When looking at the picture above you might find yourself wondering about the two ladies in the photo. About what their connection is and why they are in the same frame. You may start to think about their differences. Differences such as one of these women grew up in the UK, one in Australia, one of these women lives in Perth, WA the other in Kensington, England. One of these women is regularly splashed across the tabloids, the other is regularly splashed in her backyard pool. One of them is a high school teacher and one of them is a Princess.
Perhaps the more pertinent question here though lies in their similarities. Both ladies are in their 30s, both are mums to gorgeous young boys. Both have loving husbands, wavy brown hair, striped t-shirts and both are clearly beautiful women. But none of these things constitute the strongest bond these two women share. The most defining link between them is that they are both survivors of an illness. An illness that many have not heard of and even fewer can name. The condition is called Hyperemesis Gravidarum, or HG for short.
“It was like being seasick, hungover and having gastro all in one. For nine months.”
Michelle Sewell. HG survivor.
HG is a paralysing condition which affects 1 – 2% of all pregnant women. It is characterised by extreme sickness, vomiting; often 20 or 30 times a day, an inability to keep food down and constant feelings of nausea. Some women are affected for part of their pregnancy, others for the whole 9 months. There is no known cause. There are tenuous links to women who suffer motion sickness or adverse reactions to anaesthetic, some studies have said it is more prevalent in women who have other intestinal problems like irritable bowel syndrome, but these are all just theories, truthfully it seems there is no known reason. Similarly, it seems to strike randomly, some women might have, for example, 2 ‘normal’ pregnancies and then they may have a HG pregnancy or vice versa. The medical profession are puzzled and divided. The only thing that they seem to agree on is that for some reason the body reacts to the pregnancy hormone hCG. This is backed up by the fact that most women suffering with Hyperemesis start to get symptoms of extreme sickness around the 4-8 week mark which is the same time frame in which pregnant ladies produce large amounts of the hormone hCG or human chorionic gonadotropin.
“It’s almost like your body is allergic to the pregnancy hormone. But the natural instinct is for the body to keep the baby. The baby is getting everything fed to it but the mother’s body is breaking down.” Michelle Sewell.
Hyperemesis Gravidarum has been thrust into the spotlight recently with the two pregnancies of the Duchess of Cambridge, Kate Middleton. Kate is a HG survivor after the birth of Prince George and now she is suffering again with her second pregnancy. Kate has had to cancel some of her Royal duties as she has simply been too ill to attend; the fact that she has access to the best medical resources and the best staff available, yet she still has to cancel some of her important engagements is a sign that this is a lot more than morning sickness.
Perth mum, Michelle Sewell, also suffered with this debilitating illness and details the horrendous ordeal she went through twice when pregnant with her boys. “6 years ago, I was pregnant with my first,” she explains, “I got to 6 weeks and was fine, but then I started to feel sick. I thought it was just a bit of morning sickness, my mum, nana, aunties had all had a bit of morning sickness so I thought that was also happening to me. But then I started to arrive late to work each day as I would have to stop several times on the way to work to vomit.” Soon Michelle had to stop work altogether and was vomiting anywhere from 20 to 50 times a day. She was not eating or drinking anything at all and was spending her days in bed with no visual stimulation as that made her even more nauseous. Michelle quickly realised that this was more than morning sickness and the Doctor had to intervene. Michelle was taken to hospital and put on a drip where she was ‘fed’ a concoction of medicine, saline, vitamins and other essentials. She was assessed and diagnosed with Hyperemesis Gravidarum. Michelle then began a cycle where she would be hydrated and medicated on a drip, then leave hospital, feel a bit better for a few hours then she would start vomiting again and the whole thing would start over. In 10 weeks of pregnancy Michelle lost 16 kilos.
“With morning sickness- you might vomit in the morning or vomit at night but at some point during the day you will stop and you will be able to eat a meal and hold it down. With HG you never get that. There is no reprieve.”
