The Current

Why women battling acute pregnancy nausea suffer in silence

Many women who have hyperemesis gravidarum suffer in isolation. The debilitating nausea is a condition widely misunderstood, even by doctors.
Roughly one or two per cent of pregnant women in Canada get hyperemesis gravidarum, a debilitating acute condition of vomiting and nausea. (Shutterstock)

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Hyperemesis gravidarum (HG), a particularly debilitating form of pregnancy nausea has quietly plagued some women who have suffered in silence.

The condition is widely misunderstood, even by doctors, leaving many women to battle the severe symptoms of nausea in isolation.

I could not eat. I lost five or six kilos in the first month of my pregnancy both times.- Stephanie Nolen

But now high-profile sufferer Kate Middleton has made the condition front page news, prompting women around the world to share their own personal stories.

When journalist Stephanie Nolen battled HG during her two pregnancies, she found herself lying down on the grocery store floor due to the discomfort.

"I was so sick that the only thing that anyone ever said to me that made sense was that I should lie on the floor and yell, 'I want to die' for the whole 40 weeks and that might bring me some relief," she tells The Current's host Piya Chattopadhyay.

What makes it difficult suffering from HG is symptoms are downplayed because people tend to just see it as general morning sickness, says Nolen. 
Journalist Stephanie Nolen says after battling HG during two pregnancies, she feels a great amount of empathy for Kate Middleton, who also suffers from the condition and is expecting a third child. (Associated Press)

"People say, 'Oh, yes, I had that too. That's awful. You should try ginger ale and a cracker. And the problem is that you are so profoundly nauseated all the time," Nolen explains. 

"They just don't really understand that this is a whole other thing which I get because until it happened to me, I didn't get it either."

Nolen says during her pregnancies, she had to be in a dark room and remain completely still to deal with the discomfort.

"I could not eat. I lost five or six kilos in the first month of my pregnancy both times."

If vomiting leads to hospitalization because of dehydration, Nolen says people might take HG more seriously, but in her experience doctors just viewed her condition as a bad case of morning sickness.

"The drug I was given was the same drug my own mother was given when she was pregnant with me. So that tells you how much of a priority this is for the pharmaceutical research … it didn't work for me," Nolen tells Chattopadhyay.

During her second pregnancy however, she did take an anti-nausea drug used by chemotherapy patients that did help.

Haley Shewciw of Edmonton suffered from hyperemesis gravidarum while pregnant with her son Ben, who's now four-years-old. (Submitted by Haley Shewciw )

Many women often say they didn't get the medical help they felt they needed for HG — even in Canada.

Haley Shewciw says in her case the medical community had trouble understanding her condition.

"I had to be ambulanced to the hospital, like I could not make myself go from the bed to the car without throwing up the entire time," Shewciw explains.

"I think at the time they never had a case so severe as mine so for them it was … just morning sickness and it will pass, and you will be fine. Everyone wanted to try to help but nobody truly knew how I was feeling."
According to Caitlin Dean of the UK charity Pregnancy Sickness Support, hyperemesis gravidarum can be so severe that some women will terminate pregnancies if they don't get the help they need. (Shutterstock)

About 50 to 80 per cent of women get some degree of nausea/vomiting in their first trimester, and for the majority of those women, symptoms subside or disappear.

But for roughly one or two per cent of women in Canada, their first trimester is dominated by extreme nausea and vomiting which is hyperemesis gravidarum.  

Dr. Ellen Giesbrecht says part of the difficulty for the medical community to diagnose hyperemesis gravidarum, and help women who suffer from it, is because the condition has been normalized and so no one says anything.

"Nausea and vomiting which is so common through pregnancy is normal. And women often don't realize that their own form when they have hyperemesis is the severe form," Dr.  Giesbrecht explains.

In the medical community, Dr. Giesbrecht says, there's a fear of treating pregnancy with any medication unless the patient is very ill.

The long-term impacts of a pregnancy with HG can affect a woman emotionally and financially because she's not able to work, but it can also affect the family, she tells Chattopadhyay.

"We do know that [HG] actually has a fairly high incidence of recurrence in the next pregnancy. And it really does impact women's choice to become pregnant again."

Listen to the full segment near the top of this web post.

This segment was produced by CBC Halifax network producer, Mary-Catherine McIntosh and Vancouver network producer Anne Penman.