The pregnant woman with a strong toxicosis sitting in bathroom

    My hyperemesis hell: why doctors need to take ‘morning sickness’ more seriously

    28 April 2017

    There are guaranteed ways to shatter the sense of mystery in any romantic relationship and throwing up on yourself is one of them. For some couples this indignity might be brought on by too much booze but for others, myself included, the culprit is often pregnancy. This is especially the case if you’re cursed with an extreme form of pregnancy sickness called hyperemesis gravidarum.

    I was only four months married when I made the welcome discovery I was pregnant. Like women all over the world I trotted innocently into the loo one morning in October and returned ‘a mother’.

    At first I felt normal and hated all the dietary restrictions, particularly the lack of booze. But then came the metallic pregnancy taste, an aversion to opening the fridge, a horror of preparing any food and a feeling of revulsion at the mere sight of a Peroni.

    This is standard for most pregnant women, but the nausea and exhaustion soon began to overwhelm me. Then, one afternoon, on Halloween in fact, I threw up and then again and again. My hyperemesis hell had begun — I had never felt so sick and depressed in all my life.

    As it happened, I was due to see my GP soon after the vomiting began. When I met him, clutching my stomach, feeling (and looking) like a corpse, he estimated that I was nearing my 12th week of pregnancy and booked me in for a routine scan a fortnight later.

    Due to my inability to eat without being sick and the constant, crippling nausea, he also signed me off work for two weeks. He was concerned about dehydration and its effect on me and the baby. To make matters worse, even tap water tasted like dish water so I was struggling to drink as well as eat.

    He prescribed me a drug called Cyclizine to prevent the vomiting. I persevered with this for about 10 days and found it made little difference apart from making me feel disorientated. The nausea became worse, with vomiting throughout the day and evening.

    My husband was supportive, trying to coax me to eat when he returned from work, but nearly all of his food suggestions made me want to vomit or scream. My small diet consisted mostly of dry crackers and Haribo Starmix.

    The day of my 12-week scan eventually arrived. It was arranged for 9am when I was usually at peak nausea. I remember crawling out of bed and into the shower and as soon as the smell of soap hit me, I began to retch violently and uncontrollably. My husband found me, vomiting and sobbing on the cubicle floor, water pouring on me.

    I couldn’t bear the thought of dressing and leaving the house — every tiny task had become a mountainous effort — but I was desperate to find out how many weeks along I was so I had some knowledge as to when the nightmare might end.

    The scan revealed I was only eight and a half weeks gone, not 12 as my GP had suggested. I have to admit that seeing the baby for the first time and being told she or he had a ‘strong heartbeat’ provided some comfort and reassured me that the suffering really was for a good cause.

    I was asked for a urine sample and the hospital discovered there were traces of ketones in my pee so they decided to admit me. I was given a jab of Ondansetron — a powerful anti-nausea drug — which I was also prescribed in tablet form for daily use to ease the vomiting.

    I kept my faith in the 12-week milestone because everyone assured me I would feel much better by then. I did feel a bit stronger as I was able to eat more as a result of taking Ondansetron, but I still felt nauseous and vomited regularly — it just wasn’t quite so crippling.

    I returned to work at week 13 of the pregnancy but this turned out to be too early. The vomiting was still acute and debilitating. I remember staggering through Moorgate one morning trying to find a spot where I could discreetly puke without disgusting some poor person who was enjoying their breakfast through the window. I eventually gave up looking and was forced to let it all out. There are just too many coffee shops in the City of London.

    Despite the fact that my first trimester was one of the toughest periods of my life, I still believe I am fortunate. I had a supportive husband, a sympathetic boss and I did not have other children to look after. I also responded to the anti-nausea tablets so that some days were tolerable and vomit-free.

    Now, at 31 weeks, the sickness and nausea have almost completely gone, and I’ve managed to wean myself off Ondansetron while still keeping food down.

    But for many women this is not the case. Vomiting and nausea remain for the entire pregnancy and some suffer without medical support. A survey of 400 women with the condition found that half of them had trouble accessing care. It is thought that 1,000 babies a year are aborted because women cannot endure hyperemesis any longer.

    Caitlin Dean, who carried out the survey and who helps to run a helpline for women with the condition, says many doctors don’t grasp how severe it can be and often dismiss the symptoms as standard morning sickness.

    There is also a reluctance to prescribe anti-emetic drugs during pregnancy. Dean says this is partly a hangover from the thalidomide scandal and partly because there is conflicting advice about the drugs’ safety.

    I know this first hand: one GP was reluctant to write me a repeat prescription for Ondansetron despite the fact that I could not keep food down without it.

    Dean says: ‘There’s no high-quality evidence that Ondansetron causes problems for the baby, especially when weighed against the potential benefits, such as ensuring the mother remains hydrated. It shouldn’t be denied when first-line medications have failed.’

    Surely it’s time to start calling this cruel condition by its real name. Morning sickness? I would have taken that. But vomiting dawn, noon and night for weeks on end while feeling desperate, depressed and exhausted is something else.

    Employers need to recognise how debilitating the first trimester of pregnancy can be and accommodate women’s needs as best they can, especially as these weeks are crucial for a baby’s development and pose a higher threat of miscarriage.

    This may mean pregnant women telling their boss about their pregnancy earlier than they would like to but at least it might create a sense of support and understanding in the form of time off, flexible hours or being allowed to work from home.

    GPs also need to take women seriously and offer them whatever they can to alleviate their suffering. There will, of course, be people who prefer not to take anything during pregnancy but I felt that taking Ondansetron was safer than failing to eat or drink and nourish my unborn child.

    And to the man sitting in Eat, Chiswell Street, just before Christmas — if you’re reading — I’m very sorry and I probably owe you a croissant.