I've been busy for a few days. Like, really busy.
Not nearly enough sleep busy. You should know plans for the 'Bullying in Midwifery Conference' are evolving fast and there are some big changes afoot.
I feel like I'm in the Wallace and Gromit scene where they build the tracks just in time for the train to roll over them.
You can see a little more about the conference here, but as you can tell we're in the middle of updating - essentially, the conference in Cambridge is no longer going ahead but Midwife Diaries is now working with the University of Bradford, hosting an outstanding list of experts on bullying in midwifery on 11th November 2017. I'm honoured that this is the case. We're hoping to make a huge impact.
But on to today's post!
If you've ever cared for a woman with Hyperemesis Gravidarum, you know how difficult it can be. They can often offer no feedback or rapport because they're so poorly.
It's such a horrible condition of pregnancy that I've known amazing mothers (some of them midwives) who have suffered through the impossible conflict of wanting this baby so much, while at the same time longing for a miscarriage. That's why this topic is important.
Many are considering Hyperemesis Gravidarum (HG) at the moment as Kate Middleton is again pregnant and has it for the third time.
I'm not going to have the conversation about whether we should be paying more attention to a condition if a celebrity has it. I'm just glad the topic is out in the open.
I believe that in the midst of the media causing some awful problems, there is sometimes a note of respect for midwives and mothers. I'm grateful for this.
I'm going to hand the blog over to one of my aspiring midwife friends today. She has had HG herself and is one of those amazing people who wants her own experience to help others.
Thanks so much for this, you know who you are!
6 Ways of Helping A Woman With Hyperemesis Gravidarum
I lay in bed surrounded by my own vomit with the waves of nausea washing over me. Sweat pours from every part of my body and the tears pool around my ears as I beg in hushed tones for the smallest amount of relief. I’m not sure how long I’ve been here; days are rolling into one now. I dare not move a muscle, fearing that the sickness will start again - convinced that if I heave any harder my ribs will break. Perhaps the physical pain would be bearable if it wasn’t sharpened with the heart breaking guilt that I wished my baby would die – or I would die – because it seems impossible that we can both live in the same body for the months to come. A breeze from the open window rolls in and it’s enough to start the sickness again and I consider, just for a moment, whether I should stay lying in on my back so I choke and won’t need to live another day this way.
HG is a devastating reality for thousands of pregnant women and the words above are a small insight into how they feel.
It is an extreme form of pregnancy sickness and affects 1 in 100-150 women in the UK but has become far more well-known following Kate Middleton’s first, and now third, pregnancy. It is often genetic, occurring during in the first and subsequent pregnancies. Whilst it might be more prevalent in twin pregnancies due to the increased hormones it does not discriminate and can last anything from weeks to the entire pregnancy.
It is important to remember that the effects of HG go far beyond the physical. Pregnancy Sickness Support is a fantastic resource through which you can understand more about the illness its self, treatments and danger signs. However, there is a huge emotional impact that is often underestimated and can extend further than the sickness itself. Here are a few ways in which you can emotionally support a woman who is suffering HG:
1) Help her to take one day at a time
Most women will feel immediate relief when their baby is born. However, for many women, the thought of the next 30 weeks feeling so unwell is devastating. Aid her in setting small goals, such as moving from the bed to the sofa or showering. There is no need to look beyond the ‘now’.
2) Make practical solutions
I remember being told to make myself several low GI recipes when it had taken me 2 hours to get myself dressed to make my midwife appointment in the first place. The thought of even reading a recipe book made my body hurl and I felt so misunderstood. Suggest that she sends a friend or partner for sugary ice lollies, straws or fizzy drinks – anything that is easily accessible but maintains hydration levels.
3) Do not dismiss her feelings of guilt
For many women, the sickness is so severe they consider terminating their pregnancy. This can generate extreme feelings of guilt and worthlessness that shouldn’t be ignored. Help them to know that they are in a safe space with you and won’t be judged for expressing how they feel.
4) Respect her environment
Show her that you recognise the severity of how she is feeling by respecting her physical space. Strong smells, movement, sound can all trigger another vomiting episode and the strength taken to respond to your conversation or questions can create unnecessary stress. Take her lead on contact, tone, volume and compliment her space rather than owning it yourself.
5) Enough is enough
There may come a time when she expresses feelings of ‘reaching her limit’ and her emotional resolve has clearly been worn down by physical pain of the sickness. Listen to her. At this point it would be prudent to seek further medical advice and ensure her feelings of desperation are truly addressed.
6) Provide support afterwards
When the sickness goes away women can often feel robbed of their pregnancy and these can lead to depressive feelings. Help her to recognise these feelings and provide a listening ear and understanding, empathetic views to aid her in moving forward.
There are some further guidelines from the Royal College of Obstetricians and Gynaecologists here.
I'd love to hear your experiences on this.
Leave me a comment letting me know...
Are you a midwife or student who has tips to share about caring for women with HG? Are you someone who has suffered from HG, can you help us understand?
We're social creatures, knowing the guidelines is essential put putting the humanity into this care can have a lifelong benefit for women and families.