Pregnancy: Morning Sickness & Mental Health Struggles
This blog post discusses topics such as mental health illness and eating disorders which could be uncomfortable or triggering for some people. If you find the subjects in this article difficult to deal with please make sure that you share how you feel with someone. You can find support at BEAT, Mind and similar charities or by visiting your GP. Eating disorders and mental illnesses thrive in secrecy, don't be afraid to reach out if you're struggling,
I found out I was pregnant really early on (4w); I was experiencing bad pain in my back, what felt like terrible period cramps and an underlying feeling of nausea for a few weeks before I took a test. Even then I was shocked at the positive result and spent weeks not truly believing it.
I had never been one of those people who wanted to be a mother. Growing up I wanted to be an actress, this involved a 'no strings attached' kind of life, so marriage and kids was never something I really considered or particularly craved. As I got older and that dream didn't become a reality, I met my husband, fell in love and got married but a baby still wasn't on our agenda. Deciding to have a baby was a decision and a big one at that. My past struggles with mental health illnesses and eating disorders made me fearful; I thought I may not be able to have children because of everything that my body had been through & morally part of me felt like I shouldn't even if I could, just in case I passed on my "bad DNA" to my child. We talked about it and weighed it out but it came back to the fact that we wanted to have someone who was ours. So, despite the pandemic of 2020 I took my implant out and by October I was staring down at 3 positive pregnancy tests.
I never expected pregnancy to be a walk in the park, but I was surprised at just how much it impacted my mental health and brought up memories of having an eating disorder.
When I was 21, I was admitted into The Priory, an urgent intervention because my body had started to effectively shut down due to the constant punishment I put it through. My relationship with food had been on a decline since the age of 12 and I spent my late teens and early 20s not eating at all, eating and purging or bingeing and purging. I was diagnosed with bulimia in March 2011 after I collapsed but despite going through one round of day treatment I proceeded to get worse. So by November 2012 my potassium levels were so low that I was having whole body cramping and severe panic attacks, I was at risk of organ failure and was told that if something wasn't done there was a real possibility that I could die.
It's been 7/8 years since I was discharged and the more time that has passed the stronger I feel I've become in my recovery and personal growth. If I'm honest, I wouldn't have got pregnant if I still felt like I was at odds with my mental health or my relationship with food, I wouldn't have been ready. But despite feeling prepared and in a really good place mentally, physically and emotionally I was totally floored by that first trimester and more specifically- the morning sickness.
Between 70-80% of women experience morning sickness in their first trimester, only 1-2% experience Hyperemesis Gravidarum (HG) which is a rare form of extreme morning sickness, sometimes requiring hospitalisation. Thankfully I wasn't diagnosed with HG but that didn't mean that my morning sickness wasn't debilitating and mentally challenging.
First of all, “morning” sickness is extremely misleading. From week 6 it was an all-day job, no matter what I seemed to eat my body would reject it. I tried everything I could think of to stave it off but quickly all I could think about food and what I was or wasn’t managing to keep down. Some days were better than others and I'd be able to eat a meal but mostly, I was back in a state of what felt like total misery and chaos. It felt like nothing I did helped and not being able to tell people that I was pregnant made me isolate myself away from everyone because I didn't have the energy to put on a happy face.
It was a huge reminder of my bulimia; the sickness, preoccupation, secrecy, sudden hunger, fear, exhaustion, shame and guilt. At one stage I started questioning if I was starting to relapse -perhaps the sickness wasn't due to being pregnant and I was actually subconsciously using it as an excuse to go back to my illness? It really scared me as I hadn't questioned myself like that for a long time and the fact that I was struggling with these complicated thoughts and feelings only further challenged my mental health.
We decided to tell our parents at 8 weeks. I felt really torn between waiting to have the scan, something to hold that could really 'confirm' it and needing my Mum and Dad. I had imagined telling them in some fun imaginative way - full of excitement and happy tears. Not saying "we're having a baby" which was quickly followed by "and I am really struggling with it". Thankfully my Mum is a midwife and having my parents and in-laws in on the secret meant that I felt slightly reassured but because of lockdown we still weren’t able to see them properly so the feelings of loneliness and not coping continued.
