to get through these difficult times. If you need medication, this is ok too! Accept any help you can to get you through this.
– TALK…it is good to share your feelings, you deserve to have your experience validated! Speak to your GP or get some counselling to talk through your experience and how it has left you feeling. You deserve to be able to process your experience and have help getting through this
– Be honest…if you are depressed, anxious or suicidal…there is nothing to be ashamed of, you have been through so much but now is the time to admit this and get some help, you are worthy of help and deserve to feel better
– Be gentle with yourself…it will take time for you to feel better. Do things that help you get through this tough time. Make time just for you to do something to help your mood, whether its reading a book, getting a manicure. Anything to give yourself a treat!
– Be patient…it will take time to process what you went through, do not rush through this process. It is better to take things slowly and process it properly than rush through things only to bury them in your subconscious where they may appear one day in the future if you have not dealt with them properly!
–Be Kind!..going through HG and the aftermath of HG is awful but remember that many people are going through individual struggles too!
– Communicate…tell people what you need from them, whether its a chat or whether is it something that can help you through the day, like child care or picking up groceries. Generally people just want to help if you are struggling. Let people know what they can do to help you

Don’t
– Be Ashamed…you are a strong person but even strong people need help and support from time to time!
– Compare you HG journey and its aftermath to other sufferers…each persons experience is different, no 2 cases are the same. Your experience is just as important as anyone elses no matter what severity of HG you had. Even mild HG causes severe trauma! Do not think that someone with a more severe case of HG has it any harder than a mild case! People deal with different things in different ways, it is important to focus on your journey of recovery!
–Ignore or deny your feelings…you deserve to be heard and deserve support to get through this
– Assume your low mood/anxiety will go on its own…if you are suffering with mental health problems whether pregnant or postnatal, seek help as it may get worse if you do not treat it. Do not try and manage on your own
–Don’t assume other people have brilliant pregnancies…its ok to mourn the lack of a good pregnancy, but do not assume that other people have wonderful pregnancies. You never know what someone is going through and how they are coping with things.
– Lash out…its ok to feel bad, to be sad and angry but it is not ok to lash out at other people or yourself. It is no ones fault what you went through.
– Cope on your own!

 If you feel suicidal please reach out, nothing is so bad that you need to go down this road! Below are a list of useful numbers that you can call if you need to talk to someone!

National Suicide Helpline UK 0800 689 5652

Samaritans: 116 123
SMS: Text SHOUT to 85258

National Suicide Prevention Hotline tel:1-800-273-8255

I am always here if anyone would like some support or info of how to get support. Please send me an email to:
michellestevens1802@gmail.com or text/phone me on 07889453512

Devastating Blow

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I ask the reader to have an open mind and be as non-judgemental as possible, with remembrance that we are not all the same and don’t all think and feel the same!

This week (September 7th 2021) I had an ultrasound relating to a minor gynae issue and discovered some potentially life changing and devastating news.

The doctor scanning me asked me about my symptoms whilst scanning. I hadn’t given much thought to my reproductive system as my gastric issues have been the forefront of my mind as well as poor Ollies health problems! But some of the symptoms were there, I just hadn’t connected the dots. The doctor said it was likely I was entering premature menopause, brought on by the trauma of the HG pregnancy or the continuing starvation my body is currently undergoing or a combination of the two. Either way I would need some more tests to confirm this, including blood tests. I’m still waiting to hear back from my consultant, I’m sure it will be a while before I know for certain, the wait is the worse thing!

So most people wont get this, but I’m gutted! Why would it bother me? My pregnancies are awful…you would assume I’m done! Yes the hyperemesis is awful, yes it nearly killed me twice. But I don’t feel done! Maybe its because I’m an angel mum and no amount of babies will compensate for the massive loss I’ve gone through? Maybe its because we have looked in to adoption and fostering and its looking so unlikely we will be suitable for either. Surrogacy is way out of our price range too. Maybe that its just that I’m having my options taken away. I don’t think I would ever choose to fall pregnant again but that doesn’t mean I’m ready to throw the towel in. It is not my choice.

Rightly or wrongly I always associated the menopause with the next stage of life, getting older. Its what happens when you are starting to reach your 50s and here I am only 33. Most of my school friends are just starting to have their children and here I am learning that, that’s it for me! What happens if a miracle HG drug comes in and we decided we wanted to go for another baby? I’m just not ready to take this next step in life. I sit here deeply saddened, its brought all sorts of thoughts and emotions and I suppose it feels like a grief.

