¶ Hyperemesis Gravidarum
hey guys , welcome back to pretty lions podcast . This is sarah and I've got whitney here and we have a very special guest . Guys , this is a topic that I want to say that , if this resonates with you , our deepest support is going to go to you . So welcome Andrea . She is going to bring us into touch with the world of HG or hyperemesis gravidarum .
I might say it wrong over time HG what we're going to say for Sarah's sake on this episode . But welcome guys , welcome Whitney , welcome Andrea . Thank you so much . All right , okay , we are so excited and , whitney , I know we've said we want to talk about this subject .
Me and you both haven't experienced it , but , whitney , you may have had clients , but this is something that , when it , like we said , we saw the time , mental health is not discussed and then , I think , even so much things that we experience in pregnancy , that are physical , that impact us , are dismissed or gaslighted .
So , andrea , I'm super excited for your voice and your story . So welcome and please share with us a little bit about yourself and then we'll kind of dive into why this topic is important to you .
Thank you so much . So my name is Andrea Steffens . I am a creative arts therapist and hyperemesis coach . I'm a mom of two awesome daughters that are 18 and 15 . And I am a two-time survivor of severe hyperemesis .
And survivor is the key and our listeners will really understand further we go in this conversation of . That is a very you know , that's the most accurate description . So , andrea , let's start off . What is HG or hyperemesis ?
Okay , so to just look at the name of it itself , hyper is too much . Emesis is vomiting , gravidarum is while pregnant . So it's not a real sexy thing , but that's what it is . And it's far , far beyond morning sickness .
Like morning sickness you don't feel good , maybe you throw up once or twice here and there , you drink some ginger ale , you have some crackers , you get better and it ends pretty much usually around the end of the first trimester . Hyperemesis is diagnosed when the pregnant woman loses 5% or more of her body weight . That's a lot .
It's a lot through vomiting and also has electrolyte imbalances and dehydration . So , as I said , I went through it twice . I lost more than 10% of my body weight . I was diagnosed pretty early , like at six weeks , by my OB , who was wonderful . I was very , very lucky . My OB was very proactive and she believed me .
So you had medical support with her , some work with her .
Yes , she was . She was on it from the beginning . In the beginning , you know , we had been trying to get pregnant for a year . But like any first time mom , you don't really know what to expect . So I went to see her at six weeks and she said you know how are things going ? I'm like , oh , it's great .
You know I'm throwing up five , six times a day , but that's all she . I remember her eyes like popped wide open .
She was like oh , she got out her little clipboard , wrote some notes and she she told me the term hyperemesis gravidarum and she said you know , I'm going to put you on some medications , which I didn't want to do , because who wants to take medicine while they're pregnant ? But she said we have to cut this off at the past .
I'm going to give you something called Zofran and within a week or two of that I was hospitalized . It got completely out of control . I was throwing up 20 , 30 times a day . I couldn't keep anything down , even water . I was nauseous from the moment I woke up until I fell asleep and after I was .
So they rehydrated me , kept me there for a couple of days and they gave me a Zofran pump which was supposed to keep it continuous and even though that did stop a lot of the vomiting , it didn't touch the nausea , so I still couldn't eat or drink and I ended up having nursing care at home , like a nurse would come over to change the bags and give me more
medicine . And in my I'm kind of bouncing back and forth between the two pregnancies . But in my second pregnancy it got so bad that they decided I needed a PICC line which they thread this kind of a tube through up over into your chest wall and they and it .
I don't know if I'm explaining this well at all , but it's supposed to give you nutrition and medication . But within a couple of days of that I ended up getting a blood infection and a blood clot . So I was hospitalized for a month , and at that point I had a toddler . So I didn't see my daughter for a month .
Oh bless you , I went down to a hundred pounds . I caught C diff in the hospital .
It's like if one thing happened , everything else did too .
Yeah , Like yeah . I felt I if , if something could happen , it happened to me , I would . I didn't want my doctor to even tell me there's a slight chance of X , y , z . I'm like something could happen . It happened to me . I didn't want my doctor to even tell me there's a slight chance of X , y , z . I'm like don't .
I'll get it . Don't tell me , because that's going to make it happen .
