You may have heard that Princess Kate suffered from "severe morning sickness" with each of her pregnancies. That's the term that most media outlets seem to use when describing her battle with hyperemesis gravidarum (more simply known as HG). Probably because it's easier for the general public to understand and less difficult to pronounce. But I think the media does a disservice to Kate and other HG sufferers when it describes her illness as severe morning sickness. HG is so much more than that.
So what is hyperemesis gravidarum? It is a rare pregnancy condition that causes severe nausea and vomiting that can often lead to dehydration, weight loss, and hospitalization. In the most extreme cases, women with HG must have a feeding tube or may lose their baby. Most women have to take several different medications before they find one that remotely works to fight the nausea, and many never find one that helps. Some of these medications are not necessarily proven safe during pregnancy, but if it saves your life it's worth the risk. HG is a serious ailment and not to be taken lightly. Unfortunately, there is so much that doctors do not yet know about HG that it can be difficult to find proper treatment. Some uneducated doctors or nurses even go so far as to say it is a psychological issue, which it definitely is NOT.
I have personally experienced HG with both of my pregnancies. During my first pregnancy, I had no idea what was happening to my body. I would vomit for days on end, unable to keep down any food or water, and have to go to the ER to receive IV fluids every week or two. When the nurses spewed the long words at me as if it explained everything, I wanted to scream. I didn't care that Princess Kate had it or that it had a fancy name - I just wanted it to go away. My weight dwindled from 130 down to 113 pounds; I had not been that small since 8th grade. For you math people, that means I lost 13% of my body weight in a matter of weeks due to how sick I was. By the time I was 20 weeks, I was improving but still didn't look the least bit pregnant.
I was one of the lucky ones - my HG symptoms eventually subsided completely. Many women, however, experience the severe nausea and vomiting until the baby is born. I was able to resume a normal life, and my biggest complaint was spending my entire third trimester in the hottest part of the Texas summer.
Long before my husband and I decided we wanted to try for another child, I began doing my research on HG. I learned about causes (spoiler: the causes of HG are unknown, which means it is not preventable), treatment options, and other women's experiences. I knew that I was likely to experience this illness in later pregnancies, and I wanted to be prepared to face it. The most valuable resource for me has been a book called "Beyond Morning Sickness: Battling Hyperemesis Gravidarum," which you can purchase here. There is also an amazing support group on Facebook, which you can find here.
I am currently 26 weeks pregnant with our second child, and I had even more severe HG during my first trimester than I had during my first pregnancy. The longest I went between ER visits was 6 days. I got to be familiar with a few of the nurses at St. Luke's (shoutout to them for keeping me alive). Thanks to a wonderful OB, I was able to take a medication that made the sickness go away more quickly than the first time around. I am forever thankful to have found a doctor who knew his stuff. I'm back to working part time, cooking, playing with my daughter, and am now under the care of an amazing midwife. Best of all, I am able to enjoy the gift of being pregnant, which is nearly impossible when you are in the throes of nonstop vomiting. My heart breaks for the women who never experience a time of enjoyment until they hold their babies.
I hope that this post has helped to bring some clarity to hyperemesis gravidarum. I know it's not a scholarly article, but sometimes we learn best through hearing about experiences. My next post will focus on the impact that HG has on its victims. If you take anything away from this, I hope it is that HG is more than morning sickness. If you have a loved one who has experienced or is experiencing HG, take them seriously. And if you are personally going through it, know that you are not alone and that it will be worth it to endure to the end. Looking at my daughter was the only thing that got me through the day sometimes, because I knew that I would have another amazing little one to hold when it was all over. They are worth the fight.
Friday night I officially wrapped up my first class series with our class reunion! It was a joy to sit down with my students, to have a meal together, and reminisce over their pregnancy and birth, and discuss the joys - and hardships - of new parenthood. I am thankful to have served them as both a childbirth educator and a doula. To see their childbirth journey through to the end, to see them put what they've learned into practice, was amazing.
There was a definite learning curve with teaching my first birth class. Keeping within the time frame and making discussions and activities flow smoothly can be a challenge when you've never put it all together on your own before. Thankfully, Ben and Liz are a gracious couple and were forgiving when we went an hour past our 2.5 hour class time - on more than one occasion. (Thanks, y'all.) But perhaps the biggest learning curve was that they were expecting identical twins!
Generally, the curriculum remains the same for such a situation. You practice the same labor positions, relaxations, comfort measures, and discuss the same prenatal tests, newborn care, and variations of labor. The challenge came in specific discussions about delayed cord clamping, earlier induction talks, and the sheer amount of ultrasounds that were required by their care provider. I had some research to do! (Shoutout to the instructors who provided good information and resources. You ladies rock!)
After 10 weeks of feeling both great and disappointed in my teaching - they were getting plenty of great information and having a good time, but it was hard to fit it all into our given time slot - it was finished. All that was left to do was wait for the babies to come. And I was on call as a backup doula.
The morning came a few weeks earlier than expected - Liz went into labor at 35 weeks. Her doula was in Dallas, signing on a house. I got to fulfill my role as a backup doula. There is nothing quite like the rush of being en route to a birth!
