HG, despair and a new career

How HG tried to destroy me and instead birthed my business

My first pregnancy was the first time that I ever really doubted my ability to survive.

My husband’s best attempt at a photo of me while pregnant. Thank goodness for the cats…

Throughout my life I have always carried with me a little optimistic voice that nudges me forward. In my head she looks like a sparrow (definite Snow White vibes) and she has chirped away with relentless energy and positivity through multiple failures, losses and world upending shit storms. She isn’t perfect, she doesn’t know anything about the nervous system or acknowledge my need for rest but she does always suggest to me a “next best step” and she maintains 100% confidence that I will be successful. I credit my sparrow for my ability to survive the military spouse lifestyle and to design, and re-design my business around the changing needs of my neurodivergent children.

When I became pregnant she fell silent.

Hyperemesis Gravidarum killed my sparrow

My pregnancy hit me harder than I thought it was possible to be hit. Hyperemesis Gravidarum struck me before the positive pregnancy test with relentless nausea that never gave me a moment of solace until the birth of my daughter and at least 6 months (who was counting) of vomiting everything I ate or thought about eating. Prior to pregnancy I had been fortunate enough to not realise that you could feel that sick, let alone for that long.

Within days my mental health had started to suffer and I understood why all the analogies for depression reference blackness; I literally felt my colour and vitality draining away. Through those early weeks my little sparrow kept on tweeting in my ear but her voice became thinner and more strained as I physically and mentally diminished. Each day of lying on the sofa without purpose, meaning or any sort of pleasure weakened us both. As I approached week twelve, the point where you are “supposed” to start feeling better I felt my little optimistic sparrow die. She didn’t desert me she died from lack of nourishment.

Making sense of the darkness

It was a very visceral and all-encompassing experience and at the time I had no space for reflection. However, when I emerged from the darkness I began to try to use my knowledge as a clinical psychologist to make sense of why HG was so harmful to my mental health. These were the things that stood out to me:

Firstly, the brain is engineered to focus on things it thinks require your attention to ensure your survival. Nausea is one of those things that requires your attention because you need to find a safe place to be sick, and you need work out if you have been poisoned to ensure you are safe. This hyper focus on the AWFUL sensation of nausea obviously makes it impossible to experience any kind of pleasure. I could be looking at the most beautiful view and smelling the freshest of air and I would detect nothing other than whether the bush over there looks OK to vomit in. Life with HG was therefore devoid of any pleasurable experience.

On top of the focus on nausea the intrusive thoughts about the worst case scenario for me and the baby, and whether I could continue with the pregnancy were relentless. As I’ve talked about in other articles, I understood that these thoughts were my ancient brain trying to warn me about potential danger but they were dark, loud and scary nonetheless. There was also no good reason for them to stop. I couldn’t reassure myself that no harm was coming to my baby because I instinctively knew that being unable to eat or drink was a bad thing (even if doctors wrongly told me it was fine) and I genuinely doubted my ability to continue the pregnancy to term. Ending a much-wanted pregnancy is a tragic but necessary step that many women with HG have needed to take. It really is that bad and I felt I was clinging to my resolve to continue by my fingernails for much of the pregnancy. You can imagine the thoughts I had about myself and the damage it did to my previous belief in myself as a “resilient person.” I never had thoughts of harming myself but I do not find it difficult to empathise with those who do.

HG also instantly robs you of anything that might give you meaning, purpose or a sense of idenity. I was somebody that loved running, yoga, reading and, most importantly, I loved my job as a clinical psychologist in the NHS in a busy learning disability service. Thanks to HG I couldn't do any of those things for months. It is not surprising really, that my mental wellbeing absolutely tanked, who am I if all I do is lie on a sofa being sick? All the stories I had in my head that made me a worthwhile person had disintegrated.

Broken by the system

Perhaps the worst impact of HG for me was that it made me feel utterly unimportant. The NHS, the organisation I worked in, the system that I had dedicated my career to and thought I would spend my whole life working within… it didn't care.

I went to my GP and I was as honest as it's possible to be with another human being about how terrible I was feeling. I'm quite articulate. I think I phrased it quite nicely. And she was not tempted to do anything about it. She didn't even do anything medically about it. A common criticism of GPs is that they are only interested in the physical side of health. That was not the case. She was not interested in the physical side of my health or my mental health. She just wanted me out of her office an on the way to the shops to buy some ginger biscuits.