Why cant I have normal pregnancies? Why cant my pregnancies be filled with happiness, not tubes and drips? Being as sick as I was during pregnancy made me feel ashamed, ashamed that I couldn’t just ‘get on with it’, ashamed that I wasn’t a beautiful glowing mum to be. I felt like I let me husband down. He couldn’t be the proud dad to be showing off his wife and her beautiful bump! I was always pale and sickly or had tubes in my face and arms. Why couldn’t I just be normal? Even after the birth I had to have the sickness continue..it just feels like I let him and myself down again!
“There’s always something wrong” I hear in peoples heads, they don’t even have to say it. There is a huge hidden shame within me.

Yes I’m so lucky I have 3 beautiful children, I should be so grateful and thankful that I have been blessed with them, some poor women don’t have this good fortune! Please believe me I am grateful and I feel sad for them and deeply sorry. And I also feel ashamed at my self pity! My older 2 children are biologically mine, I gave birth to them but that’s where the mothering stopped until Sarah was about 12 and Joshua was about 10. You see as a teenage mum I had a lot of help with Sarah and I fell pregnant with Joshua when Sarah was only just a year old due to falling pregnant whilst on the coil. HG reared its ugly head and I was so unwell that Sarah had to be looked after by my grandparents. After Joshua’s birth I developed symptoms of M.E as a result of the HG and was unable to look after my children as my illness progressed. I became house bound and a lot of the time bed bound, sleeping over 18 hours a day. So I missed out on so much, the story time at bedtime, the school plays, family trips out etc. I was always in bed, unable to do very much at all. During the day they were under the care of my grandparents and then when my husband finished work he would pick them up. I certainly wasn’t a proper mother to them. Missing out on being their mother for all those years is something I will never get over. It was having Ollie that improved my symptoms of M.E, during the pregnancy I went into remission from it. After his birth the M.E did return but not to such an extreme level. I have been able to cope as a mother to all 3 of the children and able to do so much more than I could before. But for example, I have  only experience of raising one toddler (Ollie) as by the time both my older children were his age they were being cared for by my grandparents. I have never experienced raising a small child before. In some ways it is like being a surrogate mother. I gave birth to my children but did not raise them. 

I was so incredibly lucky to have such a wonderful and caring grandparents who sacrificed everything to help look after my children. Without them, my children may have ended up in care or being fostered or Gavin would have had to give up work and we would be living entirely on the state. It was a hugely kind thing of them. They loved looking after my children, my grandmother still reminds me when I am sad and cry at the burden I imposed on them that actually looking after my children kept her and my grandad young, and that they loved it! I will never be able to repay the kindness they gave to me, I have nothing but gratitude toward them and shame at how I had to rely on my elderly grandparents as I was incapable to raising the two children I should have been responsible for. I will never ever get the years I missed back… but please try to see how being too unwell to raise my children may be why I do not feel like I have completely done with having children…I didn’t experience raising 3 children.

I have loved having the chance to be a proper mum, without having fallen pregnant with Ollie I would not have got this chance. I would go through HG for the rest of my life to have the joy of my children, I’d do anything for them.. But I cant help wonder what having a sibling more his age would be like? Someone for him to play with, the older 2 are already out and about and very independent, this will only increase over time. Ollie may at times feel like an only child. Don’t get me wrong there are benefits to this, more parental attention etc. 

As a mother to babies who have not survived pregnancy, I don’t think you ever truly get over the loss. There is always feelings of what ifs. Having another baby never replaces the one you lost, but you cant help wondering if filling your life with children will stop the constant gnawing at your heart of the ones you lost. You subconsciously try to soothe your soul in whatever way you can, but the reality is you can never make up for that ache. It doesn’t take much to bring up a reminder of the day you had to say goodbye. A familiar smell or if you hear a song that you heard that same day. For me it was the smell of popcorn, we had been at a bowling alley when I got that first stab of pain and I remember I could smell of popcorn (there had been a popcorn stand) and the smell along with the pain made me feel awful. Losing my angels may be a reason why I am unable to feel ‘done’ after having my 3 live children. But I know that even if I had 30 children and wonderful pregnancy experiences it will never make up for those I lost. I will never forget my little angels but I do recognise how blessed I am to have 3 healthy children.

