Copyright Colleen Kay Porter 1995 [This was published in Mom's Network News in 1994 and in East Bay Kids in 1995] MORNING SICKNESS: COPING WITH THE DARK SIDE OF PREGNANCY by Colleen Kay Porter She leaned against her husband as she tried to stand in front of the desk in the emergency room. "It's the worst stomach flu I've ever had," she gasped. The doctor looked quizzically over top of the chart. "But you're pregnant," he said. "Yes, I know," she agreed. "But I also have some weird stomach flu. I can't eat anything." "You're pregnant," he insisted. "This is perfectly normal." Although some women find "morning sickness" to be a fleeting queasiness that is gone by noon, some moms suffer from nausea and vomiting of pregnancy (NVP) that may last all day. They find themselves constantly bent over, preoccupied with the location of the nearest bathroom and whether their most recent meal is going to stay down or not. The joy of their pregnancy turns into a nightmare of nausea. Medical textbooks say that it is a "self- limiting condition." But in the meantime, months of severe nausea can strain a marriage and hinder job performance, leaving permanent scars. For many years, nausea and vomiting during pregnancy was considered to be primarily psychosomatic in nature, representing an unconscious rejection of the fetus and associated with low intelligence and frigidity. More recent studies suggest that it is a physical condition caused by hormonal effects. NVP is a physical illness, but the psychological effects can also present a challenge. Perhaps the hardest aspect of morning sickness is that not every pregnant woman suffers from it. People who have not experienced NVP themselves or with a loved one can be unsympathetic. When you explain that you cannot do something because of pregnancy, they may respond, "So what? My wife ran marathons when she was pregnant." One tactic to avoid this reaction is simply saying that you are ill (which is true!), and don't mention the pregnancy. Denial is common, as NVP doesn't fit into plans for a glowing, happy pregnancy. But you have to accept the condition if you are going to get help. All being sick means is that you are sick; it doesn't mean that you are not a feminist, or are a wimp. Try to avoid comparisons to other pregnant women. After all, for every person who is better off than you, there is one who is worse. The only answer is to forgive your body, and focus on being the best that you can be. It is discouraging to face the nausea day after day, week after week, month after month. When I am not pregnant, I wake up thinking, "Oh, it's another day!" During pregnancy, my reaction is more like, "Ugh, it's another day." I just want it to stop. Once I had some bleeding, and found myself thinking what a relief it would be to have a miscarriage. I had planned the pregnancy, I wanted the child, but I was tired of being sick. Of course I felt guilty afterward, especially when I considered how many of my friends had infertility problems. NVP can take you on a roller coaster of health and emotions. You glance at the clock and know you really should eat, but you're enjoying a book and don't actually feel hungry...so you wait until you finally have to crawl into the kitchen and can barely keep the food down. The problem with this zig-zagging is that the low end may land you in the hospital with dehydration. The healthiest strategy is keeping an even keel by scheduling naps and eating frequently, but that takes a lot of discipline. It's frustrating that sometimes you have to give up something you enjoy in order to have energy for something you must do. Erosion of self-confidence is another problem. You have some good days, but never know when a bad bout of nausea will strikeoeand it is likely to hit at an inconvenient time. After a while you doubt your competence and ability to perform tasks which used to bring satisfaction. You become hesitant to take on any new challenge, even something you would normally enjoy. You may be apprehensive about social engagements, automatically checking out the exits even as you enter the room. It is tempting to cut out all outside activities and just stay home on the couch, but that is a depressing thought for most of us. Try to accommodate the bad days by being flexible. For example, go to a movie, which can easily be rescheduled if you feel badly, rather than to a play or concert, which requires prior commitment and would result in disappointment if you don't feel up to it. As your nausea persists, dealing with the unsolicited advice of well-meaning acquaintances can become an exercise in tact. Their suggestions are numerous: "Well you'd feel better if you just drink raspberry tea/do yoga/ etc." Just smile as much as you can and thank them for their concern. The inability to function normally takes a toll on family and friends. At first they may be sweetly sympathetic, but grow weary as time goes on. "And how much longer will this last?" they ask. They may doubt whether you are really all that sick, and question if you are trying to get better. One woman's husband was certain that she continued to suffer because she was too proud to share the severity of her symptoms with her health care team. "I can't believe you could be this sick and the doctor can't do anything," he insisted. An explanation from her physician was helpful in changing his attitude. WORKING WITH YOUR HEALTH CARE TEAM Your doctor or midwife will be your partner for the duration of the pregnancy, delivery and postpartum period, so staying on good terms with them is important. Don't hesitate to change health care providers if you are not getting the support you need, but realize that all practitioners can be insensitive on occasion, such as nodding, "Good, good," when you tell them about your symptoms. Medically speaking, it really is good news when a pregnant woman has NVP, as studies have shown that she is more likely to have a positive outcome. It can also be discouraging when some young nurse rewards your efforts by saying, "Morning sickness, huh? You've been lucky enough to have a mild case." Luck may have little to do with it; you may have been working hard at managing the illness, adhering to a strict regimen of watching your diet, taking Vitamin B6 like clockwork and turning off the phone in order to nap. You may also appear healthy on the chart because your body has slowed down to a starvation mode to accommodate the frequent vomiting. Most of us are accustomed to consulting a health care provider for a cure when we are sick, but medical science provides no easy answers for NVP. The only drug marketed for the relief of morning sickness ceased production in 1983 after a spate of lawsuits. Although a link between the drug and birth defects was never scientifically established, liability issues have intimidated other drug manufacturers from offering remedies for morning sickness. Women with NVP frequently complain that medical professionals treat vomiting, but ignore nausea as inconsequential. Speak up if you feel that your problem is being ignored! After all, if the patient was a man suffering from nausea due to an ulcer, it would be taken seriously. LETTING OTHERS HELP Many women have a difficult time letting others help. But we have all known the warm feeling that comes from helping another in need. If you have NVP, now it is your turn to be on the receiving end of charity. Just look around you: a lot of people are willing to lend a hand, if you just let them. Allow your neighbor to watch your children while you put your feet up for a few minutes of needed rest, and don't protest when your mother-in- law scrubs your kitchen floor. Above all, remember that in a few months the nausea will be over and you will have your baby.