I know what Kate Middleton is going through, says Thetford mum-of-two who was hospitalised with hyperemesis gravidarum
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The Duchess of Cambridge, pregnant with her third child, is suffering from the same severe sickness she experienced with Prince George and Princess Charlotte. Sheena Grant reports on the little-understood condition and talks to an East Anglian mum who knows exactly what Kate is going through.
Like the Duchess of Cambridge, mum-of-two Sarah Baker would love a third child.
But she has decided it can never happen.
That's because, again, like Kate, Sarah suffered from severe sickness - a condition called hyperemesis gravidarum (HG) - with her earlier pregnancies.
And the experience was so traumatic and debilitating that Sarah, who lives in Thetford, cannot contemplate the physical, mental and emotional anguish of having HG again.
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She was hospitalised several times while pregnant with both daughter Chloe, now five, and son Jacob, three, including a week spent in intensive care with blood poisoning and septic shock through an infection picked up via an intravenous feeding line.
'When I got married almost 10 years ago I always dreamed of having three children,' she says. 'But that's something that's not going to happen now and there's a little part of me that feels a sadness because of it. I don't think I could go through another pregnancy with HG.
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'It took me a long time to get pregnant with my daughter and there was a huge relief when I found out I was going to be a mum. I always imagined pregnancy would be a time of joy and anticipation but the reality was so different. The memory of what I went through will always be with me. The mental and emotional trauma remains.'
To describe HG as morning sickness does not, says Sarah, even begin to describe it adequately.
'It's like saying a fractured leg is just a scratch. HG takes over every aspect of your life and leaves you unable to do even the simplest of things. I was sick up to 50-plus times a day and when I was not being sick I was constantly feeling like I was about to be sick.'
Thankfully, both Chloe and Jacob were unaffected by the HG. It was Sarah's health that suffered more.
'I was admitted to hospital for the first time at six weeks pregnant with my son and seven weeks with my daughter,' she says. 'At one point I was an inpatient for four months. It was bad when I was pregnant with Chloe but worse with Jacob. I couldn't even take sips of water or swallow my own saliva and I got crippling reflux, which eroded my throat and teeth - three of which I had to have removed in the end.
'My condition was so severe that they found it hard to treat me because my veins were collapsing and I had to have a central line straight into my neck to give me fluids and nutrients. That was very scary for my young daughter to see. I've had problems with my liver and complications with medication as I was allergic to two I was given. The condition is hugely isolating because I couldn't even pick up the phone and talk to people. I didn't have the energy.
'There were times when I did think about whether I could go on with the pregnancy. That is hard because my little boy is wonderful and I wouldn't change him for the world but when getting out of bed and walking five feet to the bathroom is enough to make you black out, it is a very dark time.'
Sarah's HG continued throughout both pregnancies and into labour, finally subsiding in the days after she'd given birth.
'The mental side stayed with me for far longer though,' she says. 'If either of my children had a sickness bug I would have horrible flashbacks and panic because I couldn't deal with it.'
Since Jacob's birth, Sarah has had help from the charity Pregnancy Sickness Support and now gives peer support herself to other women with HG.
'Unfortunately I didn't find out about PSS while I was pregnant. It was afterwards, when I was trying to get some closure for what I went through. There isn't a lot of understanding, even from many healthcare professionals, whose attitude seemed to be: 'You've had your baby now. It's all in the past',' she says.
'It is hard for the duchess that she has HG again but I hope that if nothing else, it raises awareness and understanding of the condition and helps anyone who is suffering now to get help and support.'
What is hyperemesis gravidarum?
Hyperemesis gravidarum (HG) is more severe than morning sickness and often needs hospital treatment. It affects only 1% of women with pregnancy sickness but is extremely unpleasant and can be serious.
What are the symptoms?
Prolonged and severe nausea and vomiting, perhaps up to 50 times a day. Sufferers can quickly become dehydrated, suffer weight loss, low blood pressure and ketosis, a serious condition that results in the build-up of acidic chemicals in the blood and urine. They may also endure extreme fatigue, muscle weakness, depression, tooth loss, kidney failure, eye haemorrhages and other long-term health issues. HG may not clear up completely until the baby is born, although some symptoms may improve at around 20 weeks.
Is there any treatment?
Because of the risks of dehydration and other complications it is important to seek medical help. The charity Pregnancy Sickness Support also advises plenty of rest as HG is characterised by frequent periods of recovery and relapse and over-exertion during a recovery phase can bring on a relapse. It suggests women get to know - and avoid - nausea 'triggers', which often include sensory stimulation such as bright lights and strong smells and avoid dehydration by sucking ice cubes made of juices. Some medicines can help the symptoms of HG. These include anti-sickness (anti-emetic) drugs, vitamins (B6 and B12) and steroids, or combinations of these.
Coping emotionally can be difficult so experts advise taking a day at time and putting strategies in place to ease loneliness and isolation. Some women have found self hypnosis helpful for coping with symptoms and hypnotherapy is sometimes used to help women through labour.
Does HG affect the unborn baby?
Experts say there are usually very few effects for the baby unless weight gain continues to be poor during the second half of pregnancy or symptoms are more severe over a sustained period of time.
What causes HG?
It's believed a combination of hormonal factors are to blame. There is some evidence that it runs in families and if you have had HG in a previous pregnancy, you are more likely to get it in your next pregnancy.
For more information go to www.pregnancysicknesssupport.org.uk or call the information line on 02476382020.