Wishing the Duchess a Woo Free Pregnancy

It was announced today that the Duke and Duchess of Cambridge, William and Kate are expecting their first child.The couple had hoped to keep the news to themselves for a little longer but the Duchess being admitted to hospital with hyperemesis - severe sickness �" meant that the story was broken early to avoid press speculation.

“Morning sickness” is common in the first three months of pregnancy and can occur at any time in the day. For some women though, it can turn into morning, afternoon, evening and night sickness and seriously threaten their health and that of the developing foetus. Hyperemesis gravidarum, the “pernicious vomiting of pregnancy” affects between 0.3 and 2% of pregnancies to some degree, according to The American Journal of Perinatology.At its worse, hyperemesis can cause gagging and vomiting on even one's own saliva and milder cases may be utterly debilitating.

Of course, Kate's condition has lead to a great deal of speculation. Could the Duchess be carrying more than one heir to the English throne? While it's possible, the fact that she is suffering from hyperemesis (and yes, suffering is absolutely the right word �" I speak from experience on this one) is not an indicator of twins or more, though increased morning sickness within a reasonable range can be. Though, traditionalists among the British may like to note that some studies have shown the risk of hyperemesis to be increased when carrying at least one male foetus.

" pregnancies withmultiplemale fetuses, and male and female combinations were associatedwith statistically significantincreasedrisk of hyperemesis."

In most cases, hyperemesis can be remedied with anti-emetic medication or steroids though it may recur and parenteral fluids required to prevent dehydration. Naturally, there are plenty of alternative remedies being touted as the cure for this awful condition. On even cursory inspection, it is clear that what the purveyors of herbs, nostrums and the rest think of as hyperemesis is nothing more than morning sickness. From the very first result yielded by a Google search for "natural remedies for hyperemesis" I quote:

Get a group of pregnant mothers together, and ten to one they will start comparing their hyperemesis (morning sickness) symptoms and discussing various hyperemesis remedies. That's because about eight out of every ten pregnant women are affected my nausea and vomiting to some degree. While many pregnant women only have to put up with this problem for a few weeks early in their pregnancies, others will continue to experience hyperemesis symptoms all the way up to the beginning of the third trimester of their pregnancy.

That's really not the same as heaving on your own saliva for thirty plus weeks now, is it? About.com's pages on alternative medicine, though a little more professional looking, make similar errors. They do love a bit ofacupunctureover there and claim that:

One study looked at 88 pregnant women with hyperemesis, a severe form of morning sickness. Women received either an anti-nausea drug called metoclopramide or twice weekly acupuncture sessions for two weeks, plus acupressure. Both treatments were found to reduce nausea and vomiting intensity.Acupuncture was more effective than the drug in improving psychosocial functioning.

Of course, there was no link to the actual study nor a proper citation so I had to use my Google-fu and here it is:Acupuncture versus pharmacological approach to reduce Hyperemesis gravidarum discomfort.Now, I'll be honest, having read the the summary, I thought $50 to be a bit steep to get past the pay wall but here is what is obvious from what I could read. Where acupuncture seemingly outperformed medication was in the rather subjective "functioning" criteria, defined in this study as

"the ability to achieve the daily routine activity"

Could this simply be accounted for by a woman adapting to her sickness? It is important to note that most women who suffer hyperemesis do not do so throughout the entire pregnancy. This study was conducted over a number of weeks so it is entirely possible that the women in the study (in both the acupuncture and the medication groups) could have simply been experiencing a tailing off of their symptoms. Notably, there is no control group in this study with which to compare either or both treatment groups. That the lessening of the women's symptoms might be a function of time and nothing more is suggested in this statement, which throws up (pardon the pun) more issues with this study:

" The effect of acupuncture seems to be progressive, increasing at the end of treatment whereas pharmacological approach has a prompt effect in responders remaining stable thereafter."

So, medication gave women with hyperemesis prompt and lasting relief but acupuncture only relieved their symptoms eventually? Hmm. The poor souls thrust into the acupuncture group suffered needlessly from their health endangering sickness for weeks. That doesn't quite bear out this concluding statement:

"In our study for the first timeacupuncture, applied accordingly to Chinese formula, was compared to drugs demonstrating the same effect of both treatments on HG symptoms."

Though rare, hyperemesis can have devastating effects on maternal health and perinatal outcomes. Some women grow so dehydrated and malnourished that termination of the pregnancy is advised. Severe hyperemesis is associated with low birth weight, prematurity. pre-eclampsia and five minute apgar scores below seven. Even so, pitifully little research is being done on the condition. Though I wish the Duchess a speedy recovery and a much more pleasant continuation of her pregnancy, her illness has served to highlight what some women go through during pregnancy and may encourage others to seek help earlier should they experience the same.

Support

TheHelp H.E.R Foundation offers support for women suffering with or who have gone through hyperemesis gravidarum.