pregnancy

'I’ve had three hyperemesis gravidarum pregnancies. This is how I got through them.'

I found out I was pregnant with our third baby as bushfires ripped through Australia in January 2020. 

Smoke filled Melbourne, ashes darkened our pool, and we watched the heartbreaking destruction play out in the news each day.  

I’d anticipated 2020 with optimism – our 14-month-old daughter was finally sleeping through the night after a stint at sleep school. But on New Year’s Eve at 9.30pm, she was awake and screaming, struck down with gastro.

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What a start to the year. The gastro passed though the family like the bushfires on TV, and looking back now, it feels like an omen for the horrendous year that followed.  

I remember being on my hands and knees vomiting while our two little girls pounded at the bathroom door, thinking ‘thank goodness these bugs only last 24 hours.’  

Now, I look back and think 24 hours is literally nothing compared to 38 weeks. Because 38 weeks is how long I had hyperemesis gravidarum – the duration of my pregnancy.  

Hyperemesis gravidarum (HG) is defined by Hyperemesis Australia as "a complication in pregnancy in which sufferers experience extreme levels of nausea and vomiting… [side effects can include] oesophageal tearing, ulcers, reflux, weight-loss, exhaustion, constipation and more... 

And while there are various theories around the cause of HG, "none are, as yet, conclusive," the organisation states.

I’d start explaining what it was when asked, only to be interrupted with ‘Ohhh, what Kate Middleton had?’  

Yes, I’m in an incredibly small minority (most statistics suggest HG affects between 0.5 and 2 per cent of pregnant women), and it rendered me completely incapacitated. 

I couldn’t care for our two children or support my husband – I could barely care for myself.

I was sick. Not ‘sipping on flat ginger ale’ sick, or ‘nibbling on crackers’ sick. I was dry retching, fainting, ‘could this be what hell feels like’ sick. From about eight weeks pregnant, I had little relief until I had delivered our healthy baby girl, along with the enormous placenta that had breathed life into her for all those months.

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By February, the familiar nausea began in the afternoons with a few heaves as I was making the girls their dinner.

I found a facemask to wear (oh how familiar with them we all are now!) to minimise the food smell and soldiered on. 

I can’t remember when it first hit badly, but one day soon after the eight-week mark, I was overcome with nausea, vomiting and something that to the uninitiated, pretty much feels like gastro combined with the worst hangover of your life. All day and all night.

How Joanna spent the majority of her pregnancy. Image: Supplied.

Our surprise third baby caught us in the waiting period of our new health insurance. We’d been going back and forth about a third baby and were still at loggerheads. 

Our youngest had been a challenging infant with reflux, and my husband felt exhausted from what we’d been through. On the other hand, I felt that indescribable, primal urge for another baby and couldn’t shake the feeling.  

In retrospect, I’m so glad the universe made the decision for us, as we are all impossibly smitten with our third baby girl.  

We’d recently changed our health cover to go to sleep school with our youngest, but that meant we hadn’t served the required waiting period to access the private maternity system. I spent my third pregnancy under the mostly midwife-based care of the public system.

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The vomiting and nausea had increased significantly by the time I hit 10 weeks. I had two little girls to care for, a worldwide pandemic, lockdown in Melbourne, and a husband having a significant existential crisis.  

As an airline pilot, he was stood down indefinitely without warning or pay at the end of March 2020, just when I was approaching the end of the first trimester. 

The silver lining was that I had someone else at home with me and our girls during the day, but it also meant he was under unimaginable stress, worrying about money and his career. 

I could barely get out of bed, let alone be any sort of support to him.  

I remember making myself a coffee to try and snap out of the awful sick feeling. I had a Mary Poppins mug – it was my favourite because I joked it was about me, with the words ‘practically perfect in every way’ on it. 

Well, even my special mug couldn’t help me. I couldn’t smell coffee for the next few months without being sick. 

I dry heaved every time I opened the fridge. Some hyperemesis triggers go away once you’re well (coffee, thank goodness, smells wonderful to me again) while some triggers stay. A fragrance someone wore, a certain candle, or the texture of the bathmat I knelt on while I was vomiting, can all give me a surge of nausea even now, nine months after delivery. The body remembers.

Image: Supplied.

The first time I presented at the local emergency department at eleven weeks pregnant, I was worried I was taking valuable resources away from ‘sick’ people and felt embarrassed. 

