Preventing complications during second pregnancy

Health & Medical OB GYN
1

Hi Ladies:

I'm wondering if anyone has suggestions about preventing complications during pregnancy. We just found out that I'm about 1 month pregnant with our second child. My first pregnancy was a nightmare! I had severe morning sickness to the point where I was hospitalized 6 times for dehydration. The doctor was just about to insert a feeding tube because I couldn't keep down anything when the sickness turned around a little(during the 14th week). Even after the hyperemesis started to subside, I still had some morning sickness for the remainder of the 9 months. Along with all of that, I suffered from excruciating migraines and during the final two months I was put on bed rest for pregnancy related high blood pressure. With all of this, I was unable to continue with my job and couldn't keep up with regular household chores. This left my husband who was working full time to pick up the slack.

Currently, with my two year old, I do about 80-90% of the childcare. So, it would be much harder for us this time if the pregnancy goes the same way. I know in the end, every little ache or pain is paid a million times over! Our son is such a wonderful joy!

My question is- have any other moms experienced this? If you are or have, how are/did you deal with raising your other children and being pregnant?

2

Every pregnancy is different you may not even experience any morning sickness this time around. I had a great first pregnancy but was sick the entire nine months w/ my second but I was prescribed medication that helped w/ the nausea allowing me to at least eat a little and keep it down. I didn't have any blood pressure probems w/ either but one of my friends did w/ her first but was healthy and energetic w/ her second.

3

Hi Laura - I can relate on some levels to what you are nervous about... I had hypertension with both pregnancies and it was worse the second time, probably because I also had a toddler and was more tired and had to be on my feet more. I didn't have to go on bed rest either time, but I took medication twice a day and my dr. upped the dosage midway through with my second (I took Labetalol). As soon as I delivered, I stopped the meds. Every pregnancy IS different and it is entirely possible you will not have any issues at all this time, or the same problems as before. If you do, my advice would be to TRY as hard as you can to relax, not stress too much about chores, etc., and try to keep your blood pressure down by meditation, relaxation, good eating, and lots of water. You never know, it might do the trick. As far as child care, when I was pregnant I felt awful, just sluggish and nasty the entire nine months, so my husband had to pick up a lot of slack. It is just part of the deal... you carry the baby, but you are both parents, and your husband will have to take over some of the child care. Do what you can and what is a little easier on your body, like bathtime, or reading books, getting dressed, rather than running around at the park or playing outside with your son. I literally took it one day at a time, and I would wait until my oldest was in bed at night to put my feet up and focus on myself and the baby. I always felt better after a decent night's sleep, and it would carry me through the next day. I am a teacher too, and my job requires me to be on my feet all day long, trying to keep 24 5th graders excited and positive about learning, not easy when you are pregnant! But I enlisted help wherever I could and I made it. I do understand your fears, though, as my health issues when pregnant are a huge reason we are not having a third! Hang in there and remember, your son is still young enough that he won't remember if his mom had to hang back a little for a few months out of his life. It IS worth it, as you know!

4

Laura, I am currently pregnant with my third child having had two previous pregnancies much like you describe. In a hopes to manage the hyperemesis better this time around I began acupuncture treatments immediately. These worked for awhile helping curb nausea and vomitting and generally making be feel "better". Additionally, I spoke with the nursing staff at my ob who agreed that getting me on medication before I hit rock bottom due to my previous history was a good idea. I began Zofran at 6 weeks before the vommitting got out of control. For me my illness was cicular; the more I vomitted the worse I felt, the less I could eat or drink, which lead to more vomitting. Despite our best efforts I landed in the hospital for a five day stay at 9 weeks. With two other children who I am responsible to care for this was quite difficult. Upon returning home I spoke with my ob about preventing more ER/hospital stays in the future. My docs arranged a home visiting nurse through Critical Care Company, covered by my insurance, to come to the home and give me twice weekly iv fluids. As my needs increased, the nursing company placed a midline iv in my arm so that I could get daily fluid and iv meds at home. Giving myself my first iv med dose in bed before I even got up to go to the bathroom seemed to set me on the right track in the morning. I had a backpack pump so that I could be mobile. As awful and unpleasant as it was, it was also a real life saver when it came to taking care of my children. That said, we had to let a lot of things go and ask for a lot of help. Friends organized weekly meal drop offs as I could not cook. My house is a dirty mess and I just have to live with it. My two other children, 4 and 2 years old, watch a lot more tv than I would like. I also asked for a lot of help from friends to watch the kids. I am now in my 19th week, the iv is finally out. I am still on the max dose of Zofran, but I can function at least in terms of watching the kids. The family still eats a lot of take out and the house is still a mess. I try to remind myself that the kids won't even remember this when they are older!
Good luck as your pregnancy continues. I truely understand how hard it is and what you are going through.

