Here is my bucket full of my IV medication . I could fill 100 of these . This is the life of a HG mom.
– Starr Andrews Strong HG Activist
How do I decide to get pregnant again after having Hyperemesis Gravidarum ?
How do I decide to get pregnant again after having Hyperemesis Gravidarum ?
I have been a hardcore volunteer for the HER Hyperemesis Education Research Foundation for years.
The HER Foundation has such good information on their website and many moms do not even know are there . The information I have gathered myself over the years , is a collaboration of tips from moms I have supported , in my Facebook group HG before during and the aftermath. Many have shared with me that may just be super helpful if you are wanting to go down this road again. If you and your husband have baby fever , it is super important to talk and brainstorm . You need to plan the worst hope for the best . I get asked daily , on Facebook or via email from my website . I love all the Inspirational messages from moms all over the world that follow me , thank you it keeps me going .
If you have any input please comment so I can add it to my website, blog and my HG book .
The burning question how do I do this again ? Am I crazy or could I really have another baby ?
1. How do I know if I will have HG next time?
If you have had severe HG more than once, you have a very high probability of having HG again. Recent research by the HER Foundation finds over half of women (about 2/3rds) will have HG in every pregnancy. Your chances are greater if you have a relative with a history of HG, especially a sister. Health professionals often underestimate the recurrence rate of HG.
2. Are you willing and able to endure what you did in your previous pregnancy or worse ?
Don’t assume your next pregnancy will be different. Subsequent pregnancies are often similar though sometimes they vary – either better or worse. For some women, each pregnancy gets more severe. Hope for the best, but be prepared for the worst. Having a support system in place is important I run a support group in Facebook groups called Hyperemesis Gravidarum before during and the aftermath
FYI: Myself and my team screen every mother’s request so memberships can pend for a long time. If you need in sooner message me or my organization public page . Hyperemesis Gravidarum before during and the aftermath.
We Focus on all three aspects of hyperemesis. The before ,during and the aftermath. Find my group or reach out if you need help to plan a HG care plan or a TTC plan . If your already pregnant and need HG crisis support your not alone. Myself and team will help you ! You can always text my Crisis line .
3. Did you try all of the medication options available including Zofran and steroids?
If yes, and they did not work, know that there are few other options available currently and you may be limited to those treatment options. For some women, starting treatment earlier in pregnancy – at the onset of HG rather than after symptoms are severe, makes surviving HG possible. Also, for some, trying medications via an IV or special pump ( A PCA ) that offers continuous dosing, may be very beneficial. For a small but significant number of women, treatments are not tolerated or have no beneficial effect in any combination. These women will likely find future pregnancies to be just as resistant to treatment. Other options besides pregnancy are likely better choices.
HGBDATA we offer support and help you put a care plan action in place and have support sisters for one on one support and HG crisis support. I also have a team of women that help with HG Crisis support and ongoing support. Each moms needs are different. To get set up for this is not hard just a few forms and guidelines in place for us to help you.
4. Is your doctor or midwife willing to set up a plan for your treatment and offer all options? Will they follow a care plan you make up by speaking to one of us at my organization? Home health care and IV hydration at home ?
Normally I am the one that does this but my Director Yeni does if I’m not available, she can start your treatment plan . At HGBDATA our HG Crisis volunteers are here to help . If you feel you need more then one on one support , you have group support ! My groups are very tight knit and we keep it small and screen each member that wants in . For the safety of the group and my moms who are in my group . You can reach out to my self or my Director Yeni and we will set in place a team for you.
If your next pregnancy is similar or worse, you may face a great deal of suffering. Having at least one if not two health professionals, and a perinatologist, prepared to care for you is important to ensure you get the care you need. One may be unavailable during the time you most need medical care or may be uncomfortable treating severe HG. A Hyperemesis Gravidarum care plan and speaking with them going over in great detail what the plan is and make sure it’s in your medical record ! Print out the care plan bring a copy. I do write the care plans myself and they can range from 2-22 pages . I am very sick in the aftermath, however I do everything for the moms who come to me . Two nicknames I am called in the HG community is Mama Bear 🐻 and the HG Fairy 🧚♂️ Godmother. I will help you through this !
5. Are you willing or unwilling to take medication or do you have serious concerns over safety?
Considering most pregnancies are similar if not worse, medication is often necessary to avoid therapeutic termination or miscarriage. Review the medication page on the HER Foundation site to be informed of the risks to you and your baby. All medications carry risk, but the risks are often outweighed by the benefits they offer in managing the symptoms of HG.
