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The Duchess of Cambridge’s ‘quite horrible’ condition must be treated quickly

Almost as soon as news broke that a royal bundle of joy is on the way, the scoffing over the Duchess of Cambridge's hospitalization for severe morning sickness began. The gist of the social-media commentary? She is a weakling who cannot handle a little nausea.

But the reality is that the duchess is dealing with a severe form of morning sickness called hyperemesis gravidarum (HG) – and the derision over her illness demonstrates that the public does not recognize the seriousness of the condition.

"It can be quite horrible," said Gideon Koren, director of the Motherisk Program based at Toronto's Hospital for Sick Children. "If they're not in good hands, it's not rare for women with HG to ask to terminate a pregnancy because they cannot continue this way."

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Dr. Koren and others in the medical community say that "morning sickness," a catch-all term used to describe nausea, vomiting and fatigue during pregnancy, particularly the first three months, is not well understood, which can lead to accusations women are making up or exaggerating their condition.

To combat these erroneous assumptions, many have moved away away from the term "morning sickness" and instead refer to the condition as nausea and vomiting in pregnancy (NVP). Anywhere from 50 to 90 per cent of women will experience some form of NVP during pregnancy, which is caused by hormonal changes, said Jasmin Tecson, a registered midwife in Toronto.

But HG, a severe condition, is much rarer, and occurs in 1 to 2 per cent of all pregnancies. Women with HG are typically so nauseous they cannot keep fluid or food down, which can lead to dehydration. The continued nausea only exacerbates the condition, because they cannot take standard medication to treat the symptoms, said Ellen Giesbrecht, head of the obstetrics and gynecology department at B.C. Women's Hospital and Health Centre in Vancouver.

HG is common among women pregnant with multiples, but this doesn't mean Kate is expecting more than one baby.

If left untreated, HG can lead to severe dehydration and kidney failure. The condition must be quickly treated to prevent serious problems, Dr. Koren said. Treatment may include intravenous fluids and anti-nausea medication.

It's worth noting that NVP is a sign of a healthy fetus because it indicates the presence of pregnancy-related hormones.

For years, women have heard that they should just "deal with" nausea and vomiting in pregnancy, Dr. Giesbrecht said. But that's an outdated way of thinking, she said, adding that safe, effective medications are available.

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"You don't just have to grin and bear it," she said. "There's no need to have to just live through it."

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About the Author

Carly Weeks has been a journalist with The Globe and Mail since 2007.  She has reported on everything from federal politics to the high levels of sodium in the Canadian diet. More


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