When I read that Kate Middleton was pregnant and suffering from hyperemesis gravidarum (HG) for a third time, I cried. Just thinking about what she's going through is painful. Not only do I intimately understand the hell that is HG, but people have already started saying things about her on social media that reflect a total misunderstanding of the disease. Make no mistake, there are things you should never say to a pregnant woman with hyperemesis gravidarum, even if that pregnant woman is royalty and you don't think she'll be paying attention to Twitter or Facebook.
Perhaps the most frustrating thing people say about HG, in my opinion, is the choice to refer to it as morning sickness. People, it's not the same thing. Trust me, I should know. During my first pregnancy I had regular, run-of-the-mill morning sickness. I vomited a few times, and felt like I had a bad hangover for a couple of weeks. Luckily, I found that a steady dose of lemon hard candy and ginger ale was all I needed to function. Pretty soon I was feeling great again (yay second trimester!). But when I was suffering from hyperemesis gravidarum during my other pregnancies? Yeah, not so much. I vomited several times a day, couldn't keep anything down for days at a time, was sensitive to light and smells, got dangerously dehydrated, and actually lost quite a bit of weight before I found a combination of mediations that helped. Then, when the magical second trimester arrived and I was hoping the nausea would subside, I was still puking.
Being that sick when you're pregnant was a nightmare, and it's made worse when you have to care for other kids, work, and try to function all at the same time. I couldn't do most of the things that I relied on to manage my mental health, either, like run, do yoga, or, you know, eat. I wanted to be happy about my pregnancies, but it was so hard to feel anything other than miserable. I felt like no one understood, and I had some really dark thoughts as the result. Most medical providers I encountered completely dismissed my concerns, too, telling me to try crackers or ginger ale, as if I hadn't tried those things already. One ER doctor even refused to give me medication or fluids when I hadn't eaten for days and was so dehydrated my pee looked like apple juice, because it was "just morning sickness."
So yeah, there's quite a few things you should never say to a person with HG. You should probably keep pretty much anything other than, "I'm so sorry," "How can I help?" or, "That sounds so hard," to yourself.
"It's Just Morning Sickness"
No, it's really not. According to the Hyperemesis Education and Research (HER) Foundation, Hyperemesis Gravidarum (HG) is "unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids." Unlike morning sickness, it can seriously harm your health, causing significant weight loss (usually more than 10 percent of your body weight), dehydration, nutritional deficiencies, metabolic imbalances, and challenges completing even basic tasks.
At the height of my HG, I couldn't do anything except lie in the dark (in bed, at the hospital, or on the cold, hard floor of the bathroom) and want to die. It was a huge contributor to my prenatal depression, and later to my decision to get my tubes tied. If I ever get pregnant again, though unlikely, I would seriously contemplate termination. HG was that bad.
"I Had Morning Sickness, So I Understand"
While I totally empathize with you and know that morning sickness sucks, HG is something you really can't understand unless you've been there and suffered through it yourself. It's like some sorority or secret society that no one actually wants to join, but once you do it changes you. And, Again, HG is not morning sickness.
"Have You Tried Crackers?"
In the HG survivor community, we call this "being crackered." I was crackered by medical professionals (who should totally know better), family, friends, and co-workers. Everyone wanted me to eat some f*cking crackers. Stop. A better question would be, "Have you found foods or drinks you can tolerate?" followed by, "Can I buy some for you?"
"Are You Seriously Eating That?"
When I did find foods that I could keep down, they were usually weird or disgusting and people just had to joke about it. During my first HG pregnancy I was starving, and could only keep down greasy fast food (specifically egg sandwiches and hash browns) and drink Lemonata. One of my co-workers said, "If you eat like that, you're going to gain a ton." Unbelievable.
My second HG pregnancy is pretty much entirely made of sour patch kids, salt and vinegar potato chips, instant onion soup, and handi-snacks. HG moms should eat whatever they can keep down. Full stop.
"You Know That Medication Will Hurt Your Baby?"
It seems like any time I told people I was taking medicine for nausea or vomiting, they thought they would be helpful by telling me about all of the birth defects I was giving my baby. That's just rude. You shouldn't assume that someone hasn't the weighed the benefits (not dying and staying pregnant) against the risks of a medication (which are comparatively small) before they decide to take whatever was prescribed to them. Besides, my doctor is pretty much the only person I want to discuss my medical decisions with.
"At Least You Can Get Pregnant"
Author Brené Brown writes, "Rarely, if ever, does an empathic response begin with, at least." It's so true. Yes, having HG might be better than struggling with infertility or having any number of other pregnancy complications, but you know what? Having HG is freaking terrible and comments like these really hurt. I am not a willing participant in the oppression Olympics. If you can't have empathy for someone with HG, just don't say anything at all.
"Did You Seriously Call In Sick?"
If you can't eat or drink, and take medications that make you sleepy, it makes it really hard to drive, function, or work. I threw up almost every time I drove or rode in the car, usually peeing my pants at the same time. Sometimes, I had time to pull over first. Other times I, well, did not.
So I stayed home, close to the bathroom or using a garbage pail, when I couldn't get out of bed to make it to the toilet. Then, I had a PICC line for IV fluids and medications at home, which was so not compatible with my work day. HG cost me one job, when I had exhausted all of my leave. FML
"Have You Tried Ginger Ale?"
Shudders. I, to this day, cannot drink ginger ale because of how violently ill it made me. Vomiting warm ginger ale? 10/10 would not recommend.
"You Went To The Hospital For Morning Sickness?"
No, I went to the hospital because I was severely dehydrated after vomiting 12 times a day for three days. Besides, HG is not morning sickness. It's not. I could have died, people. I still experience side effects from my two HG pregnancies. I still have panic attacks whenever I feel nauseated or throw up. It's a big deal.
"Aren't You Happy About Your Pregnancy?"
This is probably the worst thing people said to me when I was suffering from HG. Being happy about a pregnancy doesn't change the fact that having HG is freaking hard. I was over-the-moon excited about both of my HG pregnancies. That didn't mean that I was able to cope physically, emotionally, or psychologically with HG. So, yeah, it was a major contributing factor to my prenatal depression and caused me to have some understandably dark moments during my pregnancies. I honestly don't know how I made it through. I am glad I survived and my HG babies were totally worth it, but my uterus is now closed for business. Never again.
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