“Their Royal Highness-es the Duke and Duchess of Cambridge are very pleased to announce that the Duchess of Cambridge is expecting their third child,” read the statement. “The Queen and members of both families are delighted with the news. As with her previous two pregnancies, the Duchess is suffering from hyperemesis gravidarum. Her Royal Highness will no longer carry out her planned engagement at the Hornsey Road childrens’ centre in London today. The Duchess is being cared for at Kensington Palace.”
But along with the happy announcement comes the news that she is again suffering from hyperemesis gravidarum, a debilitating and extreme form of morning sickness that affected her pregnancies with both Prince George and Princess Charlotte. In a piece first published in Vogue’s November 2005 issue, Maria Matthews writes about her own experience of the condition.
It’s there. The faint blue line in the little plastic window. I’m pregnant again and the countdown has begun. I’m not quite so overjoyed this time. I suffered severe morning sickness during my very first pregnancy, which culminated in a miscarriage after 12 weeks. All that sickness for nothing. The next time I was pregnant I threw up for precisely nine months and four days. The day I awoke and did not retch, I gave birth to our darling Daisy.
Can I do it all again? Do I have enough love this time around? Will I be as sick? This third and final question is the one that consumes me during the next few days. My GP and everyone who has an opinion on such matters has confidently told me that each pregnancy is different so I’ll probably be fine. I hope so.
Exactly four days later I am sitting in the bathroom holding my head in my hands. If I keep completely still, the nausea subsides a bit. But move too fast and my head spins uncontrollably and I retch. It has begun. Horrifying thoughts are swimming around my brain – thoughts like “I can’t go through this all again” and “I have to stop it before it’s too late”. But my husband, Mark, and I have discussed it. We don’t want Daisy to be an only child. We’d always planned to have another.
When I do decide to go back to work it seems a Herculean task simply to dress and drag myself to the bus stop. My daughter, whom I leave with her nanny, can’t understand why Mummy isn’t smiling any more. In the office I try to avoid talking or walking too much. The noise and bright lights are difficult to bear. I bury my head behind my computer screen and pretend to be busy. All I think about is how to get through to the end of the day. Every couple of hours I head for the loos, then throw up until it hurts so much I cry. There is nothing left in my stomach but burning bile. And it only gets worse as the day goes on (whoever called it “morning” sickness was so wrong). Still citing my cold, I leave early. I have achieved nothing. The next day I do the same. And the day after that and the day after that. I soon realise I cannot go on and make an appointment to see my GP. I am just seven weeks pregnant.
My doctor is vaguely sympathetic but matter of fact. “Oh dear, you’re just one of the unlucky ones,” she observes grimly. She writes hyperemesis gravidarum (a severe and debilitating form of morning sickness) on my file and signs me off work for two months, advising me to lie in a darkened room with as little stimulus as possible. I have an 18-month-old child. How on earth am I supposed to do that? But at least I no longer have to face the world at large. I tell my boss, who, with a toddler of his own, is fantastically supportive, telling me to come back only when I feel ready.
It’s strange being at home during the day, shut away in my darkened bedroom. I am faintly aware of my daughter playing downstairs with her nanny or with other children over for a play date. My isolation is complete. Such is my sensitivity to sound, light and movement, I am unable to read or watch TV or listen to the radio. So I just lie there and think myself into a black hole of self-pity and anger. Every so often Daisy pays me a visit and peers at me with enquiring eyes. She stops calling for Mummy when she wakes in the morning and calls instead for Daddy. It breaks my heart.
In a rare non-nauseous moment I enter “hyperemesis gravidarum” on Google and learn that one to three per cent of pregnant women suffer from HG, but these represent only those who are hospitalised. There are many more (one study suggests as many as 10 per cent) with severe nausea and vomiting who go untreated. It is estimated that around 55,000 women are hospitalised in the US each year due to severe HG. It is not a rare disorder.
I visit my GP again and plead with her to prescribe something for the nausea. I tell her about a drug I have found on a Canadian website that appears to have been used for decades in North America. She can’t recommend it. “Not licensed here, I’m afraid,” she says. What about vitamin B7? I’ve read somewhere that that’s supposed to help. Surely there’s a specialist I can see? Isn’t anyone conducting research?
