When You Actually Can’t Cope Through the First Trimester
Interrupting my tearful purge as I spewed flustered regrets into the room, my therapist reminded me that a second pregnancy was always a part of my plan. I felt like a basket case. Despite the fact that thing were still rocky with my husband after his company’s pandemic-induced bankruptcy scare and the difficulty of being in recovery from my own career fire-ball burnout, I had my IUD removed. It must have been my subconscious compulsion to keep our life plan moving forward, because I was pregnant just four months later.
This pregnancy was nothing like my first. My headspace, my body, and the small parasite taking root inside me were all completely different and created a concoction that had me feeling like I was pregnant for the very first time.
Almost immediately, I was blindsided by the severity of a seemingly regular case of nausea and vomiting in pregnancy (NVP). Which made me wonder, despite the internet being full of empty ‘how to kick morning sickness’ clickbait, how do women cope with this condition in real life?
Oh, so this is nausea and vomiting in pregnancy
By week five, my emotions had gone haywire and the nausea kicked in hard. I was gearing up for a two-week road trip through California and expected to manage the discomforts just fine. Assessing my initial symptoms, a friend advised me to get some anti-nausea meds before I left — just in case. But by the time we arrived in Santa Barbara I was losing control. The waves of nausea flattened me, began to last all day, and misery set in.
The OB office had given me Zofran, an anti-nausea medication that made me constipated beyond belief and only partially eased the pain. They failed to clarify how to use it properly and the constipation was nearly as bad as the nausea. Note: I’ve tactfully removed the impacted rectum part of this reflection, but that could be a post all on its own.
By week 7 I started throwing up regularly, which for me was a couple of times a day. I started bowing out of activities to refocus my energy on getting myself through the day. Heat and sun exponentially compounded the nausea. I started to burst into tears at the sensation of heat, because I feared the crippling wave of nausea that inevitably followed. I was never happier to back home where I could suffer in my own bed. And that’s where I stayed for rest of the summer.
Weeks 8–15 were seeped in nausea so debilitating I could barely get myself up in the morning. It was no longer waves, but rather engulfed me in a constant painstaking stream of sickness. It was so bad during some stretches, that I couldn’t even sit up in bed.
When I called the OB office for help, the nurse gave me a second medication. Zofran barely took he edge off, so I started taking Promethazine. It put me to sleep, but at least if I slept 14 hours a day I didn’t have to suffer through as many wakeful hours. Never mind the impact to a person’s psyche when choosing to sleep life away because being awake is too painful. Beyond the prescription, though, the OB office was no help. They said the next step was to order an IV to replenish fluids lost from vomiting dehydration.
The nurse suggested I try ginger, which was laughable. Sucking on ginger was like recommending a cup of chamomile tea to ease the fury of a broken femur.
It was severe nausea that crippled me — not vomiting
I actually vomited less during my most severe bouts of nausea. My rhythm consisted of vomiting first thing when I woke up, which was mostly water and stomach fluid, then once in the afternoon when my body tapped out. But unless you are hospitalized for need of intravenous fluids, it seems there is little to be done for the condition. I received no helpful information, guidance, coaching, or resources. I found bits of information online about hyperemesis gravidarum (HG), a severe form of NVP that results in dangerous levels of weight loss and dehydration, but apparently, I didn’t qualify for this diagnosis.
Pregnancy sickness isn’t like hangover nausea — my only other comparable experience and one at which I had become masterful over the years — where you throw up to rid yourself of the nastiness, fill your belly with boxed mac & cheese, and then sleep until the next day. With pregnancy sickness, emptying your belly just amplifies the nausea, so I fought vomiting the best I could. Consequently, I was stuck retching constantly throughout the day. Dry heaves offered momentary relief without the setback of losing the contents of my stomach.
The best relief I found was filling my stomach with a steady flow of Goldfish, pastas, bagels, and any other carbohydrates to keep my digestive system active. From there, putting a cold compress on my head, laying in cool dark places, and breathing through the pain was all I could do — similar to managing childbirth.
The month when the sickness was at its worst, I could barely care for myself let alone anyone else. My mom came to care for me and my daughter. I felt proud when I could make it to the shower.
In weeks 16–19 the nausea started to ease, and I re-entered the more moderate stretch of the sickness. The nausea broke back into waves, which allowed me get back on my feet and function. I actually started vomiting more because I was more active, but I couldn’t have cared less.
At least I could get dressed, make meals, and care for my toddler. By week 20, I started to get my energy back and engage in social commitments again. The earlier months of constant carbohydrate inhalation, couch containment, and associated depression left my mind and body weak and fatigued.
What it means when women are expected to endure NVP suffering
Luckily, I had already quit my job a few months prior to this pregnancy to fill our child care gap created by the COVID pandemic. Otherwise, I would have had to take at least a three month leave or a full departure from work to survive NVP. That is a substantial amount of time to be absent from one’s life and work responsibilities – especially considering that a half of employed new moms in the US report taking only 0-5 weeks of leave to recover from childbirth.
Between the attitude and level of care I received from my health providers, in combination with the lack of information I was able to gather from support sites, there seemed to be an unspoken assumption about NVP: Women are expected to simply endure the suffering.
How can this be? It seems as though an illness that has the potential to incapacitate women for months at a time would be well researched with various treatment and support options available. Even HG, the rare and severe form of NVP of which diagnoses are made in less than 3% of pregnancies, has little research, particularly on the spectrum between manageable morning sickness and debilitating symptoms.
If men had to endure a fraction of my pregnancy sickness symptoms, this highly dismissed condition of NVP would be properly researched and treated.
The myth of the sacrificial mother is to blame
The myth says that, as mothers, our role is to be at home and give ourselves entirely to our children and family — however painful that may be, or however much we may lose. Even though I reject this anachronistic gender role of the mother, I wasn’t able to contend with my own NVP suffering to challenge it. I was forced to surrender.
How is a woman supposed to manage NVP and maintain any meaningful responsibility in life? Answer: she can’t.
It is the subliminal perpetuation of this myth that restricts women from fully participating in society as community and civic leaders, policy makers, and business leaders. Ironically, this myth of the sacrificial mother is starkly juxtaposed to the reality in which US women already fill 47% of the workforce, upholding necessary functions of the economy.
Pregnancy is an important part of the female experience that weighs heavily on mothers, families, and workers. Expecting women to endure determinedly unbearable conditions raises the important question of what we actually want from women in modern civil society.
Do we still think women belong at home suffering and concerting all their energy to child-rearing? Or do they belong out in the world as leaders, solving problems and making the world a better place?
This failure is a clear example of women simply not being valued enough by US health care and policy to adequately meet their needs and thereby empower them to fully participate in parity with men in society. We need to fundamentally challenge the myth of the sacrificial mother if we want to value women the way the world really needs.
