Hyperemesis Gravidarum

It's hard to watch your partner suffer,

with little you can do besides take as much burden off of them as you possibly can. We're into the 7th month of pregnancy now, and it has been a long and arduous road to get here.

I think everyone knows about morning sickness. When someone gets pregnant, one of the early signs is that they'll start periodically throwing up (not alway in the morning). It's unpleasant of course, but in most cases, it subsides before the start of the second trimester, and while other pains and difficulties of pregnancy start to emerge after that, at the very least they can start eating and drinking with more stability to feed both themselves and the baby they're growing.

Hyperemesis gravidarum (HG henceforth) is what they call it when that sickness doesn't subside, and becomes worse throughout the entire pregnancy. It takes a heavy toll on both physical and mental health, and is frequently dismissed and left untreated for far longer than it should.

Here are my survival tips from the point of view of the partner

And to be clear, none of these are guaranteed cures, none of these take away from how hard this is, some are just wee things, some are bigger.

1. Minimise all objectionable smells
2. No matter what you do, it's coming back out, so just eat it anyway
3. Self advocate early and insistently
4. Gas mask
5. Get out and about
6. She needs something to puke in
7. Empathise
8. Get help
9. Months

1. Minimise all objectionable smells

Pregnancy always comes with an enhanced sense of smell, and for those with HG it's even more important because it is yet another trigger for vomiting. If you can, cook outside. If you must cook inside, use as little oil as possible (oil makes smells stronger and linger longer). You'll learn over time which smells are triggers and which are not.

2. No matter what you do, it's coming back out, so just eat it anyway

Yeah. We tried for a long time to find a pattern in trigger foods, and while some stuff ended up as definite no-goes, it became clear that whether or not she puked was mostly unreleated to what it was she ate.
The body can absorb nutrients from food even if you throw it up shortly after, so while it's so tough to convince yourself to eat when you know the outcome, you gotta get it in. The baby gets first dibs on everything, so the primary worry is actually the mother's health in this case.
Better to get 10% of something than 100% of nothing, and this approach is the reason why my wife has still been able to keep her nutrition at safe levels despite vomiting after every meal.

3. Self advocate early and insistently

You are going to be dismissed by the first doctors and midwives you speak to about this. They'll tell you it will go away after your first trimester, then they'll tell you the same thing after your second, but you need to listen to your partner's body and get through to the one who will listen to you.
Our GP dismissed it despite the severity and frequency. Our primary midwife at the hospital wrote a note for us around week 18, and only then, after our persistence, the GP

• prescribed vitamin B6 and an antihistamine (didn't work at all and made her drowsy),
• then prescribed metoclopramide (didn't work at all and made her depressed),
• eventually after a very low sodium number in a blood test sent her for an IV (this gave her a noticeable energy boost and she felt better for a few hours, but didn't have a lasting effect).
• They also suggested acupuncture, but this didn't help and she threw up during it. It's clear at that point they had run out of ideas. While I respect the desire to use of alternative medicines when nothing else has worked, it's important to also acknowledge that there's little to no evidence they would have any effect.

Only now, in the 7th month, have we been given a more comprehensive treatment plan, but it hasn't really done much to help the symptoms. The doctor at the hospital prescribed ondansetron, a medication our GP had a couple of months earlier warned us off because they claimed there was a link to birth defects. I'm not a doctor, so I'll not say anything except that the doctor at the hospital was unconcerned about the risk, especially since we are later in the pregnancy.
Anyway that didn't help either. We do now have a regular schedule of IVs to go to, which are helpful, but are a massive time and energy drain because you have to sit around at the hospital for hours and hours.
Even though none of the medications worked for us, it's possible that one may work for you.
Also: puke in front of the doctor if you can. Preferably in every appointment.

4. Gas mask

Sometimes smells are inevitable, and she needs to pass through a room without feeling ill, so we created a gas mask: a jar of coffee beans that she could hold to her nose to prevent other smells getting in. Eventually coffee became a trigger smell too, and we haven't found a good replacement.

5. Get out and about

Similar to number 2: she isn't going to feel up to much and it's tempting to just sit at home all day. But she's gonna puke either way, so it might as well be on a nice walk rather than forever stuck at home. It might be hard to motivate, but it's important to care for mental health as well as physical.

6. She needs something to puke in

It's just not practical to run to the bathroom every single time. You need something to puke in that's big enough, won't splash everywhere, and can be kept on hand. The hospital gave us loads of their vomit bags which we use when we're out. Dehydration is a constant concern, so keep drinking water on hand to help make the vomit experience less... chunky.

7. Empathise

Nothing has been more frustrating and isolating than the experience of talking to friends who are or have been pregnant, telling them how difficult it has been, and them saying "oh it's been totally fine for me". When you feel like nobody else understands it can make you feel alone, and bonding over hardship can be a powerful way to help with that.
Until people see it in person, I think they don't realise just how bad it is.
It's messy, depressing, traumatising, exhausting, frustrating, and the partner's role is extremely important in making it survivable.

8. You need help

Get backup from friends and family when you need it, because it's tough for both of you, and there's no medal for going through it alone. Go to therapy, get a massage, whatever you both need to feel okay.

9. Months

That's how long you've gotta get through. As far as we know, the symptoms of HG subside rapidly after giving birth, which is a light at the end of the tunnel.

I know the chances are low that someone in this position finds themselves reading my blog for tips and tricks. But in a way, I guess this is my way of processing, and acknowledging how far we've managed to come as a team.