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My first two pregnancies had been in the private system under the care of a very good and highly respected obstetrician. But in retrospect, I feel like the only objective was to deliver a live, healthy baby. I was the incubator. A well cared for incubator, but still, the vehicle for my baby’s existence.

I had spent those two pregnancies with (in my words) ‘really bad morning sickness.’ I had been severely unwell in the first trimester during my first pregnancy, and in the first and third trimesters of my second pregnancy. 

I thought I was weaker than other women because I couldn’t get out of bed. I thought it was normal that I was so unwell I could barely wash my hair or brush my teeth. Looking back now, my previous pregnancies were hyperemesis pregnancies – I just didn’t realise it. 

I had been prescribed an anti-nausea medication by my obstetrician, and it hadn’t helped me at all. There had been no discussions about trying alternative medications, and I now realise I should have been more assertive about how ill I was. 

However unheard I had felt regarding my nausea and vomiting, I was grateful that the illness had eased at stages during those pregnancies, and I had experienced some sense of normalcy and wellness.

But this third time, the nausea and vomiting had taken itself up a notch. 

When I finally advocated for myself and presented to the local emergency department, the triage nurse prioritised me and had me in a bed and on fluids almost immediately.

"I’ve only vomited about five or six times today though," I said to her, because I’d heard of HG sufferers who vomited up to 50 times a day. She turned around and raised her eyebrows at me: "You know, that’s actually still quite a lot."

While I pondered this, the medical staff did a range of tests on me and finally let me go home about six hours later. 

I clutched a prescription for medication and the discharge papers in my hand as I walked back to my car. There it was, in black and white - hyperemesis gravidarum. I felt a strange sort of relief. It wasn’t morning sickness. It was more. I wasn’t weak, or lazy or dramatic. 

The emergency doctor that day prescribed a medication that would become my saving grace for the rest of the pregnancy. From then on, I still felt sick but only vomited once or twice a day. I was able to drop back to half a tablet in my second trimester to minimise the grogginess the medication caused, but went back to a full dose as the third trimester was looming. It made life manageable.  

As time went on, Melbourne sunk deeper into lockdown. I tried to look for the positives in Hyperemesis, but let’s be honest, there aren’t many. I thanked my body for keeping my hormones high and our baby safe. But I was angry with myself, bitter that I wasn’t happy like other gorgeous pregnant women. I was resentful and self-pitying. 

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My husband, under extreme stress and still stood down from work, did all the heavy lifting with the parenting of our girls, while I caved under this invisible illness. My parents came and took our girls for walks and dropped off hot meals.

I was so miserable and sick that it was hard to imagine the end of my pregnancy and a sweet baby in my arms. All I could see was feeling like absolute shit indefinitely, day in, day out. 

My female GP was looking after me as part of a program within the public system called 'Shared Care'. Face-to-face appointments had significantly decreased during stage four Covid restrictions in Melbourne, and telehealth appointments had to suffice in between less regular physical check-ups. I had to go to these appointments and scans alone, but as a third-time mother, this didn’t worry me the way I imagine it would have affected a first-time mother. 

My GP booked me in for iron infusions during my third trimester, as I started the inevitable crawl towards the finish line. She checked in with me frequently, told me what a horrendous illness I had, and what a great job I was doing. I wasn’t just an incubator for my baby: I was a person, and it was important that everything possible was done to manage this terrible illness, rather than drag me through my pregnancy until I delivered a healthy baby. 

The nurse who administered my iron infusions lay me down and did it slower than usual, so my body had less chance of a reaction. Student midwives held my hand during physical examinations and distracted me. I’ll always be grateful for the professional women who supported me and cared for me during such a hard and strange time.

So, as fate would have it, the day I gave birth, the only male on the delivery floor was my husband. Our entire birthing team was female. I felt empowered; I felt heard. I felt like my body was as strong and prepared as it could be. I felt safe.  

But after the relentless struggle of this pregnancy, post-delivery I felt like hell. Mentally, I was happy, proud and relieved: our baby girl was heavenly. Physically, I felt nothing short of dreadful. I was still nauseous, drained, and utterly exhausted. The previous nine months had taken their toll on my body. I lay in the hospital bed and couldn’t even lift my phone to text anyone the good news. 

After two nights, I went home. I still remember sinking into our own bed, and finally breathing a huge sigh of relief. I did it.

I’m one of the lucky ones who has been mentally unaffected in the long term by my pregnancy. However, hyperemesis can leave psychological scars for some women, ranging from depression or anxiety to PTSD felt for months or years after birth.

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I spent an entire pregnancy totally unable to care for this baby’s siblings, and the pregnancy before that was only marginally better. 

