Pregnant and Sick with Dr Rosie Gilderthorp

In this episode of 'Pregnant and Sick,' I’m joined by Dr. Jenny Turner to discuss the often-overlooked struggles of pregnancy, including severe sickness, mental health challenges, and the societal pressures that exacerbate these issues. We talk about our personal experiences, the importance of support networks, and the role of therapy in managing the complex emotions surrounding pregnancy.Thanks for reading Know Your Mind with Dr Rosie Gilderthorp! Subscribe for free to receive new posts and support my work.Useful LinksDr Jenny Turner on Instagram: https://www.instagram.com/drjennypsychologist/?hl=enJenny’s Website: https://www.mindbodysoulpsychology.co.uk/Jenny’s Substack: Pregnancy Sickness Support: https://pregnancysicknesssupport.org.uk/Timestamps00:00 Introduction to the Podcast01:18 Guest Introduction: Dr. Jenny Turner01:33 Mental Health in Pregnancy: Overlooked Factors02:33 Personal Experiences and Initial Reactions04:31 The Importance of Early Support09:11 The Secrecy of the First Trimester12:09 Shame and Societal Expectations15:18 The Reality of Pregnancy Sickness20:34 The Need for Better Medical Support23:09 Identity Formation During Pregnancy24:37 The Impact of Labels and Self-Judgment25:23 Parenthood and the Internalised Outer Critic27:22 The Fragility of External Validation29:50 Therapy During Pregnancy36:30 Navigating Pregnancy During the Pandemic39:51 The Complexity of Emotions in Pregnancy43:23 Seeking Support and Building Resilience47:35 Final Thoughts and Resources This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit drrosie.substack.com

In this episode of the 'Pregnant and Sick' podcast, Dr. Rosie Gilderthorp, Clinical Psychologist and HG survivor dives deep into hyperemesis gravidarum (HG) with Dr. Andrew Householder from the Morning Sickness Clinic. Dr. Householder discusses the comprehensive care his clinic provides, the importance of early intervention, and debunks misconceptions about HG treatment. He also addresses the significant psychological impacts of the condition, the limitations in current research, and the necessity of a multifaceted treatment approach including anti-emetics, steroids, and nutritional support. This episode is invaluable for understanding how to advocate for better HG care and the need for systematic change in treatment protocols. Subscribe to Dr. Rosie Gilderthorp’s free Substack for more insights and practical, evidence-backed, exercises to support your mental health and make each day feel a little more bearable when you are pregnant and sick.Thanks for reading Know Your Mind with Dr Rosie Gilderthorp! Subscribe for free to receive new posts and support my work.Highlights00:00 Introduction to Dr. Rosie Gilderthal00:58 Special Episode Introduction04:05 Interview with Dr. Andrew Householder Begins04:14 Defining Hyperemesis Gravidarum (HG)05:14 Symptoms and Misconceptions of HG07:02 Mental Health and HG09:39 Treatment Options for HG17:21 Risks of Untreated HG20:05 Effective Medication and Nutrition Strategies34:08 Alternative Medication Administration Methods40:45 Overview of Dr. Householder's Clinic47:21 Closing Remarks and ResourcesConnect with Dr Householder and other useful linksThe Morning Sickness Clinic: https://www.morningsicknessclinic.com/Instagram: https://www.instagram.com/hg_morningsicknessclinic/Facebook: https://www.facebook.com/morningsicknessclinic This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit drrosie.substack.com

