Ariam Fesaha, mum to Lukas (2) and Petros (11 months), moved to Dubai from the USA when her youngest son was just three months old.
Although she experienced morning sickness during her first pregnancy, it paled in comparison to what she went through with her second, where severe dehydration and malnutrition from intense and chronic sickness put both her and her baby’s life in danger.
She shares her story of what it’s like to have Hyperemesis Gravidarum, and highlights why more couples should be made aware of it, so that they can get the treatment needed without delay:
“I was five weeks’ pregnant with my second child when the morning sickness started. I’d endured severe morning sickness with my first baby for the first 20 weeks of pregnancy, so it wasn’t an unfamiliar feeling. But it soon became obvious to me that this time around there was something more serious going on.
“With my second pregnancy, the vomiting and nausea were triggered by almost everything. If I ate; if I didn't eat. If I drank water. Even if my body temperature changed – all of it would have me overwhelmed with nausea and rushing to bathroom. There were times when I would just sit crying next to my toilet because I couldn’t stop throwing up.
“I went to doctors and other health professionals, but nobody listened to me. I was dismissed as just being ‘very sensitive’ in the early stages of pregnancy. Yet I was struggling to care for my toddler and for myself and I knew it was only going to get worse.
“I remembered hearing about Catherine, the Duchess of Cambridge, having extremely bad morning sickness, so I started reading up on what she had. That’s when I first learnt about Hyperemesis Gravidarum (HG), a condition characterized by severe nausea, vomiting, weight loss and electrolyte imbalance. I wondered if perhaps I might have the same problem.
‘I was scared I was going to lose my baby’
“My husband travels often for his job, so it was only my son and me at home when I almost fell in the kitchen from being so dizzy. I called my mother and she took me to the nearest hospital A&E. I was diagnosed with nothing more than morning sickness, once again.
“The next day I went to my midwife hysterically crying. I hadn’t been able to keep any food down for weeks and I was scared I was going to lose my baby. I mentioned that I thought I might have HG, but she told me that hyperemesis just means throwing up a lot and it would go away soon. I’d come in there begging for help and she just dismissed me once again. I was furious.
“I got a new midwife, who encouraged me to see an OB/GYN as my symptoms were progressively getting worse. Once I saw the OB I was at last diagnosed with Hyperemisis Gravidarum (HG). She prescribed IV hydration two to three times a week.
“The need to go into hospital for the IV so frequently was hard on me as I had a toddler, but at least I was getting some nutrition into my body, and an awesome family friend was kind enough to babysit my toddler and help me while I was getting treatment.
“I was also prescribed Zofran, a nausea medicine that has conflicting reviews. I stopped taking it after two weeks as the side effects were making my nausea worse.
“As an alternative I was given another nausea medication, Reglan, via IV drip, but after receiving each dose my whole body would tremble, so I stopped taking that too.
“Next up was B6 vitamins with doxylamine succinate (commonly known as Unisom), but it made me so drowsy I would sleep through the whole day and could not interact with my toddler.
“Although the hydration therapy was helping to some extent, I was still vomiting and my tolerability for food or drinks was still quite low.
“After three months of IV hydration and so many different medications, my OB suggested I see a neonatologist as I was losing weight very fast and the baby and I were barely surviving. The neonatologist suggested I get off the IV and just take things easy. By this point my esophagus was so sore from vomiting and the only safe foods I could consume were bagels and waffles. Some weeks I was able to drink sports hydrating drinks and when those made me sick I would have unsweetened ice tea.
‘The hardest point of my life’
My pregnancy with HG was one of the hardest points of my life. I was not interested in being around people as I was constantly throwing up and I had hypersalivation, which is when you salivate a lot more than normal.
“Another problem for me with HG was an intense sensitivity to smells. Certain people or things smelled horrible to me.
“I was also so exhausted, I had little energy. The energy I did have I wanted it to be spent on my toddler who I felt terrible for, because I could not play with him like I wanted to. I was so depressed that my doctor encouraged me to get mental-health therapy, but with needing to go two to three times a week for IV, I didn’t have the energy for seeing a therapist as well. There were times I felt too tired to go for IV, but I knew it was the only thing sustaining me.
“Through lots of prayers and support of my husband and family and friends I was able to make it. There were times when my husband was travelling my siblings would come over just to clean my place or hang with my toddler. My son’s babysitter was also a great person to have around. I was not interested or open to company but friends and family were really great at checking on me.
“It’s very hard for people to understand the intensity of HG if they have not experienced it for themselves.
“Family and friends often with the best intentions would suggest remedies that might help with regular morning sickness but made no difference for me; things like ginger, herbal teas or nausea wrist bands.
“I was told to ‘just eat, even if you throw up something will stay in your system,’ and I even had a few people ask if I was exaggerating my illness. It was beyond upsetting to hear such questions. Why on earth would I put myself and my unborn child through all this stress and pain if I could possibly avoid it?
“I am still a bit traumatized from my HG pregnancy. My HG baby is now coming up for a year old and I love him so much. I had a horrible experience during the pregnancy, from health professionals that didn’t listen to me, to medications that made things worse.
“The hardest part is that there is no cure and, although I had it bad, there are many women that have it even worse.
“The resources found on HelpHer.org and the group they have on Facebook were a tremendous comfort to me and encouraged me to advocate for myself. The group on Facebook consisted of women that had experienced HG and were giving advice from their experiences and others who were in the midst of it.
“My advice for women experiencing HG is to find the right doctor for you and your baby. If a doctor does not listen to you then find one that will. Make sure to ask a lot of questions, know all the medication you are taking, pay attention to what and how each medicine makes you feel.
“Lastly, find support for yourself and if you have other kids now is the time to leverage family and friends.”
About Hyperemesis Gravidarum
According to the Help Her Foundation, which is dedicated to education and research into HG, Hyperemesis gravidarum is a severe form of nausea and vomiting in pregnancy. It is generally described as unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids. If severe and/or inadequately treated, it is typically associated with:
- loss of greater than 5% of pre-pregnancy body weight (usually over 10%)
- dehydration and production of ketones
- nutritional deficiencies
- metabolic imbalances
- difficulty with daily activities
HG usually extends beyond the first trimester and may resolve by 21 weeks; however, as in Ariam’s case, it can last the entire pregnancy. Complications of vomiting (e.g. gastric ulcers, esophageal bleeding, malnutrition, etc.) may also contribute to and worsen ongoing nausea.
Unfortunately, HG is not fully understood and conclusive research on its potential cause is rare. New theories and findings emerge every year, substantiating that it is a complex physiological disease likely caused by multiple factors.
Diagnosis is usually made by measuring weight loss, checking for ketones, and assessing the overall condition of the mother. If she meets the standard criteria and is having difficulty performing her daily activities, medications and/or other treatments are typically offered.
Treating HG is very challenging and early intervention is critical. When treating mothers with HG, preventing and correcting nutritional deficiencies is a high priority to promote a healthy outcome for mother and child.
Most studies examining the risks and outcomes for a pregnant woman with nausea and vomiting in pregnancy find no detrimental effects long-term for milder cases. Those with more severe symptoms that lead to complications, severe weight loss, and/or prolonged nausea and vomiting are at greatest risk of adverse outcomes for both mother and child. The risk increases if medical intervention is inadequate or delayed. If you are pregnant and think you may have HG, suggest it to your doctor immediately.
- For more information, see the Help Her website.