a short account of hyperemesis gravidarum

Ada paused as the ultrasound technician typed furiously into the muddled image on the screen. Ada knew they couldn’t disclose information, only describe briefly what they were capturing. Ada had felt the baby kick that morning so she knew it should be okay. Still, there was always this gnawing worry in Ada’s mind that the doctor’s may have missed something. Ada’s health anxiety now extrapolated to the child in her belly much to her dismay.

The ultrasound tech – whose name tag gleamed ‘Sarah’ against the screen’s light – sighed. Ada held her breath.

‘All done. We will have the results sent to your GP and they will discuss them with you’.

Ada nodded and thanked Sarah. Ada paused as she looked into Sarah’s eyes. She tried to read her expression closely without making it obvious. Sarah must’ve picked up on Ada’s demeanor and averted Ada eyes.

‘Did you have any questions?’ Sarah asked as she rose from the backless leather stool and began to escort Ada out of the room.

‘Not really. You can’t tell me if anything was wrong?’

‘I would say if something appeared abnormal, but baby seems to be growing well since your last scan. Either way, the GP will contact you if there was ever anything concerning.’

‘Okay, no worries. Thank-you.’ Ada managed a half smile and stepped out in the waiting room which was a narrow hallway lined with plastic chairs. Ada paid for the scan and promptly drove home.

–

Ada was greeted by her dog. His tail violently crashed against the door frame as he sniffed and jumped up at Ada. Ada wasn’t entirely sure if he knew she was pregnant. He had become clingier but never seemed too intrigued by her expanding belly or gentle kicks. Ada plopped herself on the sunken couch, curled into the fetal position and turned on the TV.

This had been what every day was like for the past four months. After a cruel bout of what the doctor called ‘morning sickness’, Ada was coerced into resigning from her job as the local school counsellor. Since then, Ada spent every afternoon in front of the TV, too sick to move and too tired to care to. Ada tried not to think about what her friends were doing. ‘Georgia is probably working right now or on a lunch break in the afternoon sun’, Ada imagined. She checked her husband’s location, and he was also on a lunch break at a local pub catching up with his friend and colleague. Ada closed her eyes. It was hard to accept that while Ada’s life had become absorbed by the four walls of her lounge room, everyone else carried on as normal. It wasn’t the pregnancy she had imagined. If it had been up to her, she would’ve worked until her water broke. She would be getting up at 7am and heading to the gym before work. She’d be strengthening her pelvic floor for birth and discussing pregnancy with her co-workers. But that was not Ada’s reality and she struggled each day to accept that.

A sudden kick in the right rib woke Ada from her mind wandering. ‘There she is again’, Ada said to herself. Her baby girl rarely stopped kicking. It was a blessing, but Ada wondered what it was like to sit comfortably. Ada’s rib pain continued to worsen with each week. Ada was only relieved from the pain when lying down or when she’d make the effort to go to the local swimming pool. It was another symptom of her pregnancy that made her feel completely alone and isolated. Glued to the couch, surrounded by vomit bags, a half-empty Gatorade, and her sleeping pills, Ada drifted off to the sound of the true crime documentary.

–

Ada awoke to the sound of her husband coming through the back door. Ada slowly sat upright, mustering as much abdominal strength as she could to greet him. He smiled at her and then his face sulked, ‘Not a great day?’.

‘It was okay, the scan seemed fine. I’ve just been trying to sleep.’

‘That sucks, Ada. Any relief from the vomiting today?’ His eyes quickly glanced at the full bag of vomit that sat lazily on the coffee table. Ada was filled with embarrassment.

‘Not really, but I didn’t vomit at the scan. I only spewed when I came home. I think the sleeping medication is helping me, finally.’ Ada grinned but her eyes didn’t match the gratitude she was trying to muster.

‘Did you want me to cook you anything or order anything?’

‘I’m not really hungry right now.’

Ada hadn’t craved anything her whole pregnancy. It was another thing that made it hard for Ada to relate to other pregnant women. The conversations her friends had about craving spicy foods or sweet foods only made Ada nauseous. She couldn’t remember what it was like to want food. Yet she appreciated her husband asking each day. He always had hope, even when Ada couldn’t.

