Survival Guide for Family & Friends

Taken from here (it’s so good that it deserves a re-publish)

This guide endeavors to provide family members and friends with helpful ideas for helping a woman with hyperemesis gravidarum. Your support is crucial to her coping and recovery.

Pregnant women with hyperemesis gravidarum (HG) as well as their families and 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. 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 and fluid intake by any means possible.

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) and malnutrition only worsen HG.

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.
   Mothers with HG often are unable to tolerate the following:
   • Blinking/bright lights
   • Sight/thought/smell food (e.g. TV, others eating)
   • Noise (e.g. TV, kids)
   • Toothpaste
   • Motion
   • Standing or sitting upright
   • Empty stomach
   • 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 the extra motion, and may even be unable to shower daily.
   • Pressure on her stomach
   • Stimulation of gag reflex (e.g. swallowing pills)
   • Riding in the car (See Homeopathic Remedies.)
   • Vitamins (esp. with iron)
2. Be aware of what may make her feel depressed, guilty, anxious and/or frustrated and try to proactively resolve or minimize their influence:
   • Lack of understanding & support from others
   • Inability to take vitamins, or eat healthy
   • Taking medications perceived as risky
   • Missing out on the “fun” of being pregnant
   • Loss of a “normal” pregnancy
   • Lost work days or quitting work
   • Putting life “on hold” for many months
   • Longing to eat and drink normally
   • Money expended on care and support
   • Lack of energy and severe fatigue
   • Irritability and lack of enjoyment in life
   • Memory loss or inability to think clearly
   • Burden of care and time on others
   • Lack of socialization (i.e. isolation)
   • Inability to prepare for birth/arrival of baby
   • Inability to care for family and home
   • Wanting to terminate the pregnancy to end the misery
   • Other’s perception that HG is only in her mind
   • Loss of hope that nausea will cease before birth
   • Fear of painful treatments or being force fed
   • Reluctance of doctors to treat due to cost or liability
   • Weight loss or inadequate gain for gestational age of baby
   • Fluctuating emotions due to hormones and illness
   • Sense of inadequacy and failure at being unable to cope or function
   • Fear of harming baby or more difficult birth
   • Fear of morbidity or death
   • Difficulty bonding with baby
   • Lack of energy and socialization for kids
   • Lack of excitement about baby’s arrival
   • Dreading the prolonged recovery time
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 or guilt. Read about the impact of HG.
   • If possible, avoid major stressors such as moving until she has fully recovered from HG and birth.
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 (“birth doulas”); or experienced in providing postpartum care (“postpartum doulas”) such as mother and newborn care, breastfeeding support and advice, cooking, child care, errands, and light cleaning for the family.
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 feelings 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 ineffective or inadequate, be assertive in seeking other options and/or doctors.
   • Before she goes in for a GTT (glucose tolerance test), discuss with her health professional the use of apple juice or jelly beans (documented in published medical research) instead of Glucola. The results will often be more accurate since women with HG often cannot tolerate Glucola.
   • Consider buying Ketostix – sticks to dip in urine (like at the OB office) to test for Ketones, an indication of dehydration, starvation, and the need for IV hydration.
     (Offsite Resources: What is Ketosis? or DrugStore.com)
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 fresh fruit or vegetable juice, 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.
9. Hire cleaning, cooking, and childcare services as needed to give her time to heal and rest.
   • Continue this postpartum until she is able. It can take several months to recover, especially if HG continues into late pregnancy.
   • Remember this is a short period and it’s critical to help as much as you can.
   • Avoid cleaning products and foods with strong odors.
   • Accept all offers for help, as well as food preparation unless the smells bother her.
   • Make others aware of her food aversions and eat aversive foods away from her as needed.
10. Understand a women’s need (even postpartum) to discuss her experience with 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 she is anxious or severely depressed (i.e. her depression is interfering with her ability to care for herself and her family). See Postpartum Recovery for more info.
    • Avoid making her feel weak for struggling physically or emotionally.
    • Remember, she was sick for 6-9 months, it will likely take that long and maybe more to recover fully.
    • You may want to read the following offsite article by Bessel van der Kolk: The Body Keeps The Score: Memory and the evolving psychobiology of post traumatic stress