Did I mention that they put everything they learned into practice? Well, I meant it. Liz's labor slowed upon arrival at the hospital. Instead of accepting the Pitocin recommended by her OB, we made the environment fit her birth plan, she changed positions often, Ben snuck her snacks and water, and the list goes on and on of things they did to progress labor naturally. My instructor heart even swelled with a bit of pride when I saw the Top 10 Tools for Dad card tucked away in Ben's pocket. After just a few hours of active labor, Margaret and Dorothy were born. Liz and Ben had the amazing birth(s) for which they had hoped and prepared. And I was lucky enough to see it happen.
My first series taught me more than I expected. I got a better idea of how to keep activities and discussions within our time frame. I just finished class 8 of my second series, and the most I have extended our time is 20 minutes. I even finished our last class a few minutes early! (Thank you to my current students for the same grace exhibited by Ben and Liz.) I learned a lot about twins, and I have an itch to learn more! The most important thing I learned, though, is that nothing will ever be perfect on your first attempt - and that's okay. Practice makes better. Whenever I am teaching, I am also learning. And I hope to keep learning for a long time.
These are some of my favorite photos that I took at the birth of Margaret and Dorothy:
*Photos and names used with permission.
Natural birth. Some people cringe at the thought. Some may imagine barefoot women with sunflowers in their hair diffusing essential oils and eating organic hummus. Natural birth seems to be brushed off as being reserved for the "crunchiest" members of society. I would like to nip that stereotype in the bud and say that childbirth sans pain medication is for all women!
Why go natural? Let me count the ways! Avoiding pain medication is not out of a fear of "big pharma." Studies show that epidurals can actually increase your chances of needing further medical intervention (i.e., labor augmentation via Pitocin, or Cesarean section). This is referred to as the "Cascade of Interventions." Nobody wants to increase their chances of having major abdominal surgery!
Another reason to avoid medications during labor is so that your hormones can operate without interference. Your brain is releasing very specific amounts of oxytocin, endorphins, adrenaline, and other hormones to progress labor, to keep you going, and even to relieve pain! Dr. Sears compares this process to the conduction and performance of a great musical symphony. Medications of any kind disrupt the production of these hormones so that they are no longer working in harmony with one another. This dissonance can result in a lack of that beautiful rush of oxytocin - aka the love hormone - when baby is born. Believe me, you want the oxytocin!
Finally, I often hear women say that they are not strong enough or that their pain tolerance is too low to give birth without an epidural. Listen - if I can do it, anyone can! I'm pretty sure my toddler has a higher pain tolerance than I do. But, as I noted earlier, your body is making hormones to fight the pain! And the greatest thing? It is totally empowering! Giving birth without medication has the power make you feel like you can accomplish anything! It was definitely one of the greatest self-efficacy boosters I have ever experienced.
So, to the average woman I say "Natural birth is for you!" You don't need super strength, and you don't have to be one with Mother Nature. If you are educated and have a supportive birth team, then you can absolutely achieve a natural birth. No organic hummus required.
When I was pregnant, I had quite a few people in my life who didn't believe in my ability to have an unmedicated birth. They thought I would regret my choice to go without the epidural because, surely, I couldn't handle that much pain. They believed midwifery was inferior to obstetrics and that I would surely be in more danger giving birth at a birth center. And giving birth in water? Wouldn't the baby drown?
Despite the discouragement, I was confident in my willpower and ability to give birth without pain medication. My husband and I were well-prepared, and we had a great birth team. Plus, when someone tells me I can't achieve something, I get even more motivation to do it. Sometimes being stubborn has its advantages, I suppose.
Preparation is Everything
So what was it that gave me - the girl prone to crying over a stubbed toe - this confidence? It was the education I had gained by taking a Birth Boot Camp class with my husband. When we started the class, I actually wasn't so sure that I could accomplish what seemed to be a Herculean task. But as we learned about the balance of hormones and progression of labor, various methods to cope with and relieve pain, and about the midwifery model of care, I became more certain that this was what I wanted and that I would be able to do it. I went from fearing birth to looking forward to it.
The birth of my daughter was incredible. I actually look forward to being able to go through labor again someday. Birth Boot Camp truly empowered both me and my husband to achieve the birth we desired, and I want to share that empowerment with more couples. Natural birth takes a lot of physical, spiritual, and mental preparation. If I didn't have that, then I could have easily given in to the discouraging comments I received.
Education Relieves Fears
I have noticed that my friends have all sorts of questions about pregnancy and birth. Unfortunately, it isn't a topic that women know a lot about in the United States. I believe that lack of knowledge is part of what perpetuates this fear of childbirth. It makes people believe that natural birth is only for the strongest of women. That midwives are not truly qualified care providers. That childbirth is constantly on the edge of catastrophe. Lack of knowledge is what breeds discouragement. One class at a time, I am hoping to help break this cycle.
You CAN Have an Amazing Birth!
I decided to become a Birth Boot Camp instructor so that couples can learn that natural birth is possible and so they can face it without fear. Couples should feel strong, not discouraged or fearful, when thinking about the birth of their children. I had an amazing birth, and so can you!