Her husband left the doorway of the lounge and Ada could hear him scrambling through the fridge. Ada had stopped grocery shopping months ago. Just the thought of entering a food-filled facility made Ada salivate and gag so her husband was often left to fend for himself when it came to mealtimes. He would shut the doors to the kitchen so the smell wouldn’t drift into the lounge and induce her vomiting. She would hear the sizzle of a sausage or a steak, or the hum of the microwave, and wish she could join him. Ada craved normalcy again. Her doctor said that by the end of the second trimester, she should start to feel better. Ada’s hope wasn’t completely lost but after being told it would get better week after week, Ada was beginning to feel the weight of reality – she might be sick until the day she gives birth.

Another kick and Ada was brought out of her self-pity and back into the lounge room. She looked down at her pale belly and watched as her baby girl pressed her foot left and then right. Then a kick into the rib would send a shock of pain through Ada’s body and she would wince, ironically thankful for the smallest break from monotony.

–

It was Sunday the next day which meant Ada was faced with the decision to either attend church or watch the church’s livestream from the comfort of her ‘coffin couch’. Ada decided that this Sunday she would try to attend. She’d strategically sit at the back of the auditorium in case she needed to use the toilet. She chugged back water and an extra dose of her nausea medication then proceeded to curl her hair. The nausea crept in as she looked in the mirror. The reflection was confusing. Ada knew it was herself looking back but it was a version she wasn’t familiar with. It was a version of Ada that was just trying to survive, a version that had no choice but to keep going. Ada was trying to accept this version of herself but knew it would take time before Ada would be friends with her. Ada curled the last strand of hair, got dressed, and popped some mint gum in before heading out the door.

Church was full. Ada hadn’t been in over a month and was again reminded how people carried on with their lives no matter how much Ada’s life had changed. Ada looked around the auditorium.

‘I wonder if anyone else here feels as sick as me.’ The self-pity felt sickening to Ada but she couldn’t shake it as much as she couldn’t shake the true sickness lingering in her throat. She swallowed hard and looked down into the dark carpet in front of her. Ada thought if she tried hard enough, she could convince her mind she didn’t need to vomit. She held her breath. ‘Maybe if I don’t breathe so hard, I won’t feel this bad’. It didn’t work and Ada grabbed her bag and rushed into the toilets at the back of the building. She leaned in and allowed herself to do what she needed to do. She was too sick to care if anyone heard her. The cold tiles beneath her knees stung. Her hands pressed around the toilet seat made her vomit harder. It wasn’t so much the disgust or the embarrassment that haunted Ada, it was the feeling of being forced to surrender to an experience of pregnancy that she was not prepared for.

‘Morning sickness.’ Ada scoffed at the label and thought that even a man would know that this wasn’t just morning sickness. Ada scoffed again, nearly loud enough for the lady next to her to hear, at the thought of her pregnant friends loathing in their beautiful experiences. Ada was bitter, she knew she was. But Ada’s self-awareness never served as relief.

–

The Sunday night was filled with sickness. Ada could hardly catch her breath, and she filled yet another vomit bag to the brim.

‘How could I possibly have anything inside of me to bring up?’ Ada asked as her husband’s face recoiled at the sight of spew around Ada’s mouth and dripping down her chin.

‘Oh, Ada.’ Her husband didn’t know what else to say anymore. At the beginning it was words of hope and words of promise. He would rub her back and tell her that the sickness would go away within a couple weeks. Ada would cling to those words then became resentful when the two weeks would pass and the sickness remained.

‘I just want this to end.’ Ada responded between retching. Tears dripped down her red and blood-shot cheeks. Another dry retch. Another bout of tears. And another kick to the ribs.

‘Tomorrow we should go back to Urgent Care. Ask for an IV drip so we know you’re getting enough water. And maybe we can ask for more medication.’

‘I’m just so tired of going there and not getting any better.’

‘I know but we should at least try.’ His eyes were full of sorrow and sympathy. Ada knew he was right but sitting in a waiting room full of other sick people for hours sounded like just another version of the same hell. Ada’s last IV did feel good. It made her sleep better and provided some temporary relief. So, Ada nodded along in agreement as she passed one bag to her husband and opened another one.