Welcome to pregnant and sick with me, Dr Rosie Gilderthorp. I’m a Clinical Psychologist and I’m also a mum of 3 who did not enjoy pregnancy. At all. In fact I was incredibly pregnant and sick both with Hyperemesis Gravidarum (HG) and with the depression and anxiety that most often comes with it. I discovered the difference proper mental well-being support in pregnancy can make in my second pregnancy and I am on a mission to share what I learned so that no one has to feel alone in the dark days of pregnancy sickness like I did. So whether you are nauseas, throwing up or feeling the mental and emotional strain of pregnancy (or all three) please know you are not alone. Pop these exercises in your earbuds and take some time to look after yourself.When we are pregnant and sick, either because we are feeling physically wretched or because the mental strain of pregnancy has got on top of us it can be really hard to relax. Even when we are lying on the sofa we often find ourselves battling with thoughts like: “why can’t I be like Amy, she glowed through pregnancy” or “I don’t want to do this, I can’t do this” or even “maybe I’m not meant to do this.”All these thoughts have the power to create chaos in the body and turmoil in the mind while offering us no helpful information at all. In this post, I talk more about how and why that happens. For now all you need to know is that learning to shift our attention away from these thoughts and spending some time focusing on bringing warmth and acceptance to our body, even when it is hurting, is shown to help us deal with the challenges of sickness much better.Today’s exercise, called a compassionate body scan, fosters a deeper connection between your mind and body, promoting self-awareness and self-acceptance. By mindfully observing bodily sensations without judgment, you cultivate a sense of kindness towards yourself, even when experiencing discomfort or pain. This approach helps reduce stress and anxiety, improves emotional regulation, and enhances overall well-being. It can also be beneficial when we are coping with pain or sickness, as it encourages a more accepting mindset which means our bodies will calm and stop reacting so strongly to our unhelpful thoughts.Personally, for me this was a huge game changer. I discovered this practice when I trained in mindfulness during my second pregnancy and used it every night to get to sleep or anytime I thought the nausea was going to completely overwhelm me.Transcript of the compassionate body scan exerciseSit in a comfortable position, this can be upright in a chair with your feet on the floor, legs crossed on the floor or any other wakeful and alert but relaxed posture that works for you.Keeping your eyes open, focus on a fixed point in the room and allow your gaze to be soft.Take a deep breath in and down into the belly, briefly hold and release the breath slowly. Take a few slow breaths, just noticing how it feels. Some people find it helpful to breathe in for four, hold for four, breathe out for four and hold for four, this is called box breathing and can be a soothing rhythm. Let’s try that out together but no pressure to keep pace with me if its not right for you at the moment.in 2,3,4hold 2,3,4out 2,3,4hold 2,3,4Now just allow your body to breathe normally. Notice that the body knows how to breathe, all by itself. Just observe the body breathing for a moment.Take a moment to notice any sounds you can hear. Just let them flow in and out of your ears. Take note of any smells or other sensations. Just notice what is there.Notice the weight of your body in the places it connects with the floor or chair. How does your body feel right now? Any tension? Is it relaxed? Are you feeling any other physical sensations? Hot or cold? Discomfort or comfort?Take the time to check in with yourself emotionally, how are you feeling right now? Are any obvious emotions coming to the surface?Just notice how you feel right now without trying to change it.Now imagine there is a stream of sunlight coming through the ceiling, just above your head. As the sunlight makes contact with your body it focuses your attention on that body part, like a spotlight and fills it with warmth, relaxation and a sense of ease.As you watch the stream of light you notice it is beginning to slowly fill your body. Just watch as it fills your toes, feet and ankles. Notice how they feel as they are bathed in the sunlight. Do they feel warm? Relaxed? Soft?When your feet are completely full of light, the light continues up the body, filling your lower legs, knees, thighs with a sense of ease and comfort.You will find that your mind wanders away from the light frequently. When this happens, simply notice it and re-focus without judgement or criticism.Now you notice the light is filling your pelvis, bottom, lower back. Slowly filling your body from the ground up with warmth, light and comfort.Now your abdomen, chest, upper back and shoulders are full of the warm sunlight.You notice the light filling your arms, right the way down to the tips of your fingers.Now the light fills your neck, right to the top of the head. You can feel the light on your facial muscles softening them, relaxing your whole body.Once you feel completely full of the warm light, completely aware of your whole body with ease and comfort you notice that the light is shining from you into the room around you. It is as if every breath you take makes the light clearer and stronger.Enjoy that feeling for a few breathsNow let go of the image of the light and come back into your body. Concentrate on your breath for a few moments, noticing the sensations as you breathe in and out.Now slowly bring your awareness back to the room around you, notice what is present in the room. What can you hear? Smell? Feel?Now pay attention to your body, how does it feel? Any different from before?Finally, to seal the practice, take one more deep breath in to the belly, hold briefly and release slowly.Gently open your eyes.How to access support of you need itI really hope that has been helpful and that you feel just a little more space between you and those painful thoughts, feelings and body sensations. Every time you practice the effect will become deeper and stronger as your mind learns the skill of mindfulness. So come back here often to give yourself a moment of calm amongst the struggle.As ever please remember you are not alone. If you need urgent support, mental or physical please speak to your GP and remember that if you feel sick you deserve support.There are also great resources including peer support options and medication advice on the pregnancy sickness support website.If you think you would benefit from specialist psychological therapy to help you through this then please take a look at my website and book in a free consultation.Thanks for reading Know Your Mind with Dr Rosie Gilderthorp! Subscribe for free to receive new posts and support my work.Please share this post with anyone you know that might need itThank you for the music!Mindfulness ex backing track music: Soothing Serenade by UNIVERSFIELD -- https://freesound.org/s/719269/ -- License: Attribution 4.0Inrto musicAfter the flu by kjartan_abel -- https://freesound.org/s/611440/ -- License: Attribution 4.0 This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit drrosie.substack.com

Are you feeling overwhelmed, stressed or engulfed by pain or nausea today? Do you need a moment of space to recover?My latest recording, "Soothe the Sickness: Give Your Mind a Break," is just what you need.I’ll guide you through a serene and peaceful exercise designed to help you gain a moment of peace and let go of the thoughts that aren’t serving you well.If you’d like to know more about why this kind of exercise is worth doing (and repeating) regularly check out my previous post about how our thoughts impact our health here.In the episode, I also talk about the amazing services provided by Pregnancy Sickness Support.You can access a full transcript of this episode on substack.Finally, as always, remember that if you feel sick you deserve help. If you need urgent support please talk to your GP. We do not offer an emergency service and this inbox is not monitored outside of working hours. If it is out of normal working hours you can access the NHS urgent support site to get help immediately.Thanks for reading Pregnant and Sick with Dr Rosie Gilderthorp! Please share with anyone who needs it.Thank you for the music!Mindfulness ex backing track music: Soothing Serenade by UNIVERSFIELD -- https://freesound.org/s/719269/ -- License: Attribution 4.0Inrto musicAfter the flu by kjartan_abel -- https://freesound.org/s/611440/ -- License: Attribution 4.0 This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit drrosie.substack.com

Managing Pregnancy Nausea and Emotions with Mindfulness TechniquesJoin Dr. Rosie Gilderthorp, a clinical psychologist and mother of three, as