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Survival Guide for Family & Friends

This guide endeavors to provide family members and friends with helpful ideas for helping a woman with hyperemesis gravidarum.

Pregnant women with hyperemesis gravidarum (HG) and their families & friends need to be understanding and adaptable, especially in regard to diet. Food cravings can be bizarre, complex, irregular and often a woman's whole life becomes centered around food. It's important to create a network of support for all aspects of daily life to minimize stress and provide foods as tolerated. Stress (mental, physical or emotional) only aggravates and worsens HG.

Cravings often appear for only a short time - maybe just a few minutes and need to be fulfilled if at all possible. The primary goal is to increase nutrient intake by any means possible. 

Here are the top 10 ways you can help a women with HG:

  1. Know the typical triggers with HG and create an environment free of them if possible.
    They often are unable to tolerate the following:
    • Blinking/bright lights
    • Noise (including TV, radio)
    • Toothpaste
    • Motion (any)
    • Any smells (scented deodorant, shampoo, etc.)
      Understand she may need to sleep alone as her sense of smell is heightened and she can likely smell food on your skin and breath. Don't be offended by this. It is a hormonal reaction. She also may be unable to tolerate extra movement, and may even be unable to shower daily.
    • Pressure on stomach
    • Swallowing solids or pills
    • Riding in the car (motion sickness)
    • Taking showers (buy unscented products)
  2. Be aware of what may make her feel guilty or depressed and try to proactively resolve or minimize their influence:
    • Lack of understanding from others ("women have survived nausea for centuries")
    • Inability to take vitamins, eat enough or eat healthy foods
    • Taking medications that could harm the baby
    • Missing out on the "fun" of being pregnant
    • Lost work days or quitting work
    • Money expended on care
    • Lack of energy and severe fatigue
    • Memory loss or inability to think clearly
    • Burden of care and time on others
    • Lack of socialization (ie. isolation)
    • Inability to prepare for birth/arrival of baby
    • Inability to care for family and home
    • Perception that HG is only in her mind by others
    • Loss of hope that the nausea will cease before birth
    • Fear of pain of treatments and being force fed
    • Reluctance of health care providers to aggressively treat due to cost or liability
    • Weight loss or inadequate gain for gestational age of baby
    • Dehydration, hormonal and metabolic imbalances (cause fluctuating emotions beyond her control)
    • Sense of inadequacy and failure, especially if taking several medications (or requiring many interventions) or slow weight loss
    • Fear of harm to baby or difficult birth
    • Fear of morbidity or death
  3. Give her permission to rest and listen to her body's needs.
    • Allow her to do whatever is necessary to cope, including quitting her job without complaint. (Read our impact of HG page.)
    • If possible, avoid major stressors such as moving until she has recovered.
  4. Make a list of ways others can help and let them choose the activity that best suits their skills and schedule.
    • Women don't often ask for help when needed. Ask that they arrange a time that works for her, but not ask if she needs help. Assume she does, she just doesn't want to burden others.
    • If you have limited support and can afford to hire help, consider a doula. "Doula" refers to a supportive companion (other than a friend or loved one) who is professionally trained to provide labor support. She performs no clinical tasks. "Doula" also refers to lay women who are trained or experienced in providing postpartum care - mother and newborn care, breastfeeding support and advice, cooking, child care, errands, and light cleaning - for the family. To distinguish between the two types of doulas, one may refer to "birth doulas" and "postpartum doulas."
  5. Arrange for someone to visit or call daily to avoid depression and isolation.
  6. Empower her with as many choices as possible to decrease her feeling of helplessness and dependency.
  7. Be her advocate, especially in terms of her medical care.
    • She will likely have difficulty being assertive or thinking clearly due to metabolic imbalances. If either of you feel her treatments are not helping, be assertive in seeking other options and/or doctors.
    • Before she goes in for a routine GTT (glucose tolerance test), discuss the use of apple juice instead of glucola. The results will often be more accurate since patients can often tolerate juice better.
    • Consider buying Ketostix - the sticks you dip in your urine (like at the OB office) to test for Ketones, an indication of dehydration and the need for IV therapy. (Offsite Help: What is Ketosis? & Lab Essentials eStore: Ketone Strips)
  8. Prepare anything she can consider eating as soon as she feels she can tolerate it.
    Nutritious liquid meals are a good choice. From protein powders to fruit or vegetable smoothies, these drinks can be packed with nutrients. One possibility for building and nourishing mom and baby is the "Baby Shake," an adaptation of the "Pregnancy Cocktail" described by Fred Rohe in The Complete Book of Natural Foods. (See below for recipe.)
  9. Hire cleaning and childcare services as needed to give her time to heal and rest.
    • Continue this post-partum until she is able.
    • Remember this is a short period and it's critical to help as much as you can.
    • Avoid cleaning products with strong odors.
    • Accept all offers for food preparation unless the smells bother her.
    • Let others know her food aversions and eat the foods away from her as needed.
  10. Understand a women's need (even post-partum) to discuss her experience with hyperemesis (HG) and  allow her to recover at her own pace.
    • She will need to mourn the loss of the joy of pregnancy and the find the path to healing emotionally as she is physically.
    • Seek medical care if severely depressed (i.e. her depression is interfering with her ability to care for herself and her family).
    • Avoid making her feel weak for struggling.
    • Remember, she was sick for 9 months, it will likely take that long and maybe more to recover fully.
    • You may want to read the following offsite article: The Body Keeps The Score: Memory and the evolving psychobiology of post traumatic stress by Bessel van der Kolk

Updated on: Apr. 18, 2013

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