And us mothers, we feel all the guilt, don’t we? So, sometimes a great lump of grief wedges itself in my throat. 

My chubby cheeked toddler is now a six-year-old with gangly limbs and missing teeth. I feel like I’ve missed out on so much. While I was surviving a horrendous pregnancy, she’d undergone a metamorphosis. Sometimes the sadness and guilt I hold around her feels so heavy and painful. 

But I try to remember what she’s gained - two sisters, two best friends for life. While I was sick, she was loved and cared for by her amazing dad. Their bond is unbreakable.

Image: Supplied.

I understand that awful bitter-sweetness that comes with a terrible pregnancy. The immense pride that you feel when you’re growing a human life inside you, but the toe-curling illness and rage and bitterness and resentment that comes with it. 

The regret, the joy, the fear and the love, all swirling around inside you until it feels as though you’ll explode. 

I promise you, with the right support and care, you will get through this.

Advocate for yourself.

If your medical professional doesn’t listen, find one who will. Get your partner or support person to advocate for you if you feel unable to do so. 

My GP looked for ways to minimise my distress, organised iron infusions and medications, and checked in on me. 

She literally changed my pregnancy into something I could manage. 

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Be open to medical intervention.

If you’re so ill you can’t shower, eat or work, then that is more than morning sickness. Hyperemesis is different. 

Don’t feel like a drama queen when you turn up at your emergency department for fluids. Take the medication that you’re prescribed by medical professionals. 

It may take a few tries to find one that works best for you, and they’re often used in conjunction with each other to maximise the benefits. But trust me on this, take the medication. 

Take it day by day.

I remember lying on the bathroom floor and wailing ‘how can I manage 20 more weeks of this?’ between heaves. 

In my more resilient moments, I found it easier to focus on getting through each day, rather than thinking about how long I had until the pregnancy was over.  

Some days, I focused on getting through until the children’s nap time. Other days, it took all my energy just to get through the next hour. Baby steps. You will get there, and it will be okay. 

Accept help.

I usually have trouble accepting help, but I learnt to during this pregnancy. 

This was particularly tough during lockdown in Melbourne, but I accepted any assistance that was offered from our amazing village of family and friends. 

Talk about it.

If you’re not okay, talk to a professional. 

There is no shame in seeking help, particularly during your pregnancy or in the postpartum period. 

It can be helpful to talk with an objective person to unpack all the emotions that a difficult or traumatic pregnancy brings up. 

Pregnancy is supposed to be a happy time, and for most HG sufferers, it’s not. This can be a hard thing to accept.

On this episode of Mamamia's podcast for parents, This Glorious Mess, we talk about the effects of postnatal depression. Post continues below.

Give yourself grace.

Don’t have high expectations for yourself during your pregnancy. The house will be messy. Your children will have their face in an iPad more than you would usually allow. 

I looked like death and was barely out of pyjamas. My children called me ‘monster mummy’ to my face and spent the bulk of stage four lockdown in various stages of undress, eating chicken nuggets.  

And you know what? They survived.

And you, mama, will survive too. One day, not too far from now, you’ll be listening to the sweet little sounds of a newborn sleeping while you’re devouring some wonderful meal, and you’ll suddenly realise, ‘Wow. I did it. I really did it.’ 

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Now that I’m a safe distance from my pregnancy, I try to find the good in my experience with hyperemesis. 

From the beauty of hindsight as I sip my red wine, with three sleeping babies upstairs, I understand that it taught me some important things. Not only about myself and how resilient I really am, but about motherhood.  

It taught me that a mother’s love won’t ever diminish. It’s a living thing: it bleeds, aches, pulses. It breathes itself into her children for all of eternity. And isn’t that the most powerful thing? 

Image: Supplied.

Anne Lamott once said: "There are places in your heart that you don’t even know exist until you love a child." Oh, how true that is. Our hearts will sustain anything for our children. Us mothers we will live through hell to bring our babies Earthside safely.

Hyperemesis taught me sacrifice. It showed me what lengths my body would instinctively go to, simply to protect that little bundle of cells nestling in my body.

That’s the most important part of my story – my body got our girls here safely. The sacrifice, the illness, the bitterness at having such terrible pregnancies? I hope that’s only a small part of my greater story. 

And as for our baby girl? I haven’t told you much today about the sweet little lady who made me so ill. 

Well, she’s just like my Mary Poppins mug says. Practically perfect in every way.

Feature Image: Supplied.