Michelle spent the rest of her pregnancy vomiting every single day. She didn’t eat a meal for many months and eventually in the late stages of pregnancy when she could finally eat a tiny amount, she couldn’t keep it down. She spent her days either in hospital or at home lying in a dark, quiet room with no stimulation. The feeling of nausea was made worse by television, music, books, even people. “It was really lonely,” Michelle said. Even though she had lots of support and a husband to help her, she felt depressed and helpless. “There is nothing you can do,” she explained, “the drip helped a little bit but you really just have to ride it out. Sometimes when you’re on the drip you can hold down food for a small time. But you’re not having a lamb roast, you might have a cracker.”
At home Michelle’s husband, Dan would regularly liaise with their Doctor. Medication was given, in particular Zofran wafers but even these made Michelle sick. They are also really expensive and unbelievably they are not subsidised by Medicare or Private Health. The wafers were $80 for 3 and Michelle needed 3 a day. “It just isn’t affordable every day, for most people,” she said.
Eventually Michelle gave birth to a healthy little boy and the symptoms disappeared almost immediately.
“In the olden days, I would have died. That’s what killed a lot of women back then, a lot of women died in childbirth”
There was a small chance, about 5%, that she would have a ‘normal’ pregnancy the second time round so a few years later when she fell pregnant again, Michelle and Dan were relieved and surprised when she had no signs of HG. Maybe she was in the 5%! However in a cruel twist of fate, 9 weeks later they lost that baby.
A few months after that, Michelle fell pregnant again with her second son. Tentatively they navigated the first few weeks of pregnancy with no sickness but then at 5 weeks, she started to feel ill. Michelle ended up back in hospital on a drip with another HG diagnosis. In 8 weeks she had lost 12 kilos.
The second pregnancy was even tougher than the first as there was also a toddler to look after. Michelle spent alternate weeks in hospital and at home. During the day, while her husband worked, they were helped by their family and friends who had a daily roster to look after her first son. Michelle couldn’t have him in the room with her for any extended period of time. “Toddlers are just too noisy and colourful and they are constantly moving,” she explained. Michelle said she then started having feelings of guilt and feelings of missing out on time with her son. She also felt bad for her husband as she could not be there for him.
Michelle was very weak at this stage and her body was starting to shut down. A nurse would come to her home to help put the drip in but it was getting harder and harder to find her veins. Michelle was seeing a gastroenterologist as she was having ongoing stomach issues from both pregnancies and the second time around she started developing migraines as well.
Michelle eventually gave birth to a second healthy baby boy and once again the symptoms disappeared almost immediately.
The symptoms of HG stopped when Michelle gave birth, however, Michelle, who is an ex phys-ed teacher and always been very fit and healthy, has developed long lasting conditions due to the HG; she has deteriorated eyesight and teeth, she has suffered with pneumonia a few times, she has coeliac disease, digestion problems and gut issues as well as many food allergies and intolerances. With HG the body is starved and stripped of nutrients for so long that these are the ongoing after-effects.
When asked if she feels upset or angry about the whole situation, Michelle states that “At first I was thinking ‘why me’ and ‘poor me.’ But then I started to think about all the people who can’t have children at all and then I started to think that this was just my journey. My pregnancy story. The worst thing about it all is that I can’t have any more kids. I would do it all again in a heartbeat” she says, “but the Doctors and my husband both said no.” The Doctors have told Michelle that if she puts her body through another HG pregnancy she will only become more damaged and there is even a chance she will die early.
One of the most difficult things Michelle found throughout this journey is the lack of understanding in the wider community. “Attitudes are pretty judgemental,” she explains “people say things like ‘Just get up! I was sick too, just get up and get on with it.”
If anything good can come out of Princess Kate’s struggle with HG it is a greater awareness of the illness and a global recognising that Hyperemesis Gravidarum is a much bigger and more dangerous illness than morning sickness.
Perhaps Dr Jennifer Ashton, specialist American HG Doctor, obstetrician and gynaecologist, described it best when she said “Hyperemesis is morning sickness, like a hurricane is a little bit of rain.”
More information on HG can be found on the USA foundation website. The Link is here: The Her Foundation
Seasons Online would like to thank Michelle Sewell and her family for sharing their story.