Gosh , whoa , whoa , that's all I can say . Is like whoa .
What was your family support like during this time ? Because , I mean , you weren't around your other child , your toddler , for a whole month . You're hospitalized , you're not capable of doing anything at all .
I wasn't even capable of speaking to my daughter on the phone . That's how sick I was . I couldn't talk . But I again was extremely lucky in my family . My husband would , poor guy like , go to work , come visit me , go home . My parents flew out from California to stay with my daughter to give her some normalcy . I mean , it was like .
It was like I was dying .
I was going to say , when you say survivor , that is legitimate in this situation , because you probably did feel like you were on your deathbed .
I literally did , because you probably did feel like you were on your deathbed . I literally did and I was having , you know , internal conversations with myself about should I keep this pregnancy , the second one , should I not ?
I thought about that the first time too , which made me feel terribly guilty because these were very , very wanted pregnancies , very , very wanted pregnancies . And , by the way , 15% of women with hyperemesis terminate their pregnancies .
These are wanted pregnancies and when you think about and I'm very pro-choice , but it's a choice of a different kind it's like a choice with a gun to your head . I remember having these thoughts of you . Know , I'll keep the pregnancy unless the doctor says I'm dying and then I will have to terminate because I have another daughter at home .
But every day I would wonder if the doctor was going to come in and tell me I was dying .
I can imagine , especially if women do not seek treatment for the extreme dehydration , that the very , very real risk of dying is on the table here .
People women do die from this .
They do I mean ?
Because if you think too of like even the fact that you're so dehydrated you fall , you hit your head or you get in a certain situation you can't get up , or you know the same thing that you think with elderly , sometimes right when they have the falls , and you find them and you're incapable of activities of daily life feeding , bathing , cleaning , working .
You know , probably you needed someone to help you to the restroom , I'm sure , working . You know , probably you needed someone to help you to the restroom . I'm sure , like probably because you would try for a year and this is so wanted , and you're like what is happening ? I never knew this was going to be like this and how many women experience this .
What is kind of like the stats , like is it high number , low number ?
So the number of women that experience severe hyperemesis or hyperemesis at all is between one and three percent , which sounds like a low percentage , which it is , but if you think about the number of women that get pregnant , that's a lot of women . It really is , and it's a very misunderstood condition , very misunderstood condition .
There is actually , very happily , been some real inspiring movement on what causes it in the last couple of months that that information has come out . But for many , many , many years it was thought of as something that was psychosomatic . Maybe you don't want the baby , maybe you want more attention .
I mean the amount of gaslighting that even I got with my wonderful care .
I remember being in the hospital so sick I could barely speak , I couldn't move , and this nurse is like came in and was like , oh , you're pregnant , you should be happy oh not when you feel like you're circling the drain and the thing is , you're there you're there getting care and being told well , just be happy and it'll go away .
Ma'am , if that was the ticket to this , I would have done that months ago and you know , when you're talking about hyperemesis and mental health , that that sort of thing really impacts you . This , there is this societal cultural pressure of looking at pregnancy as something happy and something joyful .
And you're glowing and you're only supposed to speak in these positive terms , only supposed to speak in these positive terms and to be going through the most god-awful thing in your life at the same time as you're supposed to be happy , and people are saying why aren't you happy ? I had someone say you seem so mad .
I hope that that the baby doesn't think you're mad at her . You feel like a failure and a monster , you know ? Oh , my gosh .
I mean , while already battling , like you mentioned , the guilt that you had before with both pregnancies , of having HG to begin with , but also considering a termination , and you have your other daughter at home , you already had that internal battle taking place , you didn't need anybody else to add to it Exactly and I was lucky , you know .
I had my primary OB was supportive and believed me , and I had a supportive family . No one questioned my experience within my family . That is not , unfortunately , typical .
Oh sure . One thing that I'm wondering is how did you muster up the strength to go for the second baby ? Because was it in your mind going okay , this is what I went through the first time . What if this happens again ?
I mean it's when I one of the first things I said after I gave birth to my first daughter was oh , this is her way of saying she wants a sibling from Korea . Yeah , yeah , but yeah , you know , I felt like I had this great team behind me . I didn't think it could get worse . My doctor said you know , not everybody necessarily gets it a second time .
