Who knew?! The Duchess of Cambridge and I have more than one thing in common! We both think that Prince William is quite sweet and more seriously, we have both suffered from the debilitating form of morning sickness in pregnancy, hyperemesis gravidarum – an extreme, excessive, and persistent vomiting in early pregnancy that may lead to dehydration and malnutrition.
While I expected that I might feel a little queasy early in my pregnancies I never expected the severity of the nausea and vomiting that I would experience. I also soon learned that morning had nothing to do with the timing of it. While I am grateful that I was able to conceive a baby easily and that pregnancy would be sustained due to the raised level of pregnancy hormones in my body, it still didn't relieve my symptoms.
Twelve weeks of pregnancy came and went, I had hoped the nausea and vomiting would abate, but it didn't.
I wanted to conceal my pregnancy in those early weeks to allow me to adjust and just to make sure that I would get through the first few months without problems. I was working in a delivery suite, so had to hide bowls all over the place to quickly catch my frequent vomits, which often caught me off guard with next to no time to prepare myself.
Eventually like Kate, I could conceal this no longer, my illness gave me away and had to come clean. While my colleagues were delighted for me in relation to the pregnancy, I was conscious not to complain of how awful I was feeling.
It was during this time that my dear friend Sarah was rostered onto night duty as well, so I offered to pick her up on the way to work. She was aware that I was not feeling well but very surprised to see the preparation that was required for me to drive. I had a collection of bowls as well as plastic sheets and towels spread over me. She laughed at first, thinking I was hamming it up for a joke, she soon saw that this was no joke. She begged me to pull over so she could drive. I explained this is how I had been getting around and I was quite used to it.
Around 20 weeks I had a few days of reprieve and I grew hopeful that things were finally settling down, but no, it was just mother nature teasing me. As quickly as it went, the vomiting returned.
Around 30 weeks, I was working as a Midwife and had been asleep most of the day after a night duty.
It was a hot Perth summer and when I did have an appetite, it was for black globe grapes. I woke up and enjoyed a delicious bunch of my favourite grapes. I had no sooner got to the end of the bunch of grapes and an overwhelming wave of nausea came over me. I didn't have time to reach the bathroom to vomit so I flew out the front door and promptly vomited in the garden.
At the same moment my husband pulled into the driveway returning from work. He had witnessed me vomiting on many occasions through pregnancy, so no surprise to him to find me like this. I was taken aback as he flew out of the car in a complete panic. I couldn't stop vomiting and unable to speak with the repeated wretching. My husband was screaming at me and trying to get me to sit down. Poor man, he thought I was vomiting blood! Once I caught my breath I was able to explain that it was just the globe grapes.
Before I knew I was pregnant with my second child, the nausea hit me like a rock first.
As a Midwife I knew one of the early pregnancy symptoms for twins was excessive nausea. The scan confirmed there was only one fetus, which was a relief but also hugely frightening as I knew this level of nausea was big and I was probably going to be feeling very unwell for this pregnancy too. But this time I also had a very active toddler that I needed to care for; I couldn't just rest on the couch and deal with my poor health.
I kept an ice cream container close to me at all times as I couldn't leave my toddler unsupervised for long periods with frequent visits to the bathroom. In my mid trimester when my blood pressure was low, the constant wretching some days left me faint. I took to crawling around on the floor at home so I wouldn't pass out, potentially hurt myself or my unborn baby or leave my toddler alone in the house with me unconscious.
I worried a lot about this. On the really bad days I set my toddler up with his beloved Thomas the Tank Engine videos which he thought this was great and played them over and over again. To this day, if I hear the Thomas the Tank Engine theme music, a wave of nausea washes over me - not a great association that had formed between myself and Thomas the Tank.
This pregnancy was worse. I didn’t vomit much, but just felt as if I had a hangover the entire time.
At least in my first pregnancy I had relief from the nausea. Even in the delivery room, I was sick. One of my husband's memories of the labour of our first son was to hold a bowl for me as I vomited for much of this labour. Delivery was a relief on so many levels, and I knew that the vomiting and nausea would stop, which it did.
But for all of that, I was one of the luckier ones experiencing hyperemesis gravidarum. As a Midwife, I had a little knowledge of how to minimise my symptoms and did mange to avoid hospitalisation. At home I could control the noise, smells and reduce the number of people around me.
During my earlier nursing career, I had cared for people that had been born to mothers that were prescribed thalidomide for their pregnancy sickness. With this fear in my mind, I elected to take nothing and just wait it out.
It was not that long ago that I cared for a pregnant woman suffering extreme hyperemesis gravidarum. At handover I was told that many Midwives had been trying cajole her into taking a shower, eating, getting some fresh air and becoming frustrated that she “just wouldn't help herself.”
I went into this lady's room to see how she was. She looked wretched. She told me she felt that way too. She could barely speak. I just sat quietly with her and observed. Her abdomen constantly heaved, she had a towel near her mouth as she no longer had the strength to hold a bowl. She was receiving intravenous therapy to keep her hydrated and kept her eyes closed in this dark room; she didn't look at me.
After a while she opened her eyes and stared at me, confused at why I was still there but not speaking. I told her I was thinking about what to do. When she realised I wasn't going to ask her to do anything, she started to speak to me. She was in pain. Her muscles hurt, she has been wretching for weeks. Pain made her wretch even more. rang her doctor very late. He is a kind and compassionate man and was happy to prescribe paracetomol that she did not have to take orally. Within an hour the pain was reducing and so was her nausea. A short break, but a break no less.
After some sleep, she talked to me some more. She let me know that she was going to discharge herself the next day and had an appointment at an abortion clinic, she could not continue the pregnancy like this. While she was pleased to be pregnant she could not see that she could take one more day in her current state.
It was this woman's choice to decide if she wished to continue with her pregnancy but I didn't want her to make this decision while she felt so awful. We needed to relieve her symptoms so that she could make a choice in a better frame of mind. I didn't want her to regret her decision either way in years to come.
In a few days with a change in management of her symptoms she was feeling a little better. She continued with her pregnancy and had a healthy baby.
From time-to-time I reflect back and see that my pregnancy symptoms, although severe, were for a happy event. This is what motivates most women to keep going. There is an end date and the joyous feelings of inner movement when your baby wriggles, your swelling abdomen reassuring you that your baby is growing and this will result in something amazing.
But you never forget - and the empathy I have for other women experiencing this is great.
So Kate, I feel for you. I know that you have plenty of people on hand to tend to you, your baby and your husband, but still, you will feel awful and guilty that you can't manage these things yourself. It is not forever and with each day I wish for you that it is better than yesterday, and that your babies will bring you much joy - as I wish for every mother.
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