How to best support women with hyperemesis gravidarum

Imagine you have food poisoning.

Now imagine you’ve had it for weeks, day and night, night and day, you feel sick, weak and overwhelmed and your doctor says you’ll probably be sick for another couple of months.

Then this happens, someone tries to cure you by giving you a cracker to eat in the morning.

Wait, what?

Please don't cracker me I have HG

Please don’t cracker me!

Welcome to the world of women with hyperemesis gravidarum (or HG to those in the know).

HG is by definition a severe form of nausea and vomiting in pregnancy that is characterised by weight loss and dehydration.

It’s reportedly a common experience for women with hyperemesis gravidarum.  After they tell people about what they’re experiencing, crackers start flying at them from all directions, like some sort of weird cracker hailstorm. Friends, family, acquaintances and even some doctors seem to have crackers and ginger candy at the ready.

It’s a well meaning and natural thing to do – you see someone you care about suffering and you try to help the best way you know how. The trouble is, it’s tough to help a HG sufferer in the right way.

I decided to write this article after seeing an exchange on an online parenting forum that made me cringe. It went something like this:

Sue wrote: “I’ve been sick for weeks and have been diagnosed with hyperemesis gravidarum. I can’t get out of bed. I don’t know how I’m going to cope. I don’t know what to do. ”

Jane replied: “I’ve found salty crackers really help, especially if you have one first thing in the morning. Also have you tried eating small meals frequently or ginger tea? At least it’s a reassuring sign the baby is growing well, good luck hun!”

Sue got cracker-ed.

Jane was trying to help but Sue can’t eat crackers. I’m sure she has tried. Sue probably can’t even drink water and may have written her post from a hospital bed.

I felt awful for the HG sufferer (Sue) and also for the well intentioned person trying to help them out (Jane). It got me thinking about my own morning sickness experience and how significant moments like this feel when you’re so unwell.

Calling HG morning sickness is like calling a hurricane a little rain

pregnant and feeling nervous

Because HG isn’t well understood people mix it up with normal morning sickness. Or maybe normal morning sickness where the woman in question ‘isn’t coping well’ or ‘hasn’t tried the right remedies’. In reality ‘morning sickness’ and ‘hyperemesis gravidarum’ are two very different beasts.

I had severe morning sickness in my two pregnancies. My morning sickness made me vomit a lot, and left me unable to function properly. An experience that affected me so much I decided to create a business focussed around it. I had to unexpectedly take time off work, I needed extra help taking care of my home and looking after my daughter. But I didn’t lose weight and was able to keep myself hydrated without medical intervention. I didn’t have hyperemesis gravidarum.

Women with HG typically can eat and drink very little, some even struggle to sip water. They vomit all the time, even blood and bile if not treated. They often require fluid hydration and anti-nausea medication through a drip. HG suffers are often hospitalised and many are unable to work for weeks and months at a time. Some HG sufferers report they feel like they are dying. Many get depressed. Some suffer post traumatic stress from it.  So in short, HG is a  nightmare.

I think this quote from the HER Foundation* illustrates it best:

“Calling HG morning sickness is like calling a hurricane a little rain.”

How to support a HG Mama

So, to support the women in our lives suffering from HG, we need to put the crackers and ginger candy away.

All is not lost though, here are some things you can do to help (and a few things you shouldn’t do). They won’t cure anybody and may be small in the scheme of things, but it all makes a difference.

  • DO get all practical

    Do their washing, clean their bathroom, run their errands, walk their dog, drive their kids to sport or school (with permission of course – otherwise it’s kidnapping), babysit, water their pot plants, drop off and pick up clothes from hospital. Make sure they have lots of proper vomit bags handy.

  • DO help them nurture their pregnancy body

    As well as absolutely flogging HG sufferers physically, HG also steals their opportunity for the pregnancy experience they were hoping for, which was no doubt characterised by joyful expectation instead of misery and vomit. This can be really hard to come to terms with.  While you can’t give them that opportunity back, you can give them a little something to help them honour themselves and nurture their pregnant body. Buy them lip balm, body oil for their pregnant belly, hand cream, or maybe an eye pillow. Things like this are particularly important if they’re stuck in an air-conditioned room all the time. For any potions or lotions you give them, be mindful of the scent and make sure it’s pregnancy appropriate.

  • DO jazz up the room they spend the most time in

    This may be something like their bedroom, lounge room or hospital room. HG can make time stand still. Being in the same space, day after day, looking at the same wall or ceiling can be at best incredibly boring and at worst very depressing. So (with their permission and input of course) add something beautiful to their space. Posters or art on the walls or ceiling where appropriate, flowers and plants, ornaments, photos. Make sure that all triggers are removed from the space too (food and other smells, flashing or bright lights – ask them what needs changing).

  • DO keep them company

    When you feel that sick sometimes you don’t want to or can’t talk that much, but it can really help to have someone keep you company. Sometimes just having someone sit with you in comfortable silence can make all the difference.

  • DO help them kill time

    With endless hours of doing nothing except being sick at their disposal, there is way too much opportunity to focus on their worry and fears. Distractions help, so make sure they have lots of music, pod-casts, movies, TV shows, and other entertainment available to them (check first though).

  • DO be there for them

    Be there in person. Be there emotionally. Be their advocate. Be their voice when they don’t have one. They have a long hard road ahead. They need to make it to the end of their pregnancy and back to wellness. Then they need to recover from the overall HG experience. It can take time. They need your ongoing understanding and support.

  • DON’T suggest morning sickness remedies

    Being given morning sickness remedy suggestions is decidedly unhelpful and super irritating for a HG sufferer. They have heard them all and they have tried them all already. Ginger candy, tea or acupressure bands just ain’t gonna cut it.

  • DON’T go all glass-half-full on them

    Statements like these should be avoided at all costs: “At least your baby is still ok”; “at least you won’t put on pregnancy weight”;  “at least your older child will be used to doing less with the you when the baby comes”. Just don’t go there.

  • DON’T talk about the universe having a plan

    It if does, it is a really rubbishy one, and it’s not worth talking about.

Jane’s reply in the online forum conversation was obviously well intended but nonetheless I’m sure it made Sue feel worse, maybe even mad. Sue never replied and disappeared off the forum. I don’t know what happened to her in the end. She certainly didn’t log off and go and eat some crackers.

* There is a whole lot more information about what HG is and how to help on the HER Foundation website. The HER Foundation is the world’s largest grassroots network of hyperemesis gravidarum survivors and leading site for HG information on the Internet.