5

Being a health counselor, I would immediately look at your diet, and also the other "primary foods" of your life. Get on a good whole food prenatal vitamin (I like New chapter, Mega Food or Super Nutrition) get them at a health food store.(whole foods has all of these) Also start taking a good omega 3-6 oil blend(fish, flax, borage, evening primrose oil) these help immensely with hormone fluctuations, DHA for the babies' healthy brain, energy, even blood pressure!. stick with a simple, whole foods diet. Stay away from packaged foods during your pregnancy, these most likely contain MSG and other nasty stuff that can cause migraines as well. Also DRINK ENOUGH WATER I can't say this enough. YOU NEED about three liters a day, get a water bottle and always keep it with you!. I would also enroll in a prenatal yoga class (my sister teaches an excellent one in the andover area). Also try hypnobirthing classes (AWESOME)and practice meditation before going to bed. These are some suggestions that helped me, and I also recommend to my clients. Hypertension is diet related so be very conscious of what you put in your body, and also do yoga for stress reduction! Every pregnancy is different, take what you learned from your first one. I can't help you and having a young child while being pregnant, I can say that my mom had seven kids (and breastfed multiple babies while pregnant!) and managed to keep it all together! Get one of those prenatals to keep your energy up (its important to take the full dose!) and get an omega 3-6 blend. Good luck!!

6

Hi Laura
My friend Stephanie had great results with Reliv nutrition during her last pregnancy.
She saw a dramatic difference from her first two pregnancies and the last one (her Reliv PRegnancy)
It is safe and effective and is extremely helpful with dehydration.
I would love to connect you with Steph
Joanne H

7

I also highly recommend acupuncture to help with the morning sickness in particular. I had morning sickness all 9 months of my first two pregnancies, but started acupuncture early in the third, and although I still had occasional nausea and vomitting, it was only every now and then and very easily dealt with (like maybe once every week or two instead of all day every day.) There is also a good book called Managing Morning Sickness by Miriam Erick that I recommend to my clients and students who have similar issues (I'm a doula and childbirth educator.) Please don't be afraid to ask for help. We tend not to do that enough in modern society.

Good luck and Congratulations!!!

8

Laura, during both of my pregnancies I had hyperemisis, the first time I ended up in the ER once and then a week later admitted for dehyration. The second time, I got the medication Zofran as soon as I began to get sick. Although it didn't totally stop me from being sick, it did keep me functional (full time job and a 2 year) and it kept me out of the hospital.
Other than that just accept that the house may not be as clean as you want, your son may watch a little more tv than usually and you may have to ask for help. Just keep in mind that this too will pass and in the end you'll have another bundle of joy to enjoy.

Nicki
mom of 2 beautiful daughters ages 5 and 2.

9

First, if you can, try to have hope and not pre-suppose! I had a terrible first pregnancy, on bed rest off and on afgter 26 weeks for spotting and in hospital once, then on bedrest at end for BP, was induced, failed, BP spiked post partum. Had Csection. I hated it. second pregnancy totally different but I think part of it was because i was determined to be healthy- i was so happy to be pregnant and just told myself I was going to have a totally different experience- and the reality was that my son kept me so busy i didn't have time to think about being pregnant very much! I did have awful digestion/constipation/diarrehead etc. through week 16 but then it was significantly better until the end. BP did go up at the end but didn't warrant bedrest, just taking it easy. no spotting and only one stress test for eweird pains which turned out to be gas! I really do think it could be a totally different experience... I hope so for you, but start by willing yourself to have a better time of it. and CONGRATS. very happy news and no matter what you WILL get through it.

10

Other than asking for advice from your doctor and trying to line up help and support from family and friends I don't have anything else to offer. But every pregnancy is different and this one may be much easier this time a round. Try to keep positive and hope for the best. I really hope this one goes smoother for you!

Best wishes and good luck!

11

You may want to focus on what you are eating. Many people discount what extremely good nutrition can change. Start with a food diary.

12

This pregnancy could be totally different and I pray it will be for you! My friend had such bad hyperemesis with her first two babies, she was on bedrest with an IV the whole pregnancy - never kept anything down. But with her third, she didn't get sick once! Totally normal pregnancy. Hope for the best!

13

I am currently on my 2nd pregnancy 22 weeks - my first was a piece of cake, but this time around has not been as easy at all. I was suffering from migraines and not really feeling that well. I tried several things - Chiropractic care, Yoga, even went to a Neurologist, but of course all they want to do is prescribe meds. and I am not a big medicine person. So then my chiropractor suggested I try a Reiki Energy Specialist. She worked wonders and no more migraines. Still have minor headaches, but I can live with those over the migraines. As far as the sickness I heard there are different vitamins and herbs you can take to help with that, but not sure which ones as thankfully I didn't have all the sickness. Good luck to you and hope this time around is easier for you.