Let's like hope for the best plan for the worst . I didn't think it could get worse , and it did , and I can sit here and say my girls were worth it 100 percent , 100 percent .
And you know , I think the big key takeaways we're hearing is it's not something that when we're trying to get pregnant , we're going . Okay , I have a 1% chance of this I have with perinatal mood anxiety disorders . I have a one in three chance of getting this . You know , postpartum psychosis I have a 2% chance .
It's not like we're saying this to ourselves , right , and it's not like it's a normalcy of conversation , of , like moms who've had it , or medical professionals doing preconception counseling , talking about things to be prepared for . So it really is very similar to depression , anxiety . You're just thrust into it and there's really no way around it .
You have to go through it . Right , and there's really no way around it . You have to go through it and that's so hard because you're already having a life transition . Now , with your experience , your normalcy is gone , Like the basics is gone , and I'm sure that took a toll on your mental health .
I mean , how could you not feel depressed and anxious and lose hope ?
Absolutely , absolutely . I mean , I was not a therapist at that time , so I didn't have the words to express what I was going through , but I was depressed , I was anxious . I did end up with PTSD that I was diagnosed with later . It's terrible , it's terrible and , to add the guilt on top of it , it's so unhelpful .
Again , I had this vision of what pregnancy was supposed to be and what I ended up with was people in my apartment building thinking I had cancer because I looked so sick and frail .
The one thing at the time that really helped me and really inspired me is there's an organization called the Hyperemesis Education and Research Foundation hyperemesisorg , and they had message boards and I I was too sick to write on them a lot in those pregnancies , but I read them and just to know that there were other women out there that were going through this
and I wasn't alone and I wasn't crazy and I wasn't and I wasn't a bad mom , I was just unlucky . Right it , it was so helpful .
I mean that's the case . There's a lot of people in our community yeah , to hear someone say it too , right . So you know it's not just me , or you know it's not something I did or I'm not the outlier , and we hear that all the time from listeners of the podcast , from our Prevalence Moms .
I'm sure Whitney's therapy it's just , we will say something and they go oh my God , me too , that you described how I felt . You described what I couldn't say , and there is so much of that . Is this the whole platform we stand for is for moms ? No , they're not alone , because I think that's the thing .
If you can fight the loneliness of of it's just me and figure out that community , that resources , if it is a message board , because you know what your husband's probably not going to really get , what you're going through .
You know your boss is not going to understand your best friends who've had both the normal pregnancies , you know where they're just still hitting their workout class five times a week .
You know that's a different ballgame , right Like and if we're talking mental health , or we're talking literally uncontrollable vomiting , dehydration , being care , either which way you roll with it , you got to have somebody to walk with you .
You absolutely do , and to advocate for you because
¶ Understanding Hyperemesis Gravidarum and Trauma
you know . Imagine how you would feel after 200 days of the worst food poisoning you've ever had , or the worst stomach flu . How would you be able to make decisions for yourself ? How ?
would you be able to ? You can't . Your brain can't function without those nutrients , but your body rejected them . Your brain can't function without those nutrients , but your body rejected them .
Exactly . If it's okay , I would like to talk about what causes .
HG . I was fixing to say I want to know because people they're trying to get pregnant , they're going okay . So what causes this ?
Is there a risk factor ?
Yeah , let's shine some light there .
Sure . So this literally came out within the last , I think , couple of months that they figured out what happened , what causes it . So everybody has a low level of this hormone called GDF-15 in their systems and if you have a normal level of it , you are set to where , when the nausea and vomiting hormone goes up during pregnancy , your body recognizes it .
Oh , I've seen this , it's GDF-15 . There's just more of it . I'm cool . But if you have a low level , abnormally low level of GDF-15 in your system , when it goes up during pregnancy , the body freaks out and thinks you're being basically poisoned . It treats it like an allergen and tries to make you throw up to get rid of it .
That is what causes hyperhidrosis is a lower than normal level of GDF-15 before pregnancy . Does that make sense ?