Despite insisting that I won’t leave the surgery until she gives me something, she refuses to recommend anything. There is no quick-fix answer. I resolve to buy the drugs over the internet and march home intending to do just that. But my sense of responsibility is too great and I can’t bring myself to order medication from an unlicensed source somewhere in cyberspace.
Depression is kicking in. I have even stopped trying to do the right things, like eating small meals regularly and drinking plenty of water. Nothing seems to make the nausea recede. By now I can barely keep anything down and I have lost more than a stone.
My husband suggests I call the private obstetrician who dealt with my miscarriage. We don’t know if he can help, but we can’t just sit back and accept that I have to feel like this for the next seven months. The consultant takes one look at me and admits me immediately to the Portland hospital. His decisive action and reassuring words are finally giving me hope. He explains that, in some cases, a spell in hospital on a drip will break the cycle of nausea. After several excruciatingly painful attempts to get a line into my arm – I am so dehydrated that the anxious young duty doctor cannot locate a vein – I am hooked up to an intravenous drip.
After three days, nothing has changed. Finally, my consultant offers me medication. He assures me that the drugs in question have been around for years and there have been no contraindications. However, there have only been a few clinical trials, as it is understandably difficult to persuade pregnant women to undergo drug testing.
I’m supposed to take the drugs three times a day, but I’m so frightened of their impact on my unborn child that I limit myself to one dose a day. The effect on my sickness is negligible, and they make me feel light-headed and woozy anyway, so I stop taking them altogether. Now, for the rest of my pregnancy, I have an additional fear with which to contend: I am terrified that I have harmed my child irrevocably by taking chemical substances and images of Thalidomide babies haunt my dreams.
The relentlessness of the sickness is taking its toll emotionally. Mark returns home from work each evening to a sobbing wife overwhelmed with sadness. He keeps asking me what he can do to help. This infuriates me. It’s such a stupid question. Make the sickness go away, of course! I am cross all the time and I take it out on poor Mark, accusing him of not being supportive and understanding. The hurt in his eyes only adds to the guilt I have inside me. Unspoken guilt that I feel no compassion towards the being growing steadily in my womb.
A friend recommends a girl who does homeopathy and, with some scepticism, I make an appointment to see her. After asking me all sorts of in-depth questions about my lifestyle, she prescribes a course of remedies. I stick with them for a few days, but feel little improvement.
I return to work armed with the only crutch that partially alleviates the nausea – fizzy water. None of the remedies that helped first time round seem to have an effect this time. With Daisy, I chewed gum from morning till night, but now the minty taste only increases my sickness. I work short days for a month or two before I finally give up trying and gratefully accept my maternity leave.
My midwife, concerned about my fragile state of mind, recommends an appointment with a consultant midwife at Chelsea and Westminster Hospital who specialises in pastoral care for those experiencing difficult pregnancies. She is calm and comforting and listens quietly as I pour my heart out to her. I admit to her what I have not dared tell others – that I deeply resent the child in my uterus for causing me such distress. I worry that these negative feelings will still be with me after I give birth and that I won’t bond with my baby. She assures me that this will not be the case and offers me a course of reflexology to lessen my anxiety. Amazingly, this seems to have an effect and I begin to feel a little more in control.
Daisy stays with my parents while Mark goes to a friend’s wedding. I worry he is flirting with some gorgeous girl, enjoying time away from his gloomy wife. The reality is that he is as miserable as I am and feels helpless and inadequate in his inability to give me comfort.
We get a new car and to our astonishment the number plate reads LEO. It’s the name we have picked out if the baby is a boy. For the first time in eight months I feel a stirring of something positive towards the child. Perhaps this is a sign. Perhaps everything will be OK after all.
I awake this morning and do not throw up. I know it is going to happen. Later that evening I go into labour and after just four hours I give birth without pain relief to a healthy 9lb 13oz boy. We, of course, name him Leo. I am now blessed with two beautiful children, Daisy and Leo, and I love them both equally with a passion that amazes me.
So it was all worth it in the end, but I know I couldn’t possibly have another child because the getting there is just too horrible. And I wonder how many other women have suffered the isolation and depression that comes from the relentless wretchedness of HG, together with frustration at the apparent lack of a safe, effective remedy. No woman should have to suffer a genetic design fault so acute that the heavenly gift of carrying a child feels like hell on earth.