Hyperemesis Gravidarum: Ode to Its Psychological Impact


A personal reflection on the psychological impact of hyperemesis gravidarum.

Distraught woman with hyperemesis gravidarum


The 9 months of pregnancy evoke a multitude of emotions for the mother carrying the "angelic parasite". Expectant mothers are mindful that morning sickness is quite common, but it does not deter them from keeping their eye on the prize. However, intractable vomiting during pregnancy, also known as hyperemesis gravidarum (HG) is a condition that can have deleterious psychological and physiological effects in the form of depression, anxiety, significant weight loss (>5% of original body weight), and dehydration.

I have witnessed firsthand the impact HG can have on a mother’s well-being. My wife, Jennifer, experienced this condition all throughout her pregnancy. As a spouse, I attempted to comfort her as best I could but, at times, felt helpless. During the pregnancy she lost more than 30 pounds, and she required several hospitalizations. It was difficult, at moments, to find any silver linings that would help alleviate fears we had about her quality of life and the angelic parasite in her womb. Thankfully, with the help of a multidisciplinary medical team and a support system consisting of family and friends, my wife’s health improved. The ability to take a shower, brush her teeth, and enjoy a sip of water was rejuvenating.

Our daughter, Claire, now 2.5 years old, was born without any complications. She is the blessing that keeps on giving. It is important to remember that not everyone has a happy ending in the case of HG. This population is often stigmatized due to practitioner bias and skepticism regarding severity of symptoms. I encourage the medical community to realize the gravity of this condition, which is associated with increase rates of termination of pregnancy and suicidal ideation.

I have written a poem dedicated to my wife and all the women who have experienced hyperemesis gravidarum. I hope and pray that it fosters reflection.

Toilet Reflections

White porcelain welcomes two feeble disturbed patellae into their familiar position.

Exhausted cranium searches her way toward the bowl that yeans for a day without chartreuse liquid.

Listless larynx sighs to the angelic parasite: 3 months

White porcelain welcomes mammoth tears that plead for comic relief while in the wilderness.

Calloused stained appendages engulf a seat pleading for casual gluteal conversation.

Delirious heart sighs to the angelic parasite: 6 months

White porcelain welcomes famished countenance that no longer sees its reflection.

Nauseated hair follicles produce repugnance that penetrates the deflated soul.

Malnourished colors skeletons sighs to the angelic parasite: 9 months.


Dr Clark is associate professor at the University of South Carolina School of Medicine - Greenville and medical director and division chief for Adult Inpatient and Consult-Liaison Services for the Department of Psychiatry and Behavioral Medicine at Prisma Health - Upstate. He served on the American Psychiatric Association’s Task Force to Address Structural Racism Throughout Psychiatry, and he currently serves as the Diversity and Inclusion section editor and advisory board member for Psychiatric TimesTM.

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