14

Dear Laura,
My thoughts go out with you and I am so sorry you had to endure hyperemesis. I have much to say, so feel free to write me with any questions. It would have really helped me to have someone who had been through it, so i can also pass along my phone number. (I had many people think I was "just" having morning sickness!!!!)

I had hyperemesis with both of my pregnancies and wrote this exact same e-mail last year asking for help/advice from people who really had 'been there.' My second daughter was born 10 weeks ago and I was sick or in the hospital for the first 16 weeks of the pregnancy. My oldest daughter was almost two at the time.

I wish I could tell you it won't happen this time, but most likely it will. Statistically, it is 80%, but I will pray that you are okay. I don't say that to worry you, but I think it helped me to know so I could prepare. These are the things I would do:

1) Ask anyone in your families if they could come stay with you to take care of the daily duties/child care if you get ill again. I was a stay-at-home mom with an toddler and bedridden or in the hospital! :-< My mom flew to Maine for a month to care for my daughter (almost two at the time). When she left, we had friends and babysitters help out. Have numbers to a nanny service or child care provider, too, just in case.

2) Begin eating now. Gain a little weight if you can and stay hydrated so when/if it starts you and the baby will be okay.

3) When you meet with your doctor, have your records from your previous hyperemesis treatment and see if you can start meds right away at the FIRST sign of morning sickness. I have heard it keeps the worse of it at bay. It didn't work for me, but I think I waited to see if this was really "It." I used suppositories.

4) Talk to your doctor right away about hyperemesis and make sure they would be willing to admit you when needed. Get numbers and directions for how to call the hospital and put on the fridge for your husband or family. (If you were like me, I was unable to do the simplest things.) Go to the doctor as often as possible. They can make you feel better and get you hydrated. Don't be shy for asking for help!!

5) Stock your kitchen full of those foods that would be edible. Crackers, gatorade, peanut butter, etc.

6) Talk to your son (if he understands) that mommy may get sick, but she will be okay. This sickness really scared my daughter this summer and my mom and I always had to talk with her about why I was always throwing up and in the hospital, etc... Even now, she will ask me, "Mommy's tummy all better?" It's remarkable how much she comprehended.

7) Have a SERIOUS talk with your husband. Is he supportive? Helpful? Make him know it probably will happen again and how much more work it will be this time with a child to take care of, too. Also, talk with him about the dangers and how to handle emergencies. (I passed out in the kitchen one evening and he had to call 911. We knew exactly which neighbor to call for my daughter, etc. It possibly saved my life that he called 911.)

8) Talk with your job, friends, family etc. Let them know what it is and give them the website http://www.hyperemesis.org/
They need to take it seriously.

9) Possibly ask really good friends and family to be available with casseroles when you are not well. Your husband and son have to eat.

Just reach out when you can and please feel free to call/write if you need any support. I know 14-16 weeks doesn't sound like a lot on the outside, but when you feel that ill it seems so scary. You are not alone. Good luck and thinking of you, Dana

15

I experienced the exact same hyper-emesis with all 3 of my pregnancies. I am currently 24 weeks along with my third and have stopped the constant vomiting and have moved onto the occasional daily nausea and morning sickness only. I have lost 26 lbs. It's tough. I have just started to experience round ligament pains that often mean I have to put my legs up. It's scary to think that I still have a ways to go!
With my first pregnancy, almost 7 years ago, I had to quit my job. I was just to ill to work. I did continue to stay at home with my daughter and with my second pregnancy my first daughter was only 14 months old while I was dealing with the emesis.

This third pregnancy has been the most difficult, in managing my older two children (4 and 6) They are busy girls, in school and preschool with other activities. I hated to be away from them. I am lucky that my husband owns his own business. He has flexibility to re-arrange his schedule. I also have great friends who take my girls to school and help with cooking and cleaning. My mom would come by every day to check in. My good friend set up a schedule for friends to drop off meals and planned play dates for my girls.
I can only recommend that you set up a support system now, before the emesis sets in. Your husband may be able to take paternity leave now instead of after the new baby comes. In my experience, the sickness in pregnancy (especially the care of your other child) is more difficult to deal with than the care of the new baby. You may decide you need him more now than later.

I know I needed help just getting to the bathroom and having someone there to clean up when I threw up. I could not be alone for long. Not to mention having to go in to the hospital often for IV fluids. I was just too weak, there was no way I could take care of my older children.

I am sure you will get many wonderful opinions on how to relieve the nausea.... I know I did. I can also sympathize with you that none of those suggestions will work!!
Hyper-emesis is just a beast all it's own. It's not like morning sickness that many moms deal with. My doctor says less than 2% of pregnant women experience it.
Hang in there, I have done it 3 times and can honestly say it's still worth it each time! Good luck.
-Sarah

16

Laura,

Congratulations on the new pregnancy. I didn't suffer like you did with your first but I did find that smaller more frequent protein meals helped me a lot. And of course going to bed early to get the extra rest.

Good luck,
Leeanne M