6. Would you be willing to have a special IV (PICC) inserted for nutrition if needed?
Sometimes women require IV nutrition (TPN) which means you will need help at home daily, home health care nurses, and careful monitoring by health care staff to avoid infection and other complications. It is also expensive but can be life-saving. If you are unwilling due to cost, discomfort, or concerns over safety, please read up on it to be informed. There is always the possibility you will be faced with severe HG and even the choice between losing your baby or IV nutrition. IV fluids and medicine at home instead of the hospital! You have options! They may not tell you your options but you have many .
7. Did you require numerous medications and invasive treatments like a PICC line in your previous pregnancy?
Each medication carries some potential for risk to your baby, and introduces the possibility of side-effects or medication interactions. PICC lines (or other central lines) are risky and not to be taken lightly. I have a blog on it here For those very ill, they can be life-saving and necessary, however, avoiding them is ideal.
but HG is life threatening so the benefit outweigh the risk . However not all PICC LINES and veins are created equal. Check out my blog on SECURACATH you got questions on IV treatment please reach out to me. If you feel that no matter what, you will require extensive medical care, remember these present risks that you cannot always control or prevent.
8. Did you terminate your previous pregnancy due to the severity of HG?
Know that the severity often repeats in future pregnancies. Proactive, aggressive care that is planned in advance is critical to surviving more severe cases of HG. Sometimes each pregnancy will be worse than the previous even with good care. This could be due to the brain becoming more sensitive to the vomiting stimulus, thus making the brain less able to control the vomiting. If you would not terminate again and enter unto pregnancy without a plan, you are taking a significant risk. Get tested for the MTHER gene mutation.
IMPORTANT IF YOU TERMINATED
You should avoid intercourse, at any rate, during the first two weeks after a termination to decrease your chance of a post-abortion infection and a pregnancy if you are not yet on birth control. Avoid getting pregnant during the first month after an abortion to give your uterine lining time to heal to accept another pregnancy. Your uterine lining begins to heal right after an uncomplicated abortion. In case you really want to conceive after an abortion, doctors recommend you use contraception and wait until after you have at least one normal period before trying to conceive again.
After terminating a pregnancy, it is possible to get pregnant as soon as you ovulate if you have unprotected sex. This can happen within two weeks, even if you are still bleeding. Based on a 2014 review in the International Journal of Obstetrics and Gynecology, 83 percent of women ovulate in the first cycle following an abortion, and this can occur as soon as eight days after the procedure. The statistics are similar for first trimester surgical abortions and medical abortions. You are at higher risk for pregnancy complications and miscarriage if you don’t at least wait 1-2 months to get pregnant ! Having Hyperemesis Gravidarum you need to prepare your body before jumping into rushing to get pregnant ! This applies to having a miscarriage as well.
9. Do you have good social support and adequate help at home?
This is something that is very important to all pregnancies, but more so for surviving HG, especially if you have children to care for already or get very sick. Women with very high stress levels have higher rates of postpartum depression, and increase the risk of emotional and behavioral disorders in their child. We have a support group on Facebook and there quite a few other groups we can send you their way if you like so you have more then one support group each offer great support. Most of us in the HG community all know each other and each of our groups are different, but in a good way . If you like a list let me know .
10. Do you have children at home that will require your care?
It will be difficult if not impossible to maintain a normal routine for your children. You may need to depend on family, friends or day care in order to care for your child(ren) during the worst of HG. This can vary from a few weeks to the entire pregnancy. Contrary to popular belief, HG does not end at 13 weeks. It often eases by mid-pregnancy, ( FOR SOME but NOT ALL symptoms may last until delivery. The longer HG lasts, the greater your fatigue and debility, and the longer your recovery.
11. Do twins or multiples run in your family, or do you require fertility treatments that increase the risk of multiples?
Multiple pregnancies have a higher risk of HG due to the higher level of hormones in their body.
12. Are you back to normal health?
Try to be in the best physical and mental health possible before pregnancy. Some women lose a lot of weight and plan to be about 10 pounds over their normal (healthy for their height) weight at conception, so they have some weight to lose and additional stores of vitamins. Before TTC a TTC plan is important to prepare your body for Hyperemesis Gravidarum contact us and we can help.
