Hyperemesis Gravidarum: Is it all in our heads?

How many times have you heard this:

“You’d feel a lot better if you would adjust your attitude.”  “You should be more positive.”  “That Molly. She’s so excitable isn’t she.”  “Maybe you should see a tharapist?”  “You’re not sick.  You’re pregnant.”  “You’re weak.”  “You’re hysterical.”  “You’re doing this to yourself.”

From doctors. From nurses. From the lady taking your vitals in the hospital. From a friend. From a relative. From your spouse?

It’s all in our heads.  We’re doing this to ourselves.  It’s our fault we’re so sick.

Over and over and over.

Some HGers aren’t lucky enough to have a support system.  They suffer and suffer believing to their core that what they are experiencing isn’t real.  They blame themselves when they miscarry.  They feel the agony of guilt when they have to terminate the pregnancy that they were so excited for just to save their own lives.  If they’re like the woman a few years back at one of my local hospitals, they die.  It’s their own fault.  If they hadn’t been so weak, so fragile, so excitable.

A new study has come out: Is hyperemesis gravidarum associated with mood, anxiety and personality disorders: a case-control study.

Apparently, according to the abstract, HG is a relatively common medical problem among pregnant women.  Well, gosh.  I certainly learned something today.  I wasn’t aware that it’s common for pregnant women to require PICC lines, constant IV hydration, high doses of multiple medications, and bed rest.  I wasn’t aware either that it’s relatively common for pregnant women to become so dehydrated that they begin to halucinate, to vomit until their esophagi tear and they start to vomit blood, to become so malnourished that they lose their babies, for their kidneys to fail, to die.

I didn’t realize any of that was relatively common.

After looking quite a large sample size of 142 patients and observing whether or not there were mental health issues prior to the pregnancy, these psychiatrists conclude:

The results of the present study suggest that mood and anxiety disorders, and personality disturbances are frequently observed among women with HG and that there is a potential relationship between these psychiatric disorders and HG during pregnancy.

Pardon my skepticism, but this has been done before.  It was a crock then and it’s a crock now.

Look, I get that they’re saying that HG isn’t caused by mental illness. Of course not. This is all couched in the language of statistics.  But how many of us have had doctors who told us to just suck it up before sending us on our way with admonitions to take some ginger and eat some crackers?  How many of you have nearly died because of it?  I know at least one of you personally who has had this happen.  I know it nearly happened to me when I was pregnant with Cricket.  I remember that Friday night when they suddenly went from, “Molly, you’re in really bad shape. We need to get you on TPN,” to “There’s nothing wrong with you. You need to go home.” (Of course I seemed fine at that point! I’d been on IV fluids, a potassium drip, and IV zofran and nexium for 3 days!)

Oh sure.  Plenty of us who have HG are depressed and anxious.  Who wouldn’t be after what we’ve been through?  HG causes mental illness and depression.  The researchers got it the wrong way round.

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