I now know being much better educated on the subject of HG, that I should have been offered hydration and nutritional support at a minimum and that when antiemetics taken orally didn’t work I could and should have been offered alternative methods. Because being unable to eat and barely able to drink for 9 months is, in fact, pretty bad for you and your baby (never would have guessed). But, like many women, I was only offered a drip when I collapsed and even then the minuscule droplet of kindness was administered with stern words and impossible dietary advice.

Sidenote - if you are going through HG right now or you know someone who is you must listen to the episode of Pregnant and Sick I recorded with Dr. Andrew Householder because in that he describes what good care should look like and what you need to say to get proper care.

It is probably obvious from my description that I think it would be impossible to go through HG and avoid depression, anxiety, or trauma. Yet no one ever asked me about my mental health. In fact, as I was an NHS psychologist and therefore more confident than most, I asked for a referral to perinatal mental health services. I was told that I didn't meet the criteria.

I tried to refer myself to primary care counselling services. Again, I didn't meet their criteria, and when I queried this I was told that I wouldn’t get help because I knew why I was depressed. And because I was so incredibly sick and so incredibly far from the person that I am today, I just took that nonsense and decided not to do anything with it at all.

So I just lay there and suffered while my psychology became a cocktail of despair.

The birth of a baby and a “healthpreneur”

My story with HG had a relatively happy ending. I was very fortunate because when my baby was born the nausea lifted and I instantly felt like myself again. It was like my sparrow fluttered in through the window, rejuvenated after a wintering somewhere with sunshine and plenty of worms.

Not everybody has that experience. Often the trauma of what they've been through means that people can experience ongoing mental health difficulties for a long time after the pregnancy, especially when they've had invasive treatment, experienced birth trauma or their baby has been left with life altering conditions or injuries as a result of the poor care that they received. I appreciate how lucky I was that I walked away from that experience with a feeling of energy and relief.

That experience changed the direction of my career. HG is a condition that shows up all the flaws in our healthcare system. It is a mess of reactive, inadequate mental and physical care and it emphasises the devastating role of unconscious bias and postcode in access to good quality healthcare.

Since my own experience, I have been part of a research team studying the impact of HG. Our first paper has just been published in Midwifery (its Open Access so you can read it here). One of our key findings was around the importance of good quality care from properly educated professionals. Where women were heard, validated and taken seriously, their mental and physical outcomes were better. But unfortunately, many MANY women were dismissed, denied treatment and made to feel shame for their sickness. Depression and anxiety are a rational, self-protective response to a system that is often cruel and inadequate.

My experience with HG is the reason I have never been happy to just offer therapy to my clients. Therapy is rewarding work and it is a privilege to see someone step back into themselves as they recover from depression, anxiety or trauma. But as a Clinical Psychologist, I can’t ignore my lived experience that our society and systems often create mental distress. We can’t yet stop people from developing HG but we can do better at supporting them through it mentally and physically. Exhaustingly, my experience as a parent of children with SEND teaches me the exact same lesson.

If we seriously want to improve parents’ mental health, then we have to take action to support them better, right the way through the fertility journey, pregnancy, birth, and parenthood. That knowledge has been the driver behind both my businesses over the past 8 years and it is why I have recently founded a new tech start-up that I hope will enable real change in the way HG and other perinatal conditions are treated.

Who am I to be a founder?!

As a female founder of a startup, I have been told by everybody that I don't have any of the prerequisites to make this a success, I'm not young enough, I'm not free enough, I don't have enough money, I don't have enough childcare, I don't have enough stability. I don't have anything that the textbooks think you need to be a successful entrepreneur. But frankly I have heard that before and my sparrow disagrees. My co-founder and I are both women who don’t believe the current system is acceptable and we are passionate about getting people the right care at the moment they need it. So I intend to prove that if you have enough compassion, hope, and energy, you can defy the odds and create something that changes the world. Because we absolutely have to.

Join me for compassion, hope and energy

If you'd like to join me on my journey as a female founder of a tech start up with a MUCH less than ideal life, read these more personal reflections and gather up some compassion, hope and energy for your own ventures please pledge your support to receive my monthly “secret diary of a female healthpreneur”.

As these essays are so personal I’m not going to make them available to free subscribers. The audience there is too big and scary and I know that some people are here for the mental health or business tips and won’t be interested in this stuff. I’d rather share these reflections only with a smaller group who know they will benefit from a monthly boost of energy, hope and compassion through my reflections on navigating the struggles of parenting SEND children, military life and founding a tech start-up. If that is you please come on in, I want to get to know you properly so we can change the world together.