13. Do you have money saved up to pay for assistance at home, co-pays and out of pocket expenses, including childcare and non-covered treatments?
Surviving HG can be expensive if your insurance coverage is limited, you have severe symptoms, become debilitated, experience complications during or after pregnancy, or you lose your income. You can decrease the stress of HG by having extra money available for unexpected expenses. This will also prevent you from having to make choices in your care based on your finances and not your needs.
14. Do you have insurance coverage for medications like Zofran and treatments like home IV and nutritional (TPN) therapy?
One month of medications like Zofran can cost approximately $3000 (USD), and TPN at home costs upwards of $500 per day (USD). Without insurance, needed treatments may be too costly, leaving you to suffer unnecessarily. Ensure you have a plan that will cover all possible treatment options and make sure you have waited the required time period for eligibility. Also check to see if HG would be excluded for some reason. It is also very helpful to know the process for seeing a specialist (e.g. if your insurance requires you to get a referral). Be sure that your preferred doctors and hospital are covered by your insurance, or that you have the extra money required to see doctors outside of your network.
15. Do you have to work or can you take a leave of absence from employment?
Review your finances closely and determine if you could live without all or part of your income, and for how long. There is no guarantee that you will be able to take a leave from work or be able to return quickly. Alternatively, explore medical disability options and ask your health professional what criteria is used to determine when you would be placed on disability. Also, be familiar with your employer’s policies on taking a leave of absence or your vacation time. If your HG symptoms are not severe, consider part-time or flex hours. Finally, know that physical work is not recommended during pregnancy and practically impossible with HG. If this is part of your job, other options will need consideration. Recovering from HG and a complicated pregnancy can take months, not just weeks and planning ahead for this is crucial, especially if you have HG beyond mid-pregnancy.
16. Did you have complications other than HG like gestational diabetes, thyroid disease, clotting disorders, or high blood pressure (i.e. preeclampsia, hypertension)?
These complications may return in future pregnancies and present significant risks to the baby if not controlled. The risk of harm to you and baby is high if you do not respond to the treatments offered or cannot tolerate the treatments. The more complicated the pregnancy, the more difficult it is to manage, and the higher the probability you will have an early delivery or other adverse event.
17. Has your health care professional suggested that another pregnancy could be dangerous or pose significant risk to your health now or in the future?
Some women have long-term health issues due to HG including heart or brain damage, gall bladder disease, extensive damage to teeth, hernias, stomach ulcers, bone loss, depression, and joint damage (esp. jaw – TMJ). Pregnancy and delivery alone present many risks that can be life-threatening. These risks may be too great for you, especially if you have children at home that depend on you. This is something you will need to discuss in depth with your family and medical professionals before deciding. There are other options such as adoption and surrogacy, which are chosen by women with HG who desire to continue their family despite HG. It is very important to understand the risks to you and your child so you can make an informed decision.
18. Is your partner or spouse willing to support you through another pregnancy?
You will need as much support as possible to endure HG. Without a supportive person around you, it will be difficult to ensure you get the care you need. When you are ill, it’s difficult to advocate for yourself. Since many women with HG go on to experience postpartum depression and anxiety due to trauma, it is critical that you have support beyond pregnancy. Physical recovery can take several months, and emotional recovery much longer. If your partner or spouse is not supportive of another pregnancy or had great difficulty coping with previous pregnancies, ensure you have alternate support systems in place and think carefully about your decision. If you become too ill to care for yourself, you will need someone close by to advocate and care for you. Remember there are many Facebook groups for Hyperemesis Gravidarum online I run one !
19. Do you have flashbacks, severe anxiety or nightmares about HG?
HG is often very traumatic. The thought of enduring it again often creates a great deal of anxiety for women. If you are still suffering from the trauma of HG, professional help is needed to help you prepare for another pregnancy. Some areas have groups that specialize in women’s health during and after pregnancy. Your OB may be able to offer referrals. It is not uncommon for women to feel anxious when trying to conceive, knowing that HG lies ahead. Being prepared and informed about managing HG will ease the anxiety.
Going through Hyperemesis Gravidarum is forever changing and can leave a everlasting impach on you mentally emotionally and physically.
Your not alone ,
Starr Andrews Strong HG Activist
HG Fairy 🧚♂️ Godmother
Starr Andrews Strong HG Activist
FOUNDER OF HGBDATA
information courtesy of The Her Foundation.
Source : HER Foundation