It is so doubtful I’d choose to have another child but that doesn’t stop me wondering what if. It doesn’t stop me mourning the lack of a good pregnancy and feelings of joy when carrying a baby. And that doesn’t mean I’m ready for my fertility to be gone…

There is also the element of fear, I worry what the menopause will do to my body, how I’ll cope with it. I don’t feel ready for this huge next step. 
Forgive me if I seem selfish and ungrateful but I have so many thoughts and feelings in my head! Most of all I’m so angry! Angry that my HG pregnancy possibly caused this. Angry that the NHS has been so busy with covid that they have left me 15 months and more slowly starving, continuously suffering with sickness. How could they leave me to get so bad? Why has it taken so long to get the treatment my body so desperately needs. It really isn’t good enough. If something isn’t done soon, how long before other parts of my body become damaged for good?  

My 1st HG Pregnancy

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My Pregnancy with Sarah
Mild Hyperemesis Gravidarum

After I lost Charlie my mind would only concentrate on pregnancy and anything related to babies. I would look up how far along I would have been, id see expectant mothers and wonder if that’s what my bump would have looked like. And then id research into the newborn stage etc. I was so down and missed my baby so much..As a newly single young woman, I went through a whole host of one night stands and tried dating. In September 2006, a whole year after losing Charlie I met up with my now Husband Gavin on a blind date.  Our first date was a disaster but then we tried again on a second date. I had already started my nursing course at university but hated it and was still obsessed with the idea of having a family. This meant that the first time that I was intimate with Gavin I was not as careful as I should have been. I didn’t care if I got pregnant, I hated university, I hated nursing and I desperately missed my little boy. I discovered I was pregnant sometime in November. It started off just feeling ‘Off’. I felt icky, a bit like I had the beginning of a stomach upset or had a hangover. It didn’t clear up at all so I took a test and lo and behold I got a very strong Positive! As you can imagine, having only been with my boyfriend for just under 2 months, I was a little worried about how to approach the topic but in the end I just came out with it. I had been prepared to be a single mum, I was thrilled to have this baby and nothing would stop me having him/her but I wasn’t prepared for how pleased Gavin was. He was really excited and that shocked me.

The sickness didn’t begin as early as it has done in my subsequent pregnancies. I think it was around the 7 week mark that it really hit me but the nausea had been pretty intense. I had been completely unprepared for it having not had anything with Charlie. However I did find that eating small snacks helped. If I didn’t let myself get too hungry I could keep the sickness to a minimum. By this stage it was traditional morning sickness (NVP) not hyperemesis. It would affect me when I woke up before id had a chance to eat or drink anything. However by 9-10 weeks things started getting worse. The sickness was now at any point during the day. The nausea was unrelenting and I would feel dreadful all day. I think at that point I was vomiting about 5-8 times a day, however I managed to keep myself fairly well hydrated and I would have some days where I could eat and it would stay down. Things that helped me were salty crisps and fizzy drinks like coke. My midwife wasn’t at all concerned and told me this was normal so I didn’t worry. I don’t think she believed how nauseous I felt the whole time though. I had been given a midwife who specialised in teen pregnancy and I think she was used to over-exaggeration.

By 11 weeks things the sickness had become a nightmare, I was so nauseous all of the time, it started to affect my ability to eat. I would find it hard to physically swallow the food as I just felt so awful. The sickness had remained the same (vomiting no more than 8 times in a day) though having never heard of hyperemesis I found it really traumatising and I was constantly worried about my baby. I started having days when I couldn’t keep anything down including sips of water. I phoned the GP for advice and they told me the usual rubbish that morning sickness was perfectly normal and that I should keep having sips of water and dry toast/biscuits. I was trying so hard but nothing seemed to help. I would become so weak and unable to get out of bed. My blood pressure would drop and a couple of times I passed out. Gavin became increasingly worried and it got to a point where he didn’t want to leave me in case I got really hurt if I passed out. I had just started a nursing placement on the Stroke ward but it became impossible to cope. The smells were overbearing and I would frequently need to be excused to vomit. In the end I decided I couldn’t do this anymore and quit my course.