–

Ada’s husband packed some saltine crackers and medication in a Ziploc bag and helped Ada into the car that Monday morning. Ada’s pants sat loosely around her hips. These pants had fit snuggly before she was pregnant and now, they sagged sadly onto the wet pavement as she slowly walked into the waiting room. Every step felt as though it might trigger her nausea. She looked up and around the room. She was a frequent visitor, but she never saw the same people.

‘Maybe most people go here, get the help they need, and don’t need to ever come back.’ Ada thought. Again, the self-pity and bitterness brewed.

Ada sat down with her husband on the same plastic chairs that lined the ultrasound clinic hallway. She shut her eyes as that tended to keep the nausea at bay. She tried to breathe through her mouth so that any odd smells could be avoided. And she slowly chewed on a saltine cracker. After two hours of waiting, a female nurse emerged.

‘Ada?’ She called and looked around. Ada stood up slowly as to avoid any chance of fainting.

‘Oh, saltine crackers. I know what this is about! Are you pregnant?’

Ada nodded but couldn’t form a smile. Not even a fake one.

‘Let’s first have a look at bub. Feeling the kicks?’

Ada again nodded and selfishly thought why the bub even mattered. Ada felt like screaming, ‘My baby is fine, but I want to die from this sickness!’ Nonetheless, the nurse wheeled in a mobile ultrasound device and kindly asked Ada to lift her top and lower her pants. Ada did as she was asked and carefully watched the screen where she could see her baby girl wriggling around with contentment.

‘Aw, she looks great. Now how can we help you?’ The nurse smiled widely at Ada.

‘I am vomiting still up to 20 times per day, and I can’t keep water down. I am on all these medications, but they aren’t helping so I think I just need another IV.’ Ada kept her description brief. She knew what she wanted and needed and didn’t want to discuss much further. Ada had felt medically gaslit enough the past few months and was sick of hearing the same medical rhetoric around morning sickness and how normal it is. Ada never felt this was normal.

‘Okay, we can do that, for sure. Um…how about we take some bloods first and then we can go from there?’ Another needle. Ada felt the dread swell inside of her but didn’t resist.

‘Sounds good.’ Ada replied flatly. The nurse promptly cleaned her skin around the vein and took some blood. This was all routine for Ada to the point that Ada felt confident she could probably take her own blood if she needed to. The nurse read off Ada’s name and date of birth for confirmation before speed walking out of the room, leaving Ada and her husband in silence.

An hour later the nurse returned.

‘It looks like you are a bit dehydrated so we will go ahead with a couple bags of IV fluids as well as some ondansetron to help with your nausea. Does that sound okay? We also found some evidence of an infection so we might start you on some antibiotics for what we suspect might be a UTI.’

Ada felt like she was living the same day over and over. It was only a few weeks ago that Ada was here, receiving the same diagnosis and same treatment only for it provide temporary relief. Ada had accepted that she may need to do this repeatedly until baby was here.

‘Yeah, that sounds fine. Is there anything else that can help with the vomiting longer term?’

‘Not really. I mean, if it is morning sickness, which it sounds like it is, it should be getting better in the next couple weeks. It’s rough, I know, but hang in there!’ Ada fought the urge to roll her eyes into the back of her skull. She began to feel numb and the feeling of forced surrender appeared once again as she sank back into the chair, arms bared for the IV.

–

It was a Monday afternoon when Ada’s baby girl was born. The sickness wore off when the baby arrived. Ada vomited throughout her labour, but was pleased to find out it ceased the moment her baby girl was put into her shaking arms after an emergency caesarean.

When the morning came, Ada ate breakfast. She brushed her teeth, gargled mouthwash, shampooed and conditioned her hair, and rubbed lotion into her dry, cracked skin. She didn’t think twice about it. But when Ada looked into the mirror, she saw that version of her still. The matted hair, the yellowing teeth, the hollowed and bloodshot eyes. Ada wondered if this version would ever go away but only time would tell.