So Your Misses Got Hyperemesis (Gravidarum)

The second hospitalization helped us better understand how to care for my wife due to the severe hyperemesis gravidarum she suffered from. Since we didn’t receive a structured treatment protocol to manage her inability to drink, we decided to take matters into our own hands and created a care plan that would become part of her new daily hydration routine.

The key principles in our plan were:

• Let go of attempts to drink by mouth. This might sound extreme, but we realized that drinking only caused my wife physical pain, mental stress, and almost always led to vomiting — it did nothing to prevent dehydration.
• Make IV fluids her main source of hydration. Until now, we had only considered IV fluids as a secondary source of hydration or a safety net if my wife became dehydrated. During her second hospitalization, we understood that while receiving fluids intravenously isn’t pleasant due to the needle, the fluids stay in her body, and she doesn’t have to struggle with painful vomiting. We decided to go every two days for my wife to receive 2 liters (68 oz) of fluids (at the time, we didn’t know nor were told that the recommended amount is 2 liters every day for a pregnant woman).
• Get more effective anti-nausea medications for home, similar to those my wife received in the hospital. Until then, my wife was prescribed medications that only partially helped with nausea. We decided to do whatever it took to get her more effective medications like those she received during hospitalization. These are medications commonly given to cancer patients to help cope with the severe nausea of chemotherapy. More on the topic of nausea in HG in the next chapter.

Note: We do not recommend anyone to follow our plan. Deciding to let go of drinking and rely solely on IVs is an extreme solution that we decided upon only because we had no other choice. If your wife can drink, she should continue as much as possible.

The main takeaway from the plan I shared is that you should understand your own situation and develop a plan suited to your level of hyperemesis. Implement it only after consulting a doctor.

In any case, before deciding on any plan, consult a doctor, preferably one specializing in high-risk pregnancies.

My wife was discharged from the hospital, and we began implementing the plan. It became our routine for the following months. Every two days, we went to our local clinic, where the nurses gave my wife 2 liters of fluids (again, it’s important to mention that a pregnant woman needs 2 liters of fluids every day, not every two days like my wife did). On weekends, when the clinic was closed, we went to the hospital for a similar treatment.

Is such a plan ideal? Definitely not. We would have prefered a standard pregnancy with the usual complaints about back pain, swollen legs, and an uncontrollable craving for ice cream in the middle of the night.

But we were faced with a pregnancy complicated by hyperemesis gravidarum. This meant we had to adapt to a very unusual situation. IVs were not ideal, but they saved the lives of my wife and baby.

We know that many other women with severe HG eventually also had to rely solely on regular IVs as their source of fluids. We also met women with HG who didn’t understand or weren’t informed that they could incorporate IVs as a hydration solution and continued to struggle daily with attempts to drink.

Perhaps saddest and most concerning, we encountered many women with HG who did realize they needed regular IVs, but the doctors or medical staff who treated them didn’t understand the severity of their condition. Those caregivers wouldn’t approve regular IVs or only allowed partial, insufficient treatments, such as insisting on only half a liter of fluids per day instead of 2 liters. For example, one of the women in a Facebook group we were part of shared her frustration with her doctor, who approved only one liter of IV fluids every two or three days. This poor woman was constantly dehydrated for months, but her doctor didn’t understand the severity of her condition and didn’t know how to treat her. We sympathized with her, as our own doctor didn’t know how to treat HG either, even though she was a senior OB-GYN. Fortunately, we were able to research and find additional solutions. We advised this woman to find another doctor, preferably one more knowledgeable about hyperemesis or high-risk pregnancies, and definitely one who could recognize dehydration when they encountered it.