Pregnancy condition took me to brink of mental instability

Keren Watson

I am 38 years old, a former lawyer, a wife, a mother and someone who knows what it’s like to be broken. I fell pregnant when I was 29 years old, in a stable marriage with a good income. My husband and I wanted multiple children and were elated that I fell pregnant easily. We had no idea of the dark waters we were entering. The births went well and our children are in perfect health, but my experience of pregnancy pushed me to the outer limits of my mental stability.

I had hyperemesis gravidarum twice

This condition affects a small percentage of women when they are pregnant. It’s translates to “excessive vomiting of pregnant women”. The condition makes you feel sick to the point of needing to vomit and pass out, every second of every day.  Imagine that moment when food poisoning or being seasick leaves you feeling so nauseous that you think you might die. That’s the feeling. All of the time.

This lasted until I was 16 weeks pregnant and then eased in miniscule increments until I gave birth. My body rejected all food and liquid. Eventually, I just vomited bile. My mouth produced excess saliva which added to the nausea. Once in my second pregnancy, I lay outside to take in some sun. Soon after my husband came to help me back inside and found me with my face in a pool of saliva.

Added to the nausea is an inability to sit or stand. The only bearable positions were lying down or crouching on my knees, arms and face to the ground. Over my two pregnancies I spent hundreds of days in these positions, managing only to breathe.

Keren was often too sick to sit or stand

Mistaking it for morning sickness

Early in my first pregnancy, I thought I had normal morning sickness.  I wondered at the ability of pregnant women to behave like healthy adults. I tried to do the same. One morning I sat at work trying to write a document for a client. I was so sick I sat on my chair typing for two minutes, then lay under my desk for five, then back on my chair for two minutes and so on. A few days later, my family rushed me to the hospital for IV fluids because I was crying uncontrollably and convulsing.

Had I known hyperemesis gravidarum existed, I would have been kinder to myself early on. It was only after I had birthed my first child that I read what Jeremy King, co-founder of HER Foundation, had to say: “Calling [hyperemesis gravidarum] morning sickness is like calling a hurricane a little rain.” www.hyperemesis.org/our-foundation/media-center/talking-points-top-10/

 

Hyperemesis Gravidarum is much worse than morning sickness

Medical intervention

There is no cure for the condition other than not being pregnant.  Women are treated with a range of anti-nausea medications, but many only respond to Ondansetron – a drug developed to help patients undergoing chemotherapy.

Some women take Ondansetron and are able to function well.  For me, it just created a thin line between keeping my babies and miscarrying them. I took three tablets a day and was still so sick I had to move in with my parents for long periods of time.

I lay and crouched on beds and floors for most of every day. Often, I woke at night boiling hot and so sick all I could do was lie on the cold tiles of the bathroom floor. During the day my father brought me little trays of food and drink.  He held my hand, praying for me while I cried. My mother washed my hair and did all she could to ease my symptoms and make food I could tolerate.

My husband often had to take me to hospital for IV fluids. Although the fluids gave me a much-needed boost, the care and nutrition at my parents’ house was better than what I received in hospital. The Royal College of Obstetricians and Gynaecologists suggests that receiving IV fluids out of hospital is better. I could not agree more.

www.rcog.org.uk/media/y3fen1x1/gtg69-hyperemesis.pdf

Doctors don’t have time

The first obstetrician I saw didn’t perceive how distressed I was about my condition. I meekly told her my weight had dropped from 59kg to 51kg since falling pregnant. She brushed it off and proceeded to give general pregnancy advice.  When I left I saw Ondansetron on my script but I didn’t know what it was or whether there were any side effects.

The second obstetrician I saw had a fairly rigid approach, but was technically excellent. He oversaw my taking Ondansetron and allowed me into hospital urgently whenever I needed IV fluids. When I was six months pregnant with my first child, I was sent for a gastroscopy to check that there was nothing wrong in my stomach. Although the procedure was not unsafe, it was an unnecessary experience and could have been avoided if doctors in my country knew more about hyperemesis.

The problem is doctors don’t have time to really listen, or to sit for long periods and research solutions from around the world. During my pregnancies, I was too weak to question doctors; I just obeyed. Rochelle Buchbinder and Ian Harris unpack some of these issues in Hippocrasy: How doctors are betraying their oath.

The mental and emotional toll

I was a successful corporate lawyer. I graduated top of my class with a Bachelor of Laws summa cum laude soon after I turned 22. The firm where I worked made me a partner just after I turned 28.