It does . And no one's testing for it right , like it's not like we're going in and saying what's my level ?
no , I'm they just figured this out , yeah , so there it's . It's very , very hopeful information , but there's no treatment for it yet . There's no real test .
Yeah , I was wondering , I was like . Is there a supplement besides zofran and ivs and all the things to boost that hormone so that it can counteract the HG a little bit ?
Not yet . Hopefully that'll come , but it's going to be slow in coming , because who wants to do testing on pregnant women Right ? Well , that's our new new protocol .
We fight that when it comes to mental health . I mean , if you think about it , there's a lot of pregnant women in some sense are treated as the vulnerable population when it comes to when we're testing and medication and treatment and research . So we lag behind very much so on any progressive advancements .
Because , just like you said , who wants to do research or test things on a mom with carrying a child ? But I think the fact that you can go okay , this is why this is why it happened . Right , my body essentially was attacking this . Right , it gives you a little bit of that name entertainment . We say it , you know you have a little bit more of like .
Okay , there's a reason .
You can take the article in and say to your doctor , say to your husband , say to your friends this isn't my fault , this isn't because I'm weak , right that and that's what I was thinking .
Yeah , is it not that it justifies ? Justify isn't the right word , but it explains the symptoms and you think I'm not a crazy person . There is a biological reason for this taking place .
Right , right , it's a game changer . It is a game changer .
It's kind of the same sense of you know , when they came out with the new FDA approved postpartum depression drug , right . So it was the pill form that we all knew . We're still trying to figure it out , but there was this big campaign , right , and the biggest takeaway that we heard about this new research was oh , it's real .
And I think the same thing applies here to HG . Is that , oh , it's real and it's like moms are going oh it's real . But it takes headline . It takes a research paper for the ones around us and sometimes even medical communities to go oh yeah , she's not making it up .
No , and it's like why would you want to go grandpa ?
Why would you want to be away from your daughter , from you wouldn't ? And I'm so sorry that you had to deal with that . I'm so sorry that you had to deal with that . And I know you're . You know you're almost two decades out from that experience , but I can still tell how you talk about it . You relive that , you feel it still . You go back to that .
That's very real to you .
It is . It is . It was a trauma . My pregnancy was a trauma .
Well , I was about to say it's multiple layers of trauma . It's the physical aspect , but then the separation from your daughter and your family being in the hospital , getting gaslit by the provider who's giving you the Zofran . You've got trauma after trauma after trauma . That's all kind of lumped together .
Yes , it's really true and , from what I've researched , about 18% of women that have hyperemesis end up with PTSD . I don't see how they couldn't ?
Were you constantly worried about your daughters ? Were you just like you know ? Are they growing okay , you know , because the baby's taking . I remember one day during one of my scans and I did not experience this , but I had like a little bit of a sickness or something . And I don't worry , your baby takes everything from you .
We're more worried about your nutrients . Is that kind of how ?
does that work with these situations ? Absolutely , I was terrified every time I would have to take a pill or get a bolus of the Zofran , or like counting off the number of days I hadn't eaten . I'm like , what am I doing to this baby ? Is she going to be okay ? Is she going to have brain damage ? They , my babies , were born very small .
They were both full term and they were both under six pounds . They didn't . They were healthy , small but mighty . Okay , I like that , I love that . But , like with the second pregnancy , as soon as she was out my first , I was like just sobbing is she okay ? Is she okay or is she okay ?
Because meaning , from nine months of sickness and all the medications and all the , the blood infection and this is not like , can you take a look at her and tell me , is she gonna live ? And I was very lucky . I mean some women , their children do end up in the NICU . There's some research onto connections with some other kinds of issues .
It's scary , it is I was gonna say does it magically go away when you get birth , like what they say ?
yes , that's like the baby's out , give me a veggie burger . It's crazy , I don't know . Within within 24 hours I was back to eating wow , that's wild .
I've heard that , but I've never met someone or asked . You know an OB ? But that was I've heard and gosh , it's just like your body's like okay .
Well then the hormones shift . That shows how quickly the hormones shift .
Yeah , it's got to , but it's such a surreal experience . It's like I hear other women talk about being pregnant and how their experiences was . To listen to their stories and I don't relate like . I feel very much like I was sick for nine months and then someone handed me a baby .
