Pregnancy and PTSD
It’s hard for many to connect the dots between being sick during pregnancy and PTSD, unless they live through it. About 25% of cancer patients experience similar symptoms to HG moms and end up with PTSD. HG is like having a severe GI flu for months, only worse because you are pregnant. Imagine feeling like you are solely responsible for the life growing inside you, yet you can’t eat or drink even a sip of water without vomiting. You know if you don’t eat, you will kill your baby, but nothing stays down. Lights, sounds, motion, even sights or thoughts of food all trigger violent vomiting. Even the smell of your spouse makes you ill. So you hole yourself up in a dark room to survive and depression takes over.
The nausea and pain keep you from sleeping; delirium and exhaustion set in. They tell you to force yourself to eat but again it doesn’t stay down and you become fearful of even trying. You retch and gag repeatedly, almost suffocating, while your lips crack and bleed, your throat tears, and your ribs burn with every breath. You may also vomit blood, lose control of your bladder, pass out, or rupture internal organs. The intense hunger pains, reflux and constipation compound the misery. You are terrified you and your baby are going to die and anxiety paralyzes you. Your OB offers meds but you can’t keep them down, so you are written down as being non-compliant or refractory to treatment. Then they say there are no other medication options and you become increasingly desperate and scared. You are told it’s your fault because you are rejecting the pregnancy or not trying hard enough. You doubt yourself and question your sanity. You feel guilty, helpless and hopeless, yet you can’t give up because your life and your baby’s depend on you. You may have already lost a pregnancy due to untreated HG.
After a few months of being sick, you have lost 10, 20, or 40+ pounds, and are too weak to even sit up without getting sick and maybe passing out. To stand for a few moments is exhausting and evokes overpowering nausea and dizziness. You dread OB appointments which require waiting rooms and car rides which overwhelm the senses for hours and requires days for recovery. You eventually end up in the hospital getting yet another IV which is extremely painful because you’re so dehydrated and your veins are so scarred. It takes an hour of being poked by needle after needle for them to finally get an IV flowing, and you look at all the bruises and feel so terrified of needing even more invasive procedures. The medical staff chides you for not trying harder to eat and drink, and tell you that you are hurting your child and can’t go home until you decide to eat, as if you could. They may subscribe to the outdated, erroneous and detrimental belief that women are doing this for attention, so they refuse you an emesis basin so you have to try to withhold puke or end up laying in it for hours. They may lock you up on a psych ward and refuse to give you meds to curtail the vomiting, hoping it will dissuade you from acting like this. Only rarely do they offer nutritional interventions, which give you hope, though having a tube forced down your throat which is raw and hyperresponsive is tortuous. You’re living a nightmare that won’t end; few understand and so many lack compassion.
You may lose your job or be forced to drop out of school. You can’t care for your family and consider showering twice weekly a major accomplishment. The medical bills grow and your partner becomes frustrated you are “not trying” to do what the doctor says, not understanding it’s impossible. You fear he will abandon you but you can’t drive, change your IV bag, or get dressed without help. It’s terrifying to be so dependent. Your muscles waste away, as does your strength. The weeks pass and you see no end in sight. You have no idea how you can survive another day with the constant nausea so pervasive just moving or letting a blanket touch your stomach sends you gagging. You feel trapped and the only way out is to end the pregnancy. So, many do, which only adds to the trauma. Those that don’t abort live the hell for months and develop lasting aversions to foods, smells, and other stimuli. The majority have nausea and/or vomiting lasting well beyond their first trimester of pregnancy, with about 1 in 5 still suffering at delivery, causing debility and distressing, if not traumatic, delivery complications.
Residual nausea from gall bladder stones and GI ulcerations may persist postpartum. The anxiety and depression transition to debilitating postpartum depression that may become chronic, and resurface as panic when conception is considered or attempted. Most have nightmares and flashbacks for at least the first year and become very emotional talking or thinking about their pregnancy for many years. Women often say they are never the same and may struggle with poor self-esteem, anxiety when ill, bonding with or breastfeeding their new baby, and just generally resuming life. Months of fearing death and being trapped in a world of misery and pain changes them.
I won’t go on but you can see the experience is intense and can provoke deep emotional responses that are so misunderstood and poorly managed. Many of the children end up with neurodevelopmental and behavioral issues, which means these mothers go from being severely ill and trying to survive to a mothering experience that is not at all what they expected. There is no time to process and heal. Infant colic and reflux are very prevalent and cause severe sleep deprivation and stress. I hardly remember the first year of my son’s life and would not put him in the church nursery because I could not remember his face. His sensory issues and separation anxiety caused so much distress; he did not sleep more than 5 hours for 3.5 years, and only 1-3 hours intervals for most of his first year. It was extremely difficult. I am sure the severe nutritional deficiencies, in addition to the delivery and postpartum complications, interfere with recovery.
Let me know your thoughts. We hope that through the stories women share, people will see the connections between HG and PTSD. We know our experience fits the PTSD profile as we suffer greatly and fear death for months. Thank you for your interest in this project. Let me know if you have any other questions.
Director of Education & Research
Hyperemesis Education and Research (HER) Foundation