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Pregnancy, Hyperemesis Gravidarum and the Rule of 20

Updated: Mar 8, 2021

Advice from Nisha: Feel in control by locking in your support system.

Pregnancy is hard. First pregnancies are harder. Having hyperemesis gravidarum (“HG”) is even harder. Balancing a demanding job, and in my case, a new and demanding job with HG is even harder.

Heightened hormones, bodily pains, fatigue, scary amounts of puke you didn't know you were capable of producing, resisting the urge to defenestrate your partner... all true, but we tend to overlook that pregnancy is also hard because people often times feel powerless. For me, albeit a joyous occasion, pregnancy was the first time in my life where I felt as if I had limited control over something so important. It was really scary.

For me specifically, pregnancy was really rough. I had an odd blood type and hence, my insides tried to attack my baby – sorry, Mia. I had an extreme version of morning sickness called HG – Mia’s retaliation from the above. My low platelets prevented me from receiving drugs during labor unless I took an A-Rod level of steroids. Finally, I quite literally had a pain in my ass (sciatica). What’s the sitch with HG? The rule of 20 – You hurl 20+x a day and lose 20+ pounds by week 20 of pregnancy, or more commonly known as “what Kate Middleton and Amy Schumer had.”

By the way, do you have any idea how annoying it is to be pregnant at the same time as Amy Schumer? People would share her Instagrammed IV pictures and I’d wonder 1) why do you think this is helping me and 2) does Amy get a better IV rate than my $200/session?

I had IV 3x a week over 20 weeks because I was unable to keep anything in my stomach. Except for the occasional Thai Iced Tea. I recall starting my new job and wanting to make a strong first impression in week 6, and ultimately vomiting three times by the time I passed security on my first day. My desk location was suboptimal, being the farthest distance from the bathroom, which I would come to know as my second home for the next 14 weeks. For someone who loves food, the overall experience was brutal. Frankly, I was mostly worried about myself, not the lima bean-sized demon fetus inside me that was causing me all this pain. The worst was that Nick tried cooking every possible meal type and every day, I would look at his puppy dog eyes and disappoint him once again with a hurl and a side of snide remarks. By Week 10, I had lost 10 pounds and was the skinniest I had been in 15 years – and I went to high school in California where eating disorders were all the rage. I tried addressing HG through a variety of drugs recommended, acupuncture and every possible food. For the record, my acupuncturist added insult to injury by stating that this was my body’s way of rejecting my baby – thanks, dude.

When did I finally break? Week 19 (hour 1), when I realized I had no control over my body and its acceptance of food. I had no control over my future labor. I had no control over the tiny human that was expected to come out of me with their own mind and personality.

When did life improve? Week 19 (hour 10), when I explained my feelings to the people that I needed support from and realized how lucky I was to have a partner like Nick. Things turned around when I finally admitted to my loved ones how broken and out of control I felt. In some weird way, admitting this and asking for help was a means of taking back control. And, as one would expect, the third trimester was much better as I was vomiting less, actually feeling baby kicks and seeing the light at the end of the tunnel.

My advice? Put what you can and cannot control into buckets. This is one of those times where the significant stuff largely falls into the latter, so focus on those few areas you can control. You can control who you bring into your support system, how you work with your partner and truly become a team and how to mitigate whatever you are going through. I have a 43-step process for dealing with nausea, so reach out to me any time. Take solace in the being able to control some of the smaller things.

You can control your push playlist and you can control the color scheme of your nursery.

You can praise yourself for enduring the many ways in which your body is testing you. You can prevent negative self-talk. It’s easy to believe the dishonest women that claim pregnancy was blissful. The same women that post beautiful pregnancy bump pictures on social media also tend to read and sing to their bump, claiming this will positively impact the baby once born (as if I wasn't nauseous enough already). By the way, that’s not science – don’t believe it. But it would have been hilarious to see the bullpen’s reaction to me singing “Mo Money Mo Problems” at 9PM every night in the office. Try not to let yourself get down on feeling behind on parenthood. Spoiler alert – all those people reciting lessons from parenting books have no idea what they are doing either! You don’t know what you don’t know, but you can rely on your support system to provide guidance on labor, newborns, logistics and much more.

And if you have HG, the reality is, sometimes all of this isn’t enough and you just have to wait for those days to pass by. I promise, the good days come back.

If you or your partner are considering getting or already are pregnant, wishing you all the best on your beautiful journey. If you are struggling with a hard pregnancy or HG right now and want to talk about it, hit me up!

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