Oh , I'm sure it probably feels isolating .
When I'm around people that have had normal pregnancies or at a baby shower . It is isolating . But women that have this that do reach out to other women that have this , there is a real passionate involved community .
Good . I think that's important to touch on is ? You know , I had this issue because I had traumatic birth . So when I know some of my friends are fixing to give birth , I get really nervous for them , even postpartum with my depression seeing other people . I don't want them to have depression . You don't want them to have HG .
No one wants them to have any of this , but it is , it is a grief you know , whitney's taught me that like of a loss of our experience that we have to deal with , and I don't think that's talked about because none of this is talked about , right .
So then for us to say I'm grieving the experience I expected or I wanted and I didn't get , and then I see it everywhere , everybody else having different experiences . It's hard .
It's hard and there's there's a tendency again in the culture to dismiss it . And if you had a terrible pregnancy or and or a terrible birth , but a healthy baby , just focus on that .
It's fine , you got what you wanted . You got the healthy baby Right . Fine , you got what you wanted . You got the healthy baby Right . Let me ask you this Did you have to have planned C-sections with your daughters because you had no strength to do a pushing delivery ?
No , I had vaginal births , both of them .
I am so impressed because I mean how did you have strength ?
She's like it's going to end , I've got to push .
Yeah , I mean , mean I was concerned about it , but I just had been so unlucky with so many complications , I was like I just don't want to do one more risky thing . I am gonna push this baby out .
Like I can do this , this I'm gonna control I mean you have warrior through it .
Oh , thank you . I I have to say and I this sounds weird , but the and this is not everyone's experience , it wasn't yours , sarah , but the births were the most like normal and easiest part for me . Honestly , I can see that complicated part Totally . Yeah , this is something I can do . This is something I have control over .
Right , yeah , gosh , andrea , wow , I am . I'm just the fact that you have now I want to touch and turn it to this you have made it your mission to create awareness of this , support women who are walking through this , because unfortunately , it doesn't seem like this is going away for a while , and I think now even more so .
We're inundated with social media of comparison , of everything's in our face , of everybody's lives , so it's even more lonelier when you're experiencing something like this and we're isolated more right , like the days of family coming to us or being next to us or having this village . So I can imagine women and you do work with women and we'll get to that .
But how are you seeing now moms in this weird post-COVID , more demands on us than ever ? How are they navigating this ?
One step at a time . You know it's very hard
¶ Coping With Hyperemesis During Pregnancy
. You were talking about the comparisons . It is very , very hard to be lying there sick with an IV in your arm looking at people doing these , you know , like gender reveals and like pregnancy , maternity shots , and it's sad and , as you said , sad .
And , as you said , there is absolutely a grief of losing the experience you wanted to have , you should have had , you expected to have and you will not have .
No , and I think that's it . It's like it's pretty definite here , right Like it's like you know it's not going away until the birth happens .
That is not the case for everybody .
Okay .
Even me . After like 20 , 22 weeks it got a little bit better . Okay , but some people have it terrible the whole way through . Some people get a little better . Some people have good days and bad days .
It kind of does its thing there's no real pattern or predictability to it .
No .
That's hard because we all feel so out of control in pregnancy , right , because we can't control what's happening in the baby , how the baby's growing . Is it okay ? Right ? And then you're adding on top of this what do you do ? Okay , so let's talk to the mom who's going , that's me .
What is some words of wisdom that you have now , as a therapist and a coach for this and a survivor , you're speaking to her . What would you say ?
I would say please understand that you are doing the very best you can , no matter how bad it is . You are doing your very best . I would say try to look at this as it is you and the baby against the hyperemesis , as opposed to you against your body or you against the baby , that most people don't do that .
But I would say , try to remember why you're doing this , that you are sick . You're so sick , but you're sick for a reason that when you look at a lifetime with a child , the nine months will seem short . Get yourself a . Something that helped me was I rented a fetal Doppler .
So on the days when I could not I felt like I couldn't last another 10 minutes I would put the Doppler on and just listen to the heartbeat and it would help remind me of the reason I was doing it .
