One common complication among expectant mothers is morning sickness, characterised by nausea and vomiting, which normally happens within the first four months of pregnancy.
Women do not usually worry about it as it wanes gradually during the progression of the pregnancy.
The condition can also be prevented or effectively managed with supplements, anti-nausea medication and natural remedies such as choosing foods carefully, drinking plenty of water and paying attention to triggers.
Pregnancy comes with a myriad of life changes for different women. Some enjoy a smooth ride while others suffer from complications that dampen their experience.
One common complication among expectant mothers is morning sickness, characterised by nausea and vomiting, which normally happens within the first four months of pregnancy.
Women do not usually worry about it as it wanes gradually during the progression of the pregnancy.
The condition can also be prevented or effectively managed with supplements, anti-nausea medication and natural remedies such as choosing foods carefully, drinking plenty of water and paying attention to triggers.
These measures work for a majority of women with mild or normal morning sickness. But the story is different among expectant mothers that suffer from severe cases of morning sickness, which may exist for longer periods.
Doctors usually walk with them during the journey, recommending a combination of remedies to alleviate the suffering and enable the mothers to carry their babies to term.
While these remedies or treatment interventions are important for tackling the adverse physical symptoms brought about by the condition, health experts urge doctors to also pay attention to the hidden mental health consequences of severe morning sickness that can take a toll on affected mothers.
A new study published in the BMJ Open Journal shows that severe morning sickness increases the risk of depression, both during and after pregnancy.
The condition (known medically as hyperemesis gravidarum) is a debilitating ailment that is far more serious than normal morning sickness.
Indeed, it is one of the most common reasons for hospitalisation during pregnancy and can continue right up, until birth.
Affected women usually require bed rests for weeks to cope with the condition. Worse still, they also tend to suffer from dehydration and weight loss, which makes them weak and unable to engage in daily life activities.
The novel study, conducted by the United Kingdom’s Imperial Health College London and the National Health Services (NHS) researchers, found that nearly 50 per cent and 30 per cent of the women with severe morning sickness ended up suffering from antenatal (before birth) and postnatal (after delivery) depression respectively.
On the contrary, among women without the condition, only six per cent experienced antenatal depression, and seven per cent suffered from postnatal depression.
Dr Nicola Mitchell-Jones, the lead author of the study, noted that the psychological impact of severe morning sickness is often not taken seriously enough by healthcare professionals and the wider public.
“Our study shows that women with the condition are more likely to suffer antenatal and postnatal depression. Some women even had thoughts of self-harm due to the suffering,” said Dr Mitchell-Jones, who is also an obstetric gynaecologist
“These figures are shocking and should be reflected in the treatment women receive. We need to do much more than simply treat the physical symptoms of severe morning sickness. As such, assessment for mental health support should also be routine for any woman with the condition.”
During the study, the researchers recruited 214 women in their first trimester of pregnancy across three London hospitals — Chelsea and Westminster Hospital NHS Foundation Trust, Queen Charlotte’s and Chelsea Hospital, as well as St Mary’s Hospital.
Half were recruited on admission to hospital with symptoms of severe morning sickness. A similar size control group, without significant nausea or vomiting, were recruited through a midwifery-led antenatal clinic.
The women were assessed for their psychological well-being in the first trimester of pregnancy and six weeks after birth. None of the study participants had been treated for mental health conditions in the year preceding the study.
Among the women with severe morning sickness, about 49 per cent experienced depression during pregnancy compared to just six per cent in the control group.
Besides, just seven per cent of the control group had postnatal depression, compared to 29 per cent in the group with the severe morning sickness.
Half of the women with the condition were forced to take four or more weeks off work during or after pregnancy.
Although the study found no direct link between severe morning sickness and maternal-infant bonding, other research has shown that depression can have a negative effect on this bond.
heart-breaking
The findings of the new research showed that eight women recruited to the study with the condition terminated their pregnancies, despite originally expressing a desire to keep the baby.
“Although we can’t say that severe morning sickness was the main reason for those decisions, it may certainly have played a role which is heart-breaking,” said Dr Mitchell-Jones, who herself suffered from the condition during her first pregnancy in 2018.
“I was in and out of hospital, spent nearly six months in bed - but I was lucky enough to have a supportive employer and family.”
“Many women can’t afford that amount of time off work or are stay-at-home mums with young children to care for.
“Too often their partners, relatives or work colleagues are not providing the support they need because they fail to understand the severity of what these women are going through. We need to educate them, as well as healthcare professionals.”
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