Hyperemesis and health exemptions

Mary Beth Williams explains what the lack of a health exemption could mean to the 1% of South Dakota women who will experience hyperemesis gravidarum (HG) during their pregnancies. HG is morning sickness so prolonged and severe that it can kill. Women seldom die of HG in the developed world, but as Mary Beth explains from first hand experience, HG can be totally debilitating without being immediately life-threatening. In severe cases, women can't take enough food by mouth to survive and have to be maintained on total parenteral nutrition (TPN) through a surgically implanted tube. Under normal circumstances many women choose to terminate their pregnancies. However, in South Dakota, women with HG will be forced to give birth because their condition doesn't immediately threaten their lives.

Comments

[Bob Koepp]

Does anybody think the SD law will survive scrutiny by the supremes? Surely, that is where it is headed.

[m]

Bob:

The SD law was targeted at the Supremes with full malice and forethougt.

[Bob Koepp]

Sure it was targeted at the supremes, but the question was whether it stands a chance of surviving their review.

[John]

How about this for a bumper sticker:

LACK OF ABORTION IS MURDER!

Admittedly, it's a little over the top, but not more so than some of the pro-life bumper stickers we've all seen. Hyperbole is all some pro-life people understand, so this rude slap in the face might bring one or two of them to their senses......Oh, who am I kidding? Forget about it.

[Lindsay Beyerstein]

I don't think it will survive the Supreme Court challenge. However, it's important to remind people exactly what kind of vicious bullshit is being openly proposed. The fact that so many other states are following SD's lead makes it clear that we can't be complacent about public opinon.

[Wade]

If you believe that the abortion issue is a matter of a woman's right to control of her own body, then why bring up these extreme cases? As a shotgun approach to debate? This kind of pedantry can only hurt your cause; anyone can see that you're evading the issue.

[Lindsay Beyerstein]

I am a vocal supporter of abortion on demand. I don't see how I'm evading anything. I'm just discussing something that shuould be important even to people who don't go as far as I do on the abortion issue.

One of the backers of the SD abortion bill is on the record saying that abortions for the sake of health, but not life were abortions of mere "convenience." He is either ignorant of the medical facts or stunningly callous. Obviously, HG isn't the only debilitating but non-immediately lifethreatening complication of pregnancy, although it's surprisingly common (1% of all pregnancies, according to Mary Beth's article).

[Lisa SG]

I had overwhelming nausea when I was pregnant with twins 5 years ago. I didn't have HG, because I could keep liquids and (enough) food down, but I was MISERABLE. Even though I wanted to have more children (I already had one, with the normal amount of nausea through that pregnancy, and BTW, these twins were entirely natural), I comforted myself with the thought that if it got any worse, I could have an abortion. It helped me keep going.

That kind of unrelenting nausea is as bad as constant pain. There was no freedom from it at all. My relationship with food was completely severed for the entire 9 months, and it's surprising how much that changes your relation to the world. Food is so much a part of life. The following spring I felt the nausea again, as nausea is so easy to remember, unlike pain. The smell of spring brought it back again.

After those twins were born, even though we were up all night for months, I felt such incredible relief. The pregnancy had been so difficult. I was so huge. But now my body was mine again! What pleasure! How much we take for granted the simple pleasures of our bodies. And how easy it us for those who have never been pregnant, or very sick, to think that they have the right to force such difficulties on people against their will.

As far as I'm concerned, it would be completely immoral to force a woman to undergo that against her will. It would be akin to torture. There is no comparable physical suffering that anyone can be forced to undergo by state compulsion. How dare they.

[1984 Was Not a Shopping List]

A woman I knew ages ago had this condition. I haven't thought about it for some time, but her situation was for years the main reason for my support of the woman's right to choose. It may be an extreme case, but there are extreme cases out there.

[1984 Was Not a Shopping List]

>bumpersticker

I had an idea for a bumpersticker that would simply say: "My Bumpersticker Will Change Your Mind About Abortion."

Like, enough with the bumperstickers, I don't think they're really doing anything. But I liked your idea, John.

[ghostcatbce]

I'm glad you're highlighting Mary Beth's post, Lindsay. I read it over at Wampum, and all I can say is that it's too bad Wampum's own posts can't be up for a Koufax Award. I had never heard of hyperemesis gravidarum, or the theory that it may have killed Charlotte Bronte before. Just making people more aware of HG is a valuable service in and of itself.
Now, I have never been pregnant or suffered from HG, but for the last three years I have been struggling with health issues of my own that parallel what women with HG endure. Pain and nausea so profound it can wake you from a sound sleep. It's totally unpredictable. From hour to hour my physical condition changes. I can wake up feeling fine, but by afternoon need medication to function. Eating is such a problem I've lost at least forty pounds. Not only can't I work, there are some days when I can't even leave my apartment.
So I have a real feel for what women suffering from HG go through. If anything, HG is worse. I may feel nausea, but I don't suffer uncontrollable bouts of vomiting. To condemn women to suffer the torments of the damned, like some smug arrogant god out of the Old Testament, for the "sin" of having sex, is just plain evil.

