Almost Five in a Hundred
Picture a small pair of white bootees on a kitchen table, bought early, in hope. Beside them, a glass of water she can't keep down. (This scene is illustrative. The numbers below are not.)
She wanted this baby. She still does.
But for weeks she has not been able to eat, or drink, or get through an ordinary day. This is not morning sickness. It is hyperemesis gravidarum, HG, and it can mean hospital again and again.
New HSE guidelines on HG, 129 pages with 40 recommendations, were published last week. One line stops you.
"Almost 5% of women with HG will terminate a wanted pregnancy due to severity of symptoms."
Almost five in a hundred. A wanted pregnancy.
The guidelines go further. Research they cite says HG can escalate to the point where a woman may consider ending her pregnancy, and may have thoughts of suicide.
And this: "Patients report a large contributor to distress is difficulty accessing treatment or feeling to have to fight for adequate treatment of their condition."
To fight. While you cannot keep down water.
Women who end a pregnancy because of HG, the guidelines say, are "three times more likely to describe their healthcare providers as uncaring compared to those who do not terminate."
So the guidelines ask for something gentle and overdue. "Healthcare professionals should adopt a holistic and compassionate approach to assessment of HG." Routine screening for distress, during and after pregnancy. Trauma-sensitive training for staff. Referral to perinatal mental health teams where needed. Adequate treatment, offered early.
Professor Brian Cleary of the Rotunda Hospital, a trustee of Hyperemesis Ireland, hopes they will "help women to access appropriate treatment earlier; and reduce the risk of severe illness and complications for both mother and baby."
Mother and baby. Both.
Health Minister Jennifer Carroll MacNeill said: "For women experiencing severe nausea, vomiting, or hyperemesis, the physical and emotional impact can be overwhelming."
Words on a page are a start. But The Journal also reports that pregnant women are finding access to perinatal mental health support restricted. A referral is only as good as the door it opens.
If a mother wants her baby, and only the sickness stands in the way, shouldn't we move heaven and earth to carry her through it?
Somewhere tonight a little one is growing, wanted, waiting. It cannot ask for help. It needs someone to hold its mother up, until it can be held too.
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