Hi Friends! Despite our hopes otherwise, I once again developed cholestasis with this pregnancy – so our midwives decided to induce me a couple of weeks early. I’m actually writing this post ahead of time – so hopefully our new little baby has arrived by now (I’ll be sure to share any news on Instagram!) and I’m heading out for a few weeks to spend time with our new little person! But first, I wanted to share one final post about an experience from my pregnancy with Sophie. I actually wasn’t planning to share this side of my story. But I’ve drawn strength reading accounts from other women regarding their pregnancy or postpartum experiences and I thought my story might help some of you out there. So here goes. This post may be TMI for most of you, so if you’re not interested please feel free to skip!
As I mentioned before, I developed a condition called cholestasis during my pregnancy with Sophie. If there’s one thing that I learned during my first pregnancy, and now with my second, it’s that my body does not do well with extreme hormone fluctuations. I had rough first trimesters with 24/7 nausea during both of my pregnancies, and my liver decided to go on strike with cholestasis during the late third trimester – so I’ve now had to be induced for labor early on two occasions! Unfortunately, labor is pretty much one giant hormone overload – in my case with some extra prodding and lots of pitocin. I don’t know what it’s like to go into labor naturally, but my body did not react well to the induction and labor the first time around.
I won’t ever be sure if it was the cholestasis or the induction, but after Sophie was born I developed hyperemesis gravidarum. I’ve never heard of anyone else developing postpartum hyperemesis – it typically occurs during the first trimester of pregnancy – but the symptoms were all the same so I don’t know what else to call it.
It all started just a couple of days after Sophie was born. In fact, it was the night before we were first discharged from the hospital. The nausea just appeared out of thin air on a Friday night and I completely lost my appetite. At the time I chalked it up to pain management from labor – I mean, who ever heard of postpartum hyperemesis?? Saturday morning we went home from the hospital, and by Saturday night I was vomiting. By Sunday I had chills and couldn’t keep anything down – not even water. I called my OB, who thought it might be a bad reaction to the postpartum pain meds and told me to stop taking them. I did, but my condition only continued to get worse. On Monday, Sophie had her very first pediatrician checkup and was diagnosed with jaundice. We were sent back to the hospital so she could go to the NICU for light treatment; I sent myself to the ER and was eventually re-admitted (and sent back up to Labor & Delivery since the hospital didn’t know what to do with me) for extreme dehydration.
Sophie’s first week of life was probably the worst series of days I’ve ever experienced. My tiny baby went to the NICU and I was too weak to visit her even though she was just down the hall. My poor husband was completely frazzled trying to go back and forth between us. All I could do was sleep and let the nurses pump much-needed fluids back into me. Eventually I was able to keep small amounts of food down and Sophie was discharged from the NICU – so we all went home (again) to recover. I think that second episode in the hospital lasted around five days.
But even after going home, I still couldn’t keep much down. It took around two more weeks before I could keep solid food down and another 3-4 weeks after that before the nausea and vomiting went away entirely. For the first two weeks I’d have 6-8 episodes per day, and then maybe 2-3 episodes per day for the remaining four weeks.
As my friend Jen once said, the most difficult part of hyperemesis is the emotional side of the condition. I had no idea what was happening in the very beginning, but I felt completely helpless; I was too weak to do even the most basic of things (like change a diaper) and it felt like almost everyone around me was brushing me off. It became a struggle just to get through each day, and I had no idea when (or if?) things were going to get better. The OBs at my hospital had never heard of anything like this happening before and just told me to eat more so I’d feel stronger. Even my husband didn’t seem to understand what I was going through – he just told me to dig deep and get through it. When I didn’t get better he thought that I was suffering from postpartum depression – which is a totally valid concern but just wasn’t the case.