And do not be shy or ashamed or feel bad about asking for more help in whatever that means taking care of your other children , going to get more IVs , changing doctors if they're not being proactive , like I would just say you can do this . Please believe that you can do this .
I love that and you know , even to our listeners who've not experienced this , I think you can . I love that and you know , even to our listeners who've not experienced this , I think you can like this is such a story of strength , survival , perseverance that we can take away of . You deserve to be heard , you deserve to ask for help .
You deserve to know this is a medical condition . This is not just you . You didn't cause this and I think that applies to a lot of things in pregnancy and postpartum and motherhood right , that you have a voice and you matter .
And we love when we think it's very important for survivors to have their voice heard , to share to those going through it , fixing to go through it , because you need to see those ahead of you who have overcome , who you can take from those lessons . I mean , that's really the motherhood journey is .
It's like when you experience it , you need to pass on your knowledge and look to help in the same way . So I really appreciate that . How are you for our listeners ? Tell us how you're helping moms , how they can find you . I can imagine again . I just can't imagine walking that and not having anybody in my corner who got it .
Absolutely so . I am now a hyperemesis coach . I can be found at hyperemesiscoachcom and what I do is I offer sessions for the moms where I can give them coping skills . I can give them support , encouragement , information .
If I feel like they need to be seen by their doctor , I would tell them that I also do advocacy calls where I could do a Zoom with your husband , with your family , with whoever and explain what this is . I also do groups and it's all virtual of women with hyperemesis and they can talk together that I will facilitate that .
Or women who had it and they can talk about the experience they had . And partners groups where a bunch of because it's very isolating for the husband or the partner as well , like they won't know anybody that's been through this . What is that like for them ? How can they best support their pregnant partner ? Yeah , so I , I really .
This is how I want to help other women is to really be their soldier in arms with them , you know the fact that you've taken something that most women could have been like I'm just never touching that again .
Right , that was traumatic . I survived that and we do this with trauma .
We try to package it and put it away and it always reappears so thankful that you've worked through this and , again , sorry you've had to experience that so much , but so powerful and you're changing lives by walking through and I love how you said advocating and talking to those around them , because we're big with that and especially for our Prevalence .
Moms Whitney has some videos that she's done for them that's very specific , aimed at family , like in support , like this is what they need to be looking for . This is how they can help you .
This is how you can talk to them about this , because no one's given you a rule , a toolbox or like a little guide of this is how to say this to my husband , which we've maybe never talked about this subject before , or maybe I was raised where women can't complain or I should be so grateful I'm pregnant because my friend had a miscarriage and I can't tell
her I'm so miserable . You know all those things that are ingrained in us , so I love everything about that and we'll link everything for listeners who maybe you're in the car or does that for your kids and you're like , wait , I didn't catch that . You will see that in our show notes and we'll connect you to Andrea .
But , andrea , before we let you go , this does not have to be on this topic , but we ask all our guests this Andrea , now a mom of grown daughters , what ? would you tell Andrea , who is , let's say , before six weeks , let's just say very first pregnancy line test about motherhood ? What would you want her to know that would help her ?
About motherhood . No , that would help her About motherhood , that it's always shifting , it's always changing , it's wonderful and it's hard and it's joyful and it's awful and it's fantastic and it's all the things and it's utterly , utterly worth it .
That is the best description of motherhood .
I was going to say . You described my whole morning , my yesterday , all summed up all those emotions .
I mean it hits the nail on the head . Thank you .
Andrea , we are huge fans of you . We appreciate you so much and we thank you , and I believe very much in my heart that this will find the ears of those who need this the most and will also create a huge awareness for moms , who this may be their road , that they have to walk in the future . So thank you so much for being on .
Thank you so much for the opportunity . I really appreciate it .
All right , guys . Thank you for being with us . We will be back next week , so we hope you guys have the great rest of your week .
Bye hosted by CEO founder Sarah Parkhurst and licensed clinical social worker , whitney Gay . Each episode focuses on specific issues relevant to pregnancy and postpartum . Join us and hear how other moms have overcome mental health challenges , as well as access tips and suggestions on dealing with your own challenges as moms .
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