Wednesday, August 15, 2012

Preparing for Another HG Pregnancy

I had hyperemesis with my first - and as yet only - pregnancy.  According to my doctor and research, however, I have a very high likelihood (60-70%) of having it in future pregnancies as well.  Since I gave birth 21 months ago, I have been preparing myself for another pregnancy.  The physical preparations are pretty simple.  The emotional and psychological preparations are not.

Here is a list of things to do to prepare for another HG pregnancy.  I have compiled this list from the list here from the Help HER website, as well as feedback I received from other HG mothers when I asked them what they thought would be good to do in advance.  I have split it into several categories for the sake of clarity and organization.

CHILDCARE

If you have older children, be sure that they are taken care of.  Have a rotation of friends and family look after them, but keep in mind that they will sorely miss you.  For younger children, consider having a basket of quiet activities to keep near you so that they can play near you and with you if you are up for it.  For older children, let them know that you are willing to listen whenever they want to talk and ask them to come sit with you and tell you about their day each afternoon.  See if there are any activities you can do together while you lay down.  Board games?  If they are in a sport/dance/play/whatever and you can't make it to their performances or events, have someone videotape it for you and make sure to watch it with your child afterwards.

For pre-school-aged children, consider getting together with other mothers for a round-robin playgroup.  If there are five children then each mother has the children only one day a week.  Perhaps you can get a family member or friend to be at your house the day the kids are 'yours' and run the activities and take care of them.  It would even be worthwhile to hire someone to help, if that is a possibility.

HOUSEHOLD

Make sure that you aren't planning a move for the next year or more.  Moving while pregnant sucks, especially if you have HG.  Take if from me.  I did it.  DON'T DO IT.

Stock up on EVERYTHING beforehand.  Your husband/significant other will be so overwhelmed just with taking care of you and trying to keep things somewhat sane that you don't want to add extra stresses.  Stock up on all non-perishables, and if you have a deep freeze you can stock up on some frozen goods as well.  Don't forget about things like toilet paper, soaps, cleaners, clothing, etc.

In all your stocking up, try to avoid anything perfumed or otherwise scented as this can be a trigger for vomiting.

Cook and freeze in advance.  Again, a deep-freeze is good for this because the food keeps longer.  Store the food in containers that are the correct size for one meal for how ever many people are eating.  Last time soups wound up being good for hydrating me, so this time I will precook soups and freeze them in single servings in the hopes that they will work again.

Look into grocery delivery services.  Again, this will make your husband's life easier.

Do a deep clean of your house beforehand or hire someone to do it for you.  Organize.  If possible, arrange for a cleaner (or an awesome friend) to come by once a week and help out with cleaning.

Keep a cabinet full of new toys/activities to keep older children busy when you're at your worst.  Go to the dollar store or the dollar section at Target and stock up.  Brainstorm and write up a long list of fun activities so that when your brain is in HG mode you don't even have to think too hard and come up with something new.

DENTAL HEALTH

Go to the dentist for a cleaning and x-rays and address any cavities or other issues.  Also ask the dentist about a sealant for your teeth to help protect them against all the vomiting.

GENERAL HEALTH

Address any other health issues before considering trying to conceive.

Quit smoking, drinking alcohol, reduce caffeine intake.  Avoid artificial colors, flavors, preservatives, etc.

Eat a healthy, balanced diet and make sure you have moderate exercise.  With severe HG you will have muscle atrophy.  It helps if you have some muscle to begin with before it atrophies.

Make sure you are slightly above (10 lbs above) your goal healthy weight.  If you are overweight, don't add these 10 lbs.  If you are underweight, spend some serious effort bulking up.  You don't want to do this by eating ice cream all day.  You want to do this by increasing your intake of healthy food and increasing the amount of healthy fats in your diet.  For example, never eat a naked salad - always put on dressing.

Ask your doctor for a comprehensive blood test to check B12, CBC, Ferritin, Potassium, Vitamin D, folic acid and any other levels he thinks it appropriate to address.  Address any vitamin/mineral deficiencies BEFORE trying to conceive.  This blood panel will also serve as a reference point for what your blood looked like when you were healthy.

Start taking prenatal vitamins 3-6 months before trying to conceive.  Don't forget to take folic acid.  Also, magnesium deficiencies have been shown to contribute to nausea so ask your doctor if you should take a supplement and how much.  And don't forget B6 - while I didn't notice it helping any when I tried it, I was already pretty far gone before it was suggested.  Taking it in advance or from the positive pregnancy test may work better.

EDUCATE

Educate yourself.  Educate your family.  Educate your friends.  Educate your doctor.  Educate your community.  Educate, educate, educate.  I can't stress how important it is.  The HER Foundation has fantastic resources in this area.  Use them.



Obviously there are about a zillion and one other things you can do as well.  I didn't mention a lot of the things on the list at the HER Foundation because - well, why duplicate effort?  Each individual will have their own needs as well.  The best thing to do is to sit down with your doctor in advance and make an action plan.  Of course we all hope that all of this planning will be completely useless because we'll have happy, fluffy, non-HG pregnancies - but we can't count on that happening.

I hope that this list provides at least a springboard for planning for your next HG pregnancy.