Hyperemesis: Kate Middleton's rare pregnancy condition

by Ruth Nichol / 29 September, 2017
RelatedArticlesModule - Hyperemesis

Catherine, Duchess of Cambridge. Photo/Getty Images

The Duchess of Cambridge, enduring her third bout of morning sickness, is raising awareness of a debilitating condition.

Having had hyperemesis gravidarum during both her pregnancies, Joy Wadham says her heart goes out to Catherine, Duchess of Cambridge, who has been resting at Kensington Palace because of debilitating nausea and vomiting caused by her third pregnancy.

But the Wellington midwife also thinks a palace is a good place to be if you have hyperemesis: no childcare or work worries and a personal nurse to hook you up to the essential intravenous fluids used for rehydration.

“I wish I could have been taken care of at a palace,” says Wadham, laughing. “Although when you’re that sick, you don’t really care.”

Fellow sufferer – or “survivor”, as Wadham prefers to call herself – Wendy Harper agrees. “Hyperemesis is just as horrible for a princess,” she says.

Harper also had hyperemesis. After being blindsided by the condition during her first pregnancy, she was reluctant to go through the experience again. At 12 weeks, she was forced to give up work – she made it in only a few times before that – and during the rest of her pregnancy, she rarely left the house.

But eventually, the desire to have a second child overrode her fears. By the time she was seven weeks’ pregnant, in late 2015, she had such severe nausea that she could barely eat or drink, although she tried to avoid vomiting, because once she started, it was hard to stop.

Knowing what she was in for, she hired a nanny to look after her son and settled in for the long haul: extended spells in bed, punctuated by regular trips to her GP – or occasionally to hospital – to be rehydrated with intravenous fluids. She took an anti-nausea drug, ondansetron, which is used to prevent nausea during chemotherapy.

“I couldn’t really leave the house. I had to go out for medical appointments, but it was an ordeal. I had to stop the car a lot and get off the motorway, because I couldn’t keep driving.”

In the second half of her pregnancy, things settled down a bit and she no longer needed intravenous fluids. And as with her first pregnancy, she had a brief respite in the two weeks before the birth. “By then, it was more like normal morning sickness.”

Wadham, who was pregnant with her second child at about the same time, also needed regular rehydration. She took ondansetron and several other anti-nausea drugs, including metoclopramide and cyclizine.

“The reason you can take them all at once is because they work on different pathways in the brain to prevent nausea.”

She also drank Enerlyte solution to keep her electrolyte levels up, although she could tolerate only very small quantities at a time.

At about 14 weeks, Wadham stopped needing intravenous fluids, although she continued taking anti-nausea drugs until the birth. She also developed antenatal depression – a common complication of hyperemesis.

“This condition has quite a psychological impact on women as well as a physical one,” says Auckland obstetrician Gillian Gibson. “That side of it has to be recognised, because it can be 24/7.”

Gibson says about 3% of pregnant women develop hyperemesis. It’s thought to be caused by an unusual sensitivity to rising levels of pregnancy hormones in the first trimester, in particular human chorionic gonadotropin (HCG). No one knows why some women are more sensitive to HCG than others, although higher levels – as happens in a twin pregnancy – increase the likelihood of having hyperemesis.

Most hyperemesis sufferers notice a lessening of symptoms by the second trimester, when HCG levels start to plateau. A small number with persistent symptoms need nasogastric feeding and if left untreated, the condition can be fatal because of the metabolic effects of dehydration.

But as ghastly as it is, hyperemesis does go away. Even the most severely affected women get relief once they give birth.

“The good thing about it is that it’s not cancer, and it’s got an end point,” says Gibson. “I think that’s the only thing that gets women through sometimes.”

This article was first published in the September 30, 2017 issue of the New Zealand Listener.

MostReadArticlesCollectionWidget - Most Read - Used in articles
AdvertModule - Advert - M-Rec / Halfpage


How China’s skewed sex ratio is making President Xi’s job a lot harder
81865 2017-10-21 00:00:00Z World

How China’s skewed sex ratio is making President X…

by David Skidmore

As odd as it sounds, China’s economic policy is being held hostage by its heavily skewed sex ratio.

Read more
Allen Curnow: The poet who helped define New Zealand
81753 2017-10-21 00:00:00Z Profiles

Allen Curnow: The poet who helped define New Zeala…

by Sally Blundell

A new literary biography takes the measure of poet Allen Curnow, whose work helped define New Zealand’s voice.

Read more
Does sugar really cause kids' hyperactivity?
81849 2017-10-21 00:00:00Z Health

Does sugar really cause kids' hyperactivity?

by Marc Wilson

Parents blame sugar for causing kids’ hyperactivity, but the evidence suggests it’s not the culprit.

Read more
Minority Rules: Who will be the first voted off Coalition Island?
81921 2017-10-20 15:49:43Z Politics

Minority Rules: Who will be the first voted off Co…

by Jane Clifton

As a reality-TV show full of dramatic challenges, this new Labour-led Government has a lot going for it.

Read more
How to blend your TV into your interior style
81897 2017-10-20 14:13:55Z Technology

How to blend your TV into your interior style

by Noted

Most TVs are a central part of the living areas while at the same time, taking it over. Samsung's Frame TV hangs on the wall like a piece of artwork.

Read more
A play about Tinder, plus more upcoming Auckland theatre
81874 2017-10-20 11:49:18Z What's on

A play about Tinder, plus more upcoming Auckland t…

by India Hendrikse

Your guide to what's on now and later in Auckland

Read more
The decision's been made, what comes next for New Zealand politics?
81839 2017-10-20 06:58:41Z Politics

The decision's been made, what comes next for New …

by Richard Shaw

Expect some questions about how NZ forms governments, an angry National in Opposition and curiosity about political odd couple Ardern and Peters.

Read more
Bill English concedes: 'We all know the rules, we play by them'
81833 2017-10-20 06:15:01Z Politics

Bill English concedes: 'We all know the rules, we …

by RNZ

Mr English, flanked by his wife and senior party colleagues, appeared emotional towards the end of a short press conference accepting the decision.

Read more