PREGNANCY SICKNESS: IS IT NORMAL?

Any level of pregnancy sickness is unpleasant, but if you are asking ‘is this normal’ then the chances are you are suffering from more severe symptoms.

Nausea & vomiting in pregnancy (NVP) is very common. On average it affects 70-80% of pregnant women to a greater or lesser extent and the degree of severity is very much on a continuum from the mild nausea, which is helped by eating little and often, to the very extreme cases of Hyperemesis Gravidarum (HG) in which without medical intervention and IV therapy the life of the mother and baby would be at serious risk.

Hyperemesis Gravidarum affects between 1 in 100 and 1 in 150 pregnant women who are often experiencing crippling nausea, being sick up to 50 times per day, dramatic weight loss, being house or even bed bound and struggling to eat or drink. If you are suffering from persistent nausea and/or vomiting which is preventing you from eating and/or drinking then you may be suffering from Hyperemesis Gravidarum (HG).

Frustratingly this condition is much misunderstood and is often dismissed as ‘Morning Sickness’, with many reports of people being told that there isn’t anything that can be done as this is a normal part of pregnancy. Others say their GP’s have told them the medications aren’t safe to take in pregnancy and some even report being laughed or shouted at by their healthcare practitioner and told to try ginger.

When you are suffering symptoms that are impacting how you are eating, drinking and functioning the thought of going to the doctors surgery and asking for help or having to advocate for yourself with healthcare professionals that might not understand can be overwhelming but here are some things that can help…

· Be prepared

Make a note of your symptoms in the following terms to enable your doctor to understand the severity of your symptoms and treat you accordingly:

- Number of times you are being sick per day

- How many hours you have nausea each day

- Number of times you are retching per day

- Amount (In millilitres) of drink you are having per day and keeping down

- Amount of food (ie. Bites or toast) you are having per day and keeping down

- Changes in your urine: darker, not going as much, when you go you pass less

- Any other symptoms of dehydration: Dry mouth, dry lips, headaches, dizzy, weak, confused

If you are dehydrated you may need to go to the hospital for IV rehydration - your GP can refer you. Take information on dehydration with you - Some GP’s, Midwives and hospital teams will rely on ketones for admission for fluids however this is not best practice or evidence based. The healthcare professionals should instead be looking at fluidbalance and clinical symptoms.

Take the RCOG Green top Guidelines and the BMJ Clinical update with you to your appointment - There are a lot of treatments available for the condition as detailed in the RCOG Green Top Guidelines 69 and the BMJ Clinical Update Nov 2018 – your GP and hospital team need to make sure you are on the right combination to give you as much relief as possible. Unfortunately, there isn’t a complete cure but the medications can help to make the symptoms more manageable.

Take someone with you - Speaking up and discussing your symptoms when you are ill is not easy. If possible, take a trusted partner, family member or friend with you who is confident and can help to advocate for you. Show them the notes you have made on your symptoms and discuss with them what you would like to get out of the appointment so that they can help keep all discussions on track and achieve your goal.

· Arrange a PSS Peer Supporter - Pregnancy Sickness Support runs a peer support network of women who have experienced HG themselves who are on hand to offer 1-2-1 support via text, WhatsApp and calls. It may be useful for you to have a peer supporter who appreciates the burden of the condition physically, mentally, socially, and financially, and validates your suffering. They are trained to provide information and support for as long as you need it within your pregnancy.

· Join the PSS Online Forum - Having a safe place to talk to other sufferers and survivors of the condition can reduce the loneliness and isolation you may be experiencing. A lot of sufferers don’t know anyone else in their communities and networks that have experienced the condition so having a secure, moderated place to discuss what you are experiencing can be a relief.

· Coping Strategies - Visit the Pregnancy Sickness Support website for coping strategies that you might not have tried yet. The page includes information on; eating, drinking, oral hygiene, coping with your emotions, resting and employment which can all be helpful on your Hyperemesis journey.

· Help others to help you - Sufferers of NVP and HG need as much support as possible. Suffering with this condition can often mean having to reveal your pregnancy before 12 weeks as the sufferer and their family needs practical and emotional support. Speak to trusted members of your family and friendship group and ask them to help. Give them a role or task that they can complete regularly on your behalf. They feel useful and you know that tasks are being done.

If you have an older child or children you might find it useful to speak to their key worker or teacher to let them know they might need additional support whilst they are there and also to see if any other parents could help with lifts or playdates.

For more information and support visit www.pregnancysicknesssupport.org.uk

Or call the helpline on 024 7638 2020

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