The devastation of my first pregnancy lay in my loss of control.  I tried to work in the most ridiculous ways. Once I lay on the floor of my sister’s house, dictating a set of rules for an association to my mum. She typed them up and sent them to the partner who had briefed me to write them. I was so sick I had to take regular breaks from speaking.

Eventually I gave up trying to work for two months.  My husband – also a lawyer – would sit near me, pull out his laptop and do my work and his. When I returned to the office, my clothes and shoes were loose and my boss looked at my emaciated body with horror.

The devastation of my second pregnancy was that I could not care for my two year old son. I remember lying on my parents’ bed and my husband and son came to visit. I held my son for a little bit and spoke with him as best I could.  After a time my sister came to take him to her house. He and I were crying desperately. My mum said they had to take him because I could not care for him.  I knew she was right so I let him go.

In my second pregnancy, I developed a coping mechanism. I lay quietly and transported my mind to made-up scenarios.  I imagined myself in different places, doing daring things or just being healthy, beautiful and widely adored.  It was mental escapism and it worked. My sister said to my doctor: “My mum feels like she is watching her daughter die”. I guess it looked like that, but I needed to vacate my body to cope with the reality of my life.

Depression and drugs

Then I discovered Ondansetron is a serotonin suppressant. Nine months after I birthed my first child, my mum and sister came to visit me. They were concerned because I was being hyper-critical of my husband and I never smiled or laughed. The truth was everything felt heavy and sad, I had chronic insomnia and was afraid to go out with my baby.  The anti-nausea drug had left me depressed.

I saw the obstetrician who delivered my baby. I explained who I had been before and who I had become. He sent me to a psychiatrist who prescribed anti-depressants, anti-anxiety medication and sleeping tablets. Within a few months I had some spunk back. The doctor weaned me off the medication, though I dipped into the sleeping tablets and anti-anxiety pills for some time afterwards.

Mid-way through my second pregnancy, I reached a crisis point. At 14 weeks pregnant I said to my husband “if I’m not better by 16 weeks, I can’t go on”. He gently asked me what exactly I meant by “can’t go on”. What was I planning to do?  In hindsight I think I was saying I would have a mental breakdown if the suffering didn’t ease. By about 20 weeks, I was back at the psychiatrist and for the next few months I took a cocktail of Ondansetron, anti-depressants, sleeping tablets, bowel stimulants (I was severely constipated from dehydration) and anti-acid tablets for heartburn.

The healing process

Shortly before my due date for my second child I was at the grocery store. The woman at the till asked me if I was having a boy or girl. I said I was having a girl and she said: “She will be an angel”. At that stage, I was really worn out.  On top of all my other symptoms I had started to lose my vision regularly and had been unable to drive for a while. Her words gave me a lift and a promise of a brighter future.

I birthed my baby girl quite easily and had a beautiful stay in the maternity ward. It was a very healing time for me, being in a dimly lit environment with my baby for three days. Still, after three months I felt depression descend on me again and I had to go back to the psychiatrist. Thankfully, all I needed that time was the anti-depressants.

Keren’s second birth went well but the effects of her pregnancy condition continued after her daughter was born

To heal the hurt my son and I experienced from our separation, I let him sleep next to me at night as soon as I could tolerate it physically. He would wake up crying for me and I would say “Mommy’s here” and let him put his little hands on my belly. The physical connections I have maintained with my children have healed me and them.

As my daughter’s first birthday approached, I decided it was time to stop being a lawyer. Quitting law took a huge burden off my shoulders. My soul and mind were lighter than they had been in years and I was able to quickly wean from the anti-depressants.

The dramatic change in lifestyle, a steady return to good eating and exercise, counselling and healing prayer, grace and honesty from friends and family and my husband’s unwavering strength combined over the past four years to set me right again. Several months ago a friend said to me: “You sound like your old bubbly self again.”  And I am.

The benefits of suffering

I am a Christian, so I believe in redemption. Ugly things can be made beautiful. I’ve suffered extensively in my body.  And yet, all of that has been turned around for good.

I see people with health or behaviour problems and I know there’s a story behind their state of being. I believe they are made for better and I feel compassion as they suffer.  I would be lying if I said I could have done this without having suffered myself. I was simply too proud. But now I know what it’s like on the edge and I will never forget how it feels to be desperately in need of help.

I hope sharing my story helps other women who might be suffering from this condition. May they be affirmed that their experience is real, not try to do paid work while unwell, advocate for themselves to clinicians and dedicate time to their recovery afterwards.

 

Worth the struggle

 

 

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