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From someone who's been through it: Kate's hyperemesis gravidarum is very real

Advice to Kate Middleton: You’re not alone, and the nausea does eventually end. In the meantime, go ahead and lie in the dark.


When I saw the news story about Catherine, the Duchess of Cambridge, being hospitalized with hyperemesis gravidarum, I sent it off to four friends scattered between Kuala Lumpur, Stockholm and Canada. In our various corners of the world, we were united in an uncharacteristic bit of sympathy for Middleton, for we know her pain: All of us have suffered as she is currently. We know it is an almost unimaginable misery, and we suspect that to compound it, she is surrounded by people telling her to just have a ginger ale and another saltine and she will be fine.

"Severe morning sickness," dear reader, does not do it justice. For the first months of my pregnancies, the world pitched and roiled and heaved. I could tolerate no food, or the smell of food. I don't mean that I was a little pukey. I mean that I spent 50 days curled up motionless in the dark under a blanket, unable to bear rolling over at even a glacial pace. I lost five kilograms in a couple of weeks. I could not speak, I could not open my eyes, and when a sympathetic friend crept in to see me, the undulating pattern of her black-and-white striped pants triggered a round of heaving.

Abandoning my preconception plan to steer clear of pharmaceuticals while pregnant, I tried every drug, not that that took long – morning sickness, plague of the life of millions of women, is still treated with the drugs they offered my mother in the 1970s.

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No drug worked. They rarely do, one nurse admitted to my friend Stephanie on her third or fourth hospitalization for hyperemesis, but doctors like to try because it makes women cling to hope.

In what I suppose was a silver lining of my own version of "severe nausea and vomiting of pregnancy," or SNVP, as I soon learned to call it, I rarely actually vomited. I just almost-vomited, all day and all night. On the upside, I didn't dehydrate and need intravenous fluids. Downside – you know the relief when you know you're going to vomit, you can feel it coming, and then you do, and once it's done you feel better? Yeah? I never got that. I spent four months perpetually, constantly, always, just about to vomit.

Meanwhile, I was surrounded by chipper pregnant women or new mothers who said, "Oh, I had morning sickness! I threw up four times!" And then asked if I had tried ginger ale and saltines. "Green apples really worked for me." Fewer than 2 per cent of pregnant women suffer from SNVP, and until this week it was almost unknown to the rest of the world – which means that pretty much everyone suspects that a woman who lies in the dark sobbing, but being careful not to move while she sobs, is maybe being a teensy bit dramatic. And should have a saltine.

I tried green apples, ginger slices, acupuncture, and a vile concoction from a maniacal practitioner of Chinese medicine. I tried every folk remedy anyone's grandmother had suggested, and every one I could find on the Internet. I stopped brushing my teeth, which a midwife told me was often a trigger. (Nothing nicer than a vomity woman who hasn't brushed her teeth in two months.)

Many women have some nausea while pregnant. They throw up, they can't eat the foods they usually love, they feel lousy. Women with what Kate Middleton has can vomit without interruption for hours. They dehydrate severely, they often need hospitalization (but many don't get it, due to ignorance of the condition). And they are overwhelmed with despair. At one point a kindly obstetrician, moments after admitting she could do nothing for me, told me about a study showing that sick people who experienced both severe pain and severe nausea said they would choose the pain, every time.

One friend told me about her aunt who had SNVP, and who found a technique that brought a tiny shred of relief: She lay on the cold tile of her bathroom floor and yelled, "Please, God, let me die! Just let me die!" This did more for me than anything else.

Regular morning sickness is associated with the first weeks of pregnancy, but SNVP can continue for all 40 weeks. Mine let up enough that I could work in the later months of my pregnancies; also, I became used to living with the constant sense that I might vomit at any second. I had to have an emergency banana in my handbag at all times, and I had to forfeit dignity: When the waves of nausea overcame me, I would lie down, right away, flat, and no matter whether I was in a grocery store in Johannesburg, or the office of the chief of the anti-Maoist commando squad in rural India.

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When my first child was born and the midwife placed him in my arms, I felt not the rush of joy some of my friends had described, or the rush of alarm others had, but only the realization that it was gone – it was gone! In an instant! The vomiting feeling – gone! It was like being given back my soul, like that moment in The Wizard of Oz when everything turns to colour.

My SNVP-survivor friends and I briefly discussed sending Kate a crate of sour apples – a little hyperemesis humour there, folks. But really, what I would like to tell her is this: You're not being melodramatic, and it ends. And it will seem worth it, eventually – but for the next while, this is going to seem like the worst, most terrible idea you ever had. Just lie still, and let yourself cry.

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