Another difficult part of my condition: I was unable to breastfeed Sophie. In hindsight (always 20/20!), I should have totally figured this out on my own, but once the extreme dehydration set in I wasn’t able to produce what Sophie needed. I continued to try even after coming home from our second stay in the hospital, but my body simply wasn’t taking in (or retaining) enough food to make it work. I felt so much pressure to continue trying – from my husband to our then-doula to my mother-in-law – but I knew that I needed to focus on making myself well enough to help care for Sophie, so we switched to formula. I don’t really want to get into a conversation about breastfeeding, and I struggled with a lot of guilt for a really, really long time, so I’ll just say that I did what was best for my family at the time and ask all of you to please respect that decision. Ironically, the one person who supported me was my sister-in-law – who exclusively breastfed all three of her children and is a passionate advocate of breastfeeding. She told me to do whatever I needed to do to get better and take care of my family, which was exactly what I needed to hear at the time. I’m forever grateful for her support.
Again in hindsight, I think I probably did a poor job of conveying exactly how bad I was feeling at the time and advocating for myself with our doctors. I’ve always been the kind of person to tough things out and it’s hard for me to admit when I’m struggling. I don’t think I even told any of my friends truly how awful I felt – I remember wanting to put on my brave face and pretend to be in those first few weeks of baby bliss. I mean, that’s what you’re supposed to be experiencing, right? But in the end I just ended up feeling terribly alone and misunderstood.
Eventually, slowly, things got better and my condition disappeared entirely. I was lucky to have my husband home on paternity leave for pretty much the entire time that I experienced hyperemesis gravidarum, and by the time he went back to work I was strong enough to take care of Sophie on my own during the day. I’m terrified of going through the same experience this time around, but if that happens I hope I’ll be able to recognize the signs earlier and seek help and/or treatment before things get too bad.
Just in case any of you experience something similar, here are a few of the things that I learned or that helped me recover:
+ Don’t force yourself to eat / get IV fluids if you need them Lots of people – including medical professionals – will tell you to eat smaller meals more frequently to build up strength and get past the nausea. This didn’t work for me, and I don’t think I’ve ever heard of it working for someone with a case of hyperemesis. In fact, it made things worse since the food would just come back up and I’d get even more dehydrated in the process. None of the other traditional remedies worked for me either, from ginger to Zofran. Several rounds of IV fluids in the ER and hospital saved me when things got really bad, and once I was back home I learned to trust my body and focus on keeping hydrated with water and electrolyte-filled liquids.
+ Be your own best advocate I’m not a doctor, so please read all of this as my personal account and consult with your caregivers on how to treat your condition. But also be sure to advocate for yourself in the process. Some caregivers tend to brush symptoms aside or don’t take the condition seriously enough – I know I felt like I wasn’t being taken seriously while things were happening to me. Be vocal and let your caregivers know the details of how bad things are in the hope of finding a treatment that will work for you.
+ Sleep as much as possible So yeah – this one is tough when you have a newborn (or older children!) at home, but during both the nausea of my early pregnancy and postpartum hyperemesis I found that sleep (and fluids) were really the only things that helped me feel better.
+ Let people in – and ask for help! During those first few weeks I tried to put on a brave face and pretend like everything was fine – when it really just wasn’t. I’m terrible at asking for help in general, but with a newborn at home and without much family nearby it meant that everything fell on my poor exhausted husband. A couple of dear friends helped keep us going by bringing food (which he needed even if I wasn’t really eating), but I wish I’d been better about letting our friends know what was happening to us. I think our friends would have wanted to help more, but couldn’t since I didn’t tell them enough about our situation or ask for anything specific – and they were all afraid of getting in the way. We definitely would have benefited from more support – even just having someone come over to hold a baby and talk is a huge help when you feel helpless and overwhelmed.
+ Give yourself a break After cholestasis and the induction, I wanted so badly to have that blissful newborn experience – and when things didn’t go the way I’d planned I made the mistake of laying a huge amount of guilt and anger on myself that I carried with me for a really long time. Pregnancy and labor are tough enough for any woman, and it’s okay to let things go when reality doesn’t match your plans. Try to be kind to yourself, since emotional stress certainly won’t help you recover faster.
If any of you have experienced hyperemesis gravidarum – either during pregnancy or after delivery like me – I wish I could reach through the computer and give you a big hug! I haven’t met too many other women who went through this experience, which can make you feel even more isolated while it’s happening to you. I’d also recommend reading this post from Jen and this post from Stephanie, both of which are really honest and insightful – and helped me feel less alone by sharing their experiences.
Photos by the wonderful Katie Stoops – from when I was pregnant with Sophie!