[Helen of Troy]

The post at wampum reminded me to think of secondary medical effects. In this case, I'd never heard of HG, but I do know a bit about IV feedings. As I wrote there:

'Long term IV feeding is bad for the liver. A former next-door-neighbor is on permanent IV feeding and has been told to expect liver transplants every 15 years for the rest of his life. That the gradient of nutrients is going the wrong way through the liver causes the damage, as I remember it.

He'll be on IVs much longer than a few months per year for pregnancies, but the proof remains- it has the potential for damage.'

Plus that level of nausea could cause as much damage as GERD, couldn't it?

For the person who called this an "extreme case," 1% of pregnancies is 60,000 women with HG per year in the US.

We have the luxury of thinking about medical complications of pregnancy and childbirth as "extreme cases" only because of 100 years of good medicine in developed countries. Pregnancy and childbirth are dangerous-- we're not well designed for it.

Wow, I'm seeing one root of the problem here: many religious fundamentalists are also creationists.

They think the female body is well-designed, with just 'pain' thrown in after the fall (sin in the garden of Eden). *If you believe in creationism you can't really accept that pregnancy and childbirth are dangerous, just painful.* You'd be insulting the designer, wouldn't you?

Instead, if you believe in evolution you can accept that pregnancy and childbirth are amazing, beautiful, and powerful but still darned risky.

Our 500,000th grandmas did the best they can with what they had to work with, but a system evolved for small-brained quadrupeds might not work as well for big-brained bipeds. And it doesn't. It only works well enough- mostly we live, mostly we can have more children after.

But the South Dakota law doesn't accept mostly. Napoli can only imagine (ick) an exception for raped religious virgin girls (remember, he says "girl" twice!). The anti-abortionists don't usually let age be a factor- they don't base exceptions on age. Why isn't girl-pregnancy worth an exception? Perhaps in part because they don't think pregnancy is inherently dangerous. If she's old enough to be pregnant she's old enough to be a mother *if we're well designed for pregnancy.* That we're not well designed isn't in their thoughts.

[Lisa SG]

There's an interesting article in today's NY Times about pregnancy, and how it can be understood as a battle between mother and fetus. (Battle is their word, not mine). The fetus wants to take more from the mother's body than the mother's willing to give it, and has evolved to try to get as much as it can. The mother's body has evolved to limit this process. Apparently they now think this may be the cause of pre-eclampsia. The fetus excretes some substance to raise the mother's blood pressure to get more blood flow, but excretes a little too much, perhaps because it is not growing enough, and the mother's blood pressure goes crazy.

Hardly the pretty picture of pregnancy the far right wing has painted. They would like to pretend there is no conflict between mother and fetus at all, when nature itself provides that conflict. There is no question that I felt invaded by my second pregnancy, taken over, consumed. I still feel that way sometimes as a parent, (sometimes? haha), but at least it is no longer a PHYSICAL CONSUMPTION. I desperately love my children, but that scene from Alien is not entirely inappropriate. Scientifically speaking, fetuses are a form of parasite.

[Wade]

I called this an extreme case because in the case of the abortion debate it is a red herring. I'm objecting to the way pro-life advocates split hairs on an issue where it's obvious that the parties disagree on a much deeper level. If it's clear that you stand for unfettered access to abortion, why entertain the less-than-half-measure of legalizing emergency abortions? You're only preaching to the choir with arguments like these (if I may be permitted the religious analogy). The rest see it as posturing.

You might reply that some access to abortions is better than none. But this is to deny the political facts of the situation: neither side is willing to tolerate any such compromise, and everyone knows it.

[ghostcatbce]

In this kind of conflict semantics matter. STOP CALLING THEM PRO-LIFE! They are NOT pro-life. They are pro-forced births. They are pro-Rapist's Rights. Or, if you prefer, plain old anti-abortion. They are most definitely NOT pro-life.

[Lurker#291883]

As far as bumper stickers go, how about this:

Rapist, move to SD...they LOVE you.

[HGmomX4]

I am a survivor of 4 HG pregnancies and cannot stress enough how devastating South Dakota's abortion policy would be for women facing high-risk pregnancies. I chose to have my children and fought very hard to get them here, but it was absolute hell. I lost 20% of my body weight in a matter of days, was in and out of the hospital, and faced an endless barrage of medications and treatments and IV procedures. Had I not been treated, I would certainly have died. Three of my four babies made it here, but even with treatment HG mothers are more prone to late-term miscarriage and eclampsia; their babies are at greater risk of being low-birthweight and having reflux. Yes, this is a fairly rare pregnancy complication (anywhere from 1-3% of all pregnancies), but it is a very real phenomenon for which there is no medical explanation. Because of the lack of knowledge, many doctors dismiss HG as "morning sickness" and refuse to take it seriously until the mother's life is in danger. Half of all HGers worldwide terminate at least one pregnancy because of the illness, often at their doctors' advice. For South Dakota, or any government, to say that women like me MUST continue with such debilitating pregnancies, or that the decision rests not on my own judgement but on whether or not my doctor believes my life is at stake, is an outrage. HG is just one of many high-risk conditions of pregnancy, and perhaps bringing more emphasis to these stories will help the pro-choice argument. So-called "pro-lifers" seem to believe that since women like me can get pregnant, we thereby give up our rights and our lives. Putting a different spin on happy, glowing pregnancy and exactly whose life is at stake will perhaps open some eyes.