Things were at their worst in January, I remember being so sick I hadn’t kept down anything including water for 2 days and I felt like I was going to die. I called the GP again and spoke to the same doctor who said that I should be fine but to call back if I hadn’t been able to go for a wee in over 24 hours and they would then consider getting me some treatment. I had gone for a wee that morning so assumed I wasn’t serious enough for any treatment. I didn’t know what was wrong with me, I didn’t have a name for the condition.

Come February things got a bit easier, I started tolerating fluids and even small bites of food. I went to my GP after my midwife had found protein in my urine and thought I had a UTI and advised I go and get antibiotics. I saw a different doctor and she found ketones in my urine sample. She asked me about my sickness and I had explained what had been going on. She explained that she thought I had been suffering Hyperemesis Gravidarum. I was dumbfounded…I had been blown off my the other doctor twice and left at 18 years of age to just get on with it. No one had even suggested what I had been going through was not normal. She asked how I was coping and decided to prescribe me an anti-emetic medicine, it was metaclopramide syrup. I think she gave me it as a syrup as I was keeping down fluids but not much solids. I took the medicine and it did help me keep down a lot more. By 20 weeks, I was experiencing NVP not HG. I would vomit once or twice a day at maximum and even my constant nausea had gone.

The second trimester was so much kinder on me and I was able to continue on with the pregnancy. I struggled with anaemia and a lot of hip and back pain. But it was more like what I had imagined ‘normal’ pregnancy to be. Scans showed our baby was growing nicely, but we didn’t find out the babies gender. At around 32 weeks into the pregnancy my nausea increased again. The vomiting was still only a few times a day (3 or 4 times a day maximum).

I went into labour naturally at 39 weeks. It started on the evening of July 18th , I got dull period type cramps and my mucus plug began to come away. The morning of the 19th I thought I was in labour and warned Gavin to be on alert as I was getting regular pains. I managed during the day though noticed my body was unable to keep down any food. I did wonder if I was experiencing food poisoning as my bowels were very loose. Come the evening of the 19th I knew I was in labour for sure, I was restless. The contractions were regular, but I worried if I turned up too early at the hospital I would be turned away (I had heard horror stories). Gavin went to bed at about 11.30 pm and i laboured on my own til about 3.30am. The pains were becoming too much and I couldn’t cope on my own anymore. I had already had 3 baths (I would later get complaints from my neighbour downstairs that I had kept her awake all night, as she had heard me). Gavin helped me through the contractions but noticed they were lasting longer and coming much more frequently and so phoned the labour ward for advice. They said to bring me in straight away, we got to the hospital at about 4.30am

I was examined and found to be 4cms dilated, I requested an epidural as I was frightened of how much worse the pain could get and given entonox whilst I waited for the anaesthetist. After my epidural was put in it worked partially, they were about the replace it but found my babies heart rate kept dropping. Doctors decided to speed up my labour as the baby was getting tired. They broke my waters for me. The epidural by this point did not work at all. Within the next hour I went from 4 to 6 cms at the next check. Then I felt like I needed to go the toilet, I was checked again and found to be fully dilated to 10cms. I was told I could start pushing. It took me just under 3 hours to push Sarah into the world. I was so proud of myself, at the age of 19 I had survived hyperemesis gravidarum and pushed out our daughter with only entonox! After Sarah was out, I had no more nausea or sickness, I enjoyed tea and toast whilst we blissfully took in the fact that we were actually parents. At the time I thought this pregnancy was hard, and in a lot of ways it was. Whilst my HG had been mild, it was still a lot harder than normal morning sickness. I didn’t think anymore about the pregnancy and what we had endured to get Sarah, I was so grateful to have got my beautiful baby. After having lost Charlie I felt so blessed to have this little girl! Having not known about Hyperemesis Gravidarum, I didn’t even consider I might get it again in future pregnancies, no one had told me anything more. Even my midwife had been fairly clueless about it. It frightens me to realise that even as recently as 2007, there was so much ignorance concerning HG, so many people had no idea that someone could become so sick in pregnancy.

During my pregnancy I hadn’t been weighed by any of the medical professionals, i didn’t even weigh myself, I do think I lost a few pounds in the first half of the pregnancy. Because after Sarah was born I was 2lbs less than what I had weighed in the beginning. Whilst I had been officially diagnosed as having Hyperemesis Gravidarum, it was at the very mildest on the spectrum compared to my subsequent pregnancies.

Sarah Louise Stevens
Born 20th July 2007
at 8.40am
7 lbs 8