By the time I went for my first appointment with the midwife I felt like I was at breaking point. I explained I wasn’t coping well, she was very kind and understanding and advised me to talk to my Dr about getting some anti-sickness medication. Meanwhile they would ask the perinatal mental health team to contact me, just to check up on my mood and see if I needed any further support. Unfortunately, the weeks following my appointment I didn't receive a phone call so I was left to fend for myself and deal with it as best as I could.
Dealing with morning sickness after previously living with bulimia brought up behaviours, old thoughts and feelings which I thought I had left behind.
When I was ill I would often be caught in binge/purge cycles that could go on for hours or even days. I would usually get to a point where I would be weak, shaking and exhausted, but then I’d feel like I had to have something in me, so I’d eat and subsequently trigger it all again. Over the years of treatment I learnt how to break those cycles and then not to enter into them at all, but the pattern of trying to put something in my body to help it to grow a tiny human only for it to be constantly rejected felt like being back at square one. The impetus behind it was different but the result was similar.
Googling "pregnancy with a history of bulimia" and "morning sickness after bulimia nervosa" for help was the worst idea I had. The online resources and papers that I found were all discussing the risks of miscarriage and the dangers of having an eating disorder whilst pregnant. There was no useful information, just stuff that made me even more petrified that I was going to kill my baby. Everything referred to the ED being in the present tense which really put me off- I didn't have an eating disorder again. I wasn't ill, was I?
The questions spiralled in my head constantly making me feel very low and my confidence in myself and my recovery was starting to slip away. I thought that when we had our 12 week scan I would feel some sort of relief; I'd see that the baby was ok, I'd feel a connection and I would start getting excited but when it came to it, I was almost too scared to believe that this little thing could survive the chaos that my body was going through which made me feel even more guilty.
Guilt and shame cause us to be less likely to admit when we are struggling and therefore reaching out for help can feel like a defeat instead of what it is: a positive step.
When we began to tell people about the baby I was scared of the judgement that I was going to be under if I said that I had been having a hard time with pregnancy. I know a lot of people who have really struggled with baby loss or even getting pregnant and I didn't want to appear ungrateful or selfish. However, one day I ended up briefly talking about how the sickness was making me feel on my Instagram stories and I was amazed at how many women reached out. Morning sickness is very common, disordered eating is also very common, so it shouldn't have shocked me that many others had dealt with experiences similar to mine - but it did. From women who struggled massively with their body image, to binge eating, to relapsing into an eating disorder. There were so many and hardly any of them had sought out help, either because they didn't think they classified as someone who could look for support, or for fear that they would be coined an 'unfit mother' and have to deal with the stigma surrounding that.
Staying silent and trying to cope on your own with the myriad of emotions and thoughts you have when pregnant can be really challenging, if I hadn't shared my own experience that day, I wouldn't have realised just how many others were in similar boats as me. That feeling of camaraderie may not calm the stormy waters that we are in, but it can definitely help us to navigate better and lets us know that we're not alone.
By my 16-week appointment with my midwife I was starting to feel like I was getting somewhere; I’d managed to find some coping techniques to deal with the constant sickness and I knew that I had some kind of handle on the negative thoughts and feelings that were playing on a loop in my head. My mood was still very low though and I asked for her to get in touch with the perinatal mental health team again who thankfully arranged an appointment 2 weeks later.
I'm so glad that I continued to ask for help when I needed it, despite the fears and misjudged feeling of failure that it brought.
As my pregnancy has gone on, thankfully things have improved - I even have some days where I'm not sick at all, others it may only be once or twice. On the days where it is bad, I lean on some of the techniques that I have added to my mental health toolkit over the last 7/8 years as well as using the resources that I've been provided with.
The main reason that I wanted to write this blog post and share my experience is because I didn't want someone else to feel as low and isolated as I did. Being pregnant can be the most incredible experience of a woman's life, but it can also be the most challenging, scary and lonely period too. It's important to know that it's ok to feel both. If you are someone who has had previous experiences with eating disorders and mental illness please know that you’re not alone. Make sure you give yourself permission, the time and space to figure out how you're feeling, welcome all of your emotions and don't be afraid to reach out and ask for help. There are some helpful links at the start of this blog post or you can talk to your midwife or GP.
