The trouble with morning sickness is that it's usually treated one of two ways: as a trivial (even amusing) rite of pregnancy passage, or as the potentially life-threatening condition hyperemesis gravidarum, which can land women in the hospital for dehydration (as was the case with Kate Middleton).
In between those two extremes lies the wide, debilitating land of nausea and vomiting that's often part of pregnancy. And that is where I spent many, many miserable months when I was pregnant with my two sons.
Now pregnant with my third child, I am just beginning to see the light at the end of the porcelain-enameled tunnel, and I realize that it's time for us to speak honestly about what this condition really feels like.
Once again, at just three weeks pregnant, I felt a pang of nausea that made me wonder whether I was lucky enough to be expecting. At four weeks, when the tests confirmed my hopes, I was plunged into a familiar disorienting rabbit hole of horrendous nausea.
And, once again, it did not keep to the widely-publicized morning schedule. No, this was an all-day, all-night misery that woke me from sleep and never stopped no matter what remedies I tried -- ginger, saltines, medication, fizzy water. Even the forbidden Diet Coke didn't help.
The best way I can describe the feeling to someone who has never experienced nausea and vomiting during pregnancy is that it's like having food poisoning all the time for months on end. Each day -- foggy, repulsed by every smell and taste, unable to walk without crippling dizziness and nausea -- I wondered how I would make it through.
It rendered me nearly incapable of having a conversation, let alone caring for my 4-year-old and 18-month-old sons. Bedtime stories went out the window and, with them, anything beyond procedural parenting. Even feeding, bathing and taking my eldest to school felt impossible. I disappeared mentally and emotionally from my husband, my children, my friends and my colleagues. I did the absolute minimum just to get through the day.
All while my Facebook feed and casual conversations constantly suggested that I "lean in" professionally. How on earth can anyone "lean in" when all they can manage is leaning over? I thought to myself, closing the browser windows.
As a trained psychotherapist, I know the damage that physical illness can wreak on mental health. And, as the founder of a nonprofit dedicated to supporting women's mental health during their reproductive years, I am shocked that there is not a more honest discussion of how debilitating nausea during pregnancy can be.
Believe me, I was brought up in England where you're taught to "get on with it." And to a large degree I was getting on with it, or at least trying to. I don't want anyone to throw me a pity party. I know how lucky I am to be pregnant, nausea and all.
But I began to wonder how other women were coping. Were they coping? Or was unending nausea the trigger for depression or other mood disorders? Shockingly, there is almost no research, not only on more effective treatments for nausea during pregnancy, but also on its effect on a woman's mental health.
According to the American Congress of Obstetricians and Gynecologists, up to 85 percent of pregnant women experience nausea and vomiting, but it's often minimized and undertreated by doctors. And I wonder if that's because we laypeople minimize morning sickness ourselves.
For instance, we often don't talk openly about it. The nausea usually starts before nine weeks, during the window when women are encouraged to keep a lid on their news until the period of highest miscarriage risk has passed.
In my agony, I decided to open up to two friends and two close coworkers because I knew I couldn't get through without their support. (I'm lucky to work in an organization that is founded on supporting women through pregnancy.) And their understanding and excitement for my pregnancy -- along with the understanding and support of my husband -- helped me maintain my own enthusiasm and kept me from sinking.
As I begin to lift my head and see through the fog of these past 20 weeks, I propose three things:
1. Let's stop underselling this monumental physical experience by breezily passing it off as morning sickness. Let's call it what it is: nausea and vomiting of pregnancy.
2. As pregnant women who are sick, let's ask for support when we need it. Tell your doctor how you really feel. Call your friends who have been through it. (They will understand you like nobody else can.) And explain to others what you are going through and how they can help.
3. As friends and colleagues of a pregnant woman, please, offer up your understanding. Drop a cold bottle of seltzer water on her desk and ask how she is feeling that day. If you both have kids, offer to pick up her children and host them for dinner and a playdate so their mom can lie down guilt-free.
If we all start treating nausea and vomiting of pregnancy like a medical condition worthy of treatment, sympathy and support, it will go a long way toward helping women have a more physically and emotionally comfortable 10 months.
This article originally ran on the Seleni Institute website. Seleni is a nonprofit organization providing clinical care, research funding, and information to transform mental health care and wellness for women.