My (2nd) HG story: Caitlin Kay-Smith
I have to admit to writing this with a little bit of egg on my face. I was one of those HG survivors who adamantly swore she would not be having any more kids. When I went to midwife appointments during my first pregnancy and they asked me if it was my first pregnancy I said ‘yep, and my last’, so convinced was I that I would never put myself through that again. It wasn’t just something I said for laughs, or to prove a point - it was absolutely how I felt at the time and the only logical conclusion I could reach after that particular ordeal.
But then, I was let down by a period cycle tracking app that shall remain nameless. I was fertile at a time I did not expect to be and four weeks later I was peeing on a stick. Looking back I think the surprise pregnancy was actually a blessing in disguise. I didn’t really have to decide whether I wanted to get pregnant again at a particular time. It wasn’t left up to me and really I am grateful for that. Obviously, the husb and I had decided to a certain enough extent that we wanted to have another baby that we were engaging in particular activities but the timing was taken out of our hands. From the time of getting a positive test I knew I had about 7-10 days to get my ducks in a row before everything went tits up. So here’s what I did:
I arranged for my toddler to get an extra day at daycare. This took her days from two to three and I knew, with my husb working full time, that her having the majority of her weekdays sorted out was a pretty big priority
I went to see my GP with my HG treatment plan and asked for all the necessary scripts and blood tests. I used this exact template to put together the plan I wanted and ran it all past her. She’s been my doctor for years and so knew my history and what I would need moving forward. I was lucky that she worked with me and let me tell her exactly what I wanted to do. That’s the least you can expect from your GP so if you’re not getting it take your business elsewhere
I told my parents and in-laws. It was the least exciting, most business-like pregnancy announcement ever. It was filled with emotion (my mum burst into tears and not from happiness). Everyone was worried about what was going to happen to me and how we were all going to cope. We told them because we knew we would be relying on them A LOT (spoiler alert: we did) especially when it came to helping to look after our daughter. There were hurried congratulations followed by long conversations about what we needed and how they could help
The husb told his boss what was about to happen. Again, not the best way to announce a pregnancy but he was working in a very high-powered and demanding environment and needed to alert his workplace that he may need a bit more leeway in the coming months. His boss and most of his coworkers weren’t familiar with HG and so it took a bit of convincing for them to understand the severity of the situation. I don’t think it was until he’d had to call them a few times to let them know I was in the hospital and that he’d be working from home for a few days that they began to understand
I took my scripts and went to the chemist. I got stocked up on everything I needed including Restavit, Doxylamine, Ondansetron, Rabeprazole, and Hydralyte ice blocks. I got wet wipes and vomit bags and a little toiletries bag that I could keep everything in, all together and easy for me to grab on the rare occasions I left the house (usually to go to the hospital)
And then I just sat back and waited for the inevitable to happen. Did I hold out hope that I would miraculously dodge the HG Freight Train this time around? Sure! But I knew that, statistically, that was unlikely (we currently believe HG has around an 80% recurrence rate). So, I did what I tell every woman who gets in touch with me to do, I hoped for the best but prepared for the worst. That way, when the nausea started and the vomiting came soon after I wasn’t surprised or disappointed or unprepared.
I won’t bore you with a week-by-week account of my suffering but here’s a little snapshot to give you the general idea:
Nausea started at 5 weeks, vomiting at 6 weeks
First hospital presentation 7 weeks
Twice-weekly fluids scheduled from 8 weeks
Thrice-weekly fluids commenced from 9 weeks
PICC line placed at 10 weeks but removed 2 days later due to nerve pain issues
Blood clot found at 11 weeks, Clexane commenced for 5 weeks
Steroids commenced at 12 weeks for 3 weeks
Clexane ceased at 16 weeks with confirmation of no clot
Hospitalised at 16 weeks for a suspected clot in my lung, CT scan confirmed no clot
Regular visual migraines from 24 weeks
Swapped from public hospital care to a private Obstetrician at 26 weeks to ensure I had more control over the way my pregnancy came to an end (read: I wanted to be induced)
Thrombosed hemorrhoid at 30 weeks due to chronic constipation from Ondansetron use. This had to be lanced by a colo-rectal surgeon and I was on Lactulose 3 times a day until I delivered to keep the constipation under control
Continued thrice-weekly fluids until I delivered
Induced at 38 weeks and after a swift six-hour labour delivered my bouncing 3.3kg baby boy!
What I’d like to focus on in this post are the ways in which this pregnancy was different from my first, in the hope that maybe it will give you a little hope that if you’re thinking about going for another HG baby things can be different.
While my physical suffering was much the same this time to the first time, worse in some ways (see: PICC line complication and the resulting clot), the mental suffering was far, far less. This made everything else seem manageable because I wasn’t constantly fighting my own mind to get through each minute of the day. I attribute this improvement to one main thing: control.
In my first pregnancy, I felt like I had absolutely no control over anything that was happening. I didn’t understand why I was so sick for so long; I didn’t understand why there was nothing anyone could do to help me. My mind went to such dark places and once thoughts of termination or suicide enter your mind they tend to linger - either because you can’t quite shake them or you begin to beat yourself up over ever having thought them in the first place. I could not get a handle on what was happening, why it was happening, and why there was absolutely no help to be found.
Two and a half years on and infinitely wiser (in part because of the work I do with you all every day) I knew what to expect, what was available to me in terms of treatment, and what I was ‘allowed’ to ask for to make my life easier. I wasn’t going to sit back and let this pregnancy just happen to me this time, and I hope that you know that you don’t have to accept that either.
Part of the mental game was knowing that I had access to regular fluids. I cannot overstate the importance of IV fluids to sufferers of HG and NVP. Not only do they reverse the dehydration caused by your symptoms, but they have also been proven to actually reduce nausea and vomiting themselves - the double whammy! There is very little harm that can come from receiving regular fluids, in fact, the SOMANZ guidelines recommend receiving them 2-3 times a week until you can eat and drink completely normally. That means, even if you’re not vomiting uncontrollably you should still be receiving them.
I went into the maternity ward at least twice a week every week of my pregnancy. On top of the physical relief the fluids gave me, the mental relief was indescribable. If I was having a bad day then I knew that, at most, I was 48 hours from receiving my next fluid top-up - which also presented an opportunity to be seen by, and speak with, midwives and doctors who could help me with my symptoms. It was a total game-changer not to have to play games with myself over if, or when, I should brave the circus of the Emergency Department. Whenever I speak to a woman planning another HG pregnancy this is my biggest piece of advice: find a practitioner that will, without hesitation and without waiting for you to be irreversibly sick, arrange an IV hydration protocol that allows you to receive fluids at least twice a week.
My little boy is just shy of six months old and already HG seems like another life. My fourth trimester was beautiful and healing - I do not carry any of the trauma or shame or resentment that followed me for months after the birth of my first baby. I feel more myself than I have for a long time and I believe that I would not feel this way if I hadn’t done it again. Yes, a big part of that is the beautiful little boy I get to cuddle every day, and watching his big sister fall in love with him more and more. But I also think that part of it was taking ownership of my experiences and doing a second pregnancy in my way. I found the strength to say NO to subpar treatment, to advocate for myself even further, and to surround myself with a care team who would do whatever was required to keep me healthy and sane. I know that I am lucky - lucky that my circumstances afforded me the opportunity to do this again in my way, lucky that my local hospital and the private OB I found were open-minded and receptive to treating my condition in the way it needed to be treated. I know that these are not options available to everyone. But it is my promise to you that I will do everything in my power to help you have a pregnancy like mine.