Adriana Lozada offers practical advice on how to deal with whatever level of nausea you are experiencing. She also lays out how hyperemesis gravidarum (HG) is not just a bad case of morning sickness, but a severe and debilitating condition.
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Related Birthful episodes:
- The HER Foundation (Hyperemesis Education & Research)
- Pregnancy Sickness Support
- Hyperemesis Gravidarum, the National Organization for Rare Disorders (NORD)
Ways To Deal With Morning Sickness— Whether It’s Mild Or Debilitating
Adriana: Welcome to Birthful Mighty Parent or Parent-to-Be. I’m Adriana, Lozada and I’m so thrilled you’re here, as we continue on, on our Nutrition and Nourishment series. So today you’re gonna get one of my deep dives without a guest, because I really wanted to talk to you one on one about the range of morning sickness experiences that can go from mild to debilitating, and also for us to really explore a pregnancy complication that is not talked about that much, but if you have it, it basically consumes your life. I’m referring to “hyperemesis gravidarum,” or “HG” for short.
Now, if all the pregnancy tropes and clichés have taught us anything is that morning sickness is an expected part of early pregnancy. In fact about 70 to 80% of pregnant people will experience some level of nausea and vomiting. And if you have experienced morning sickness, you know, it’s a misnomer because it can happen at any time and more often than not, it comes and goes continuously day or night.
What I dislike the most about these tropes is that they minimize and trivialize the wide spectrum of nausea and pregnancy sickness that many people experience. Yes, some people may not have much nausea or vomiting, but for others, things can be debilitating and dangerous. And when it gets to that extreme, then it becomes HG, which is by the way, what Duchess of Cambridge Kate Middleton has experienced with all three of her pregnancies.
And before we dive deeper into HG, I want to share some suggestions that were given to me by OB Dr. Theresa Nesbitt regarding how to navigate morning sickness. She says, first off, consider that the trigger for nausea comes via smell, so identify whatever smell is bothering you and try to avoid it. And that’s not limited to foods, right? You may remember from the episode with Cameron Rogers, where her heightened sense of smell made it so that she couldn’t have her puppy close by for several weeks.
Then the other thing is that lemons can be your lifesavers because their smell sort of cuts through any other smells. So you can place them near your nightstand, carry them in your bag, cut them up and sniff them, suck on them, squeeze them in your water. Whatever works for you. Try it and see if it helps.
And then the third thing is that Dr. Theresa recommends the magnesium supplement for basically anyone who doesn’t have kidney disease. She says that it can help with the nausea and that it’s also good for leg cramps and even sleep. Ideally you want a sustained-release magnesium so that it doesn’t give you loose bowels and similarly, registered dietician Lily Nichols also recommends magnesium since it can be a tool to help maintain optimal blood sugar levels. So there are different bonuses to taking magnesium. Of the different types of magnesium out there, Lily suggests magnesium glycinate. Now definitely consult this with your care provider!
And I wanna say that, although I’m gonna be focusing on extreme nausea during this episode, centering those most in need will provide a lot of information for anyone within the spectrum from mild morning sickness to debilitating HG.
So hyperemesis gravidarum, which is Latin for “extreme sickness of pregnancy” is the condition of experiencing such severe and debilitating nausea and vomiting during pregnancy that it can lead to weight loss of more than 5% of your pre-pregnancy weight, dehydration, electrolyte imbalance, and even anemia and malnutrition.
Pregnancy Sickness Support describes HG like having food poisoning and the hangover on a boat in a storm for several months. Yeah. That bad. I mean, some people report vomiting 25 to 50 times per day! Now the research tells us that HG occurs in about 1 to 3 pregnancies, classifying it as a rare complication. But remember how I said nausea and pregnancy sickness was a spectrum? If the symptoms are treated early enough, the severe nausea and vomiting may be managed so that it doesn’t get to a point of the diagnosed HG. The reality is that about 10% of pregnant people experience severe vomiting, meaning vomiting more than a few times per day. And recent data says that about 16% of pregnant people take some sort of medication to address this.
And this is super important. If you are experiencing severe symptoms, don’t wait until you’re losing weight due to vomiting and needing IV fluids for dehydration before getting treatment. Be proactive because early access to treatment can be more effective.
Adriana: So when HG is full on, dehydration is a really big issue. And some signs of dehydration are having dry skin, feeling faint, dry mouth, not peeing enough. If that’s happening, it’s vital to drink whatever stays down. If you can’t keep water down, try something else, like juice, tonic, water, lemon soda, even flat Coke, whatever stays down. It might be helpful to try sipping through a straw or taking tiny sips to help you keep it down and if that doesn’t work, freezing it, and then, just sucking on the ice cubes might help. If you’re still not able to keep down fluids, then maybe you can nibble on some fruit that’s high in water content. Whatever you do, don’t delay in getting IV fluids if you are dehydrated, because then you’re gonna spiral into bigger problems.
Now, if drinking, keeping something down is a huge problem, eating is of course even worse. What you have to do is eat whenever you can. Meaning, whenever you have a hunger window— and those can come on quick! And if you miss it, that can bring on a relapse, so eating during that hunger window is really important, and it can also help you avoid a new episode of vomiting.
Try to carry foods that you are able to keep down, whatever that might be, crackers, bananas, nuts, whatever works for you. And if you can’t eat much, pay attention because this can lead to anemia and malnourishment, so don’t just power through— talk to your doctor about it.
And speaking of things to carry with you, you may want to put together an emergency vomit kit, as lovely as that sounds, that includes airline type bags, then also some wipes, tissues, some bags for disposal, and some water for rinsing.
Believe it or not, this can give you some sense of control and also minimize embarrassment, which may encourage you to get out and about more. And getting out and about is important because people who experience HG or severe nausea and vomiting tend to isolate, which can in cases, lead to depression. In fact, people with HG are eight times more likely to experience depression.
To help with your mental state, try to figure out what can lift your mood and do that, if you can. Listen to podcasts with your eyes closed in bed, if you can’t watch shows or read, hint, hint. And talk with supportive friends that will listen or find someone who has experienced HG. And remember to take it one day at a time and celebrate each day you get through it
Now to minimize your symptoms, figure out your triggers and avoid those. They might not just be food aversions or strong smells, but even noises or moving images or bright lights. You probably may have to avoid cooking if you can, and if so, don’t feel guilty to ask for help.
Now then in terms of treatment, that’s also a broad spectrum. I’m not gonna say ginger because that’s one you’ve probably heard thousands of times, but the wristbands that stimulate your P-6 point, on your wrist? Non-blinded, randomized trials have shown a decrease of persisting nausea by at least 50% so they can actually help. And in a very similar vein, acupuncture has also been shown to help, as well as self hypnosis. All of that varies by individual!
There are also a broad range of medicines that can help with the different symptoms and that’s way beyond the scope of this podcast, so talk to your care provider— we don’t give medical advice. Similarly though, vitamin B6 and B1 seemed to help.
Now, if you do get dehydrated, it’s common to have to go into the hospital for IV fluids, or sometimes you can even arrange home care for an IV. I even had a client once who had such severe HG, that they had to install a PICC line, which is a peripherally inserted central catheter, so basically a port that was in their body all the time, Because they were going to get IV fluids so often that they just had a quick line in there.
Take your symptoms seriously and know that you are not being dramatic, hormonal or overreacting. This is real. Other things you can do are make sure you get rest, even though it can be tempting to try to catch up on life when you’re feeling better. Not resting can lead to another debilitating cycle.
Regardless of where you are in the spectrum. We don’t quite know the cause for all this nausea and vomiting, so it might be genetic or hormonal or overall stress who knows. And for everybody, it might be different.
In terms of timing, both morning sickness and HG can start around four to seven weeks and peak around nine to 13 weeks. However, then morning sickness usually goes away after the first trimester while people with HG may get some relief, maybe around 14 to 20 weeks, although one in five, have it during the whole pregnancy.
If you have had HG before, you probably will get it again, it might be as strong or more severe as the first time and understand that pregnancy is a depleting event, so focus on repleting your system before becoming pregnant again, to hopefully lessen the severity of the new HG situations. And even if you aren’t planning to get pregnant again, it is important to create a replenishing plan with your care provider.
Know that you are not alone. Figure out what helps. Develop your own coping strategies and ask for help. Having severe nausea and vomiting during pregnancy is super hard, and if anyone says that they also had “morning sickness,” quote-unquote, make them listen to this podcast.
You can connect with Birthful on Instagram @birthfulpodcast. In fact, if you’re not driving, I’d love it. If you would take a screenshot of this episode right now and post it to Instagram, sharing your biggest takeaway from the episode, especially if you found a helpful tool for dealing with whatever level of nausea you’re experiencing, or maybe this episode really resonated with you and you felt seen, make sure to tag @birthfulpodcast so we can see it and share it.
You can find the in-depth show notes and transcript of this episode at birthful.com, where you can also learn more about my birth and postpartum preparation classes and download your free postpartum preparation plan. Birthful is created and produced by me, Adriana, with production assistance from Aysia Platte. This episode was produced in part by LWC Studios: Paulina Velasco, Virginia Lora, Cedric Wilson and Kojin Tashiro.
Thank you so much for listening to and sharing Birthful. Be sure to follow us on Goodpods, Apple Podcasts, Spotify, Amazon Music, and everywhere you listen, and come back for more ways to inform your intuition.
Lozada, Adriana, host. “Ways to Deal With Morning Sickness— Whether It’s Mild or Debilitating.” Birthful, Birthful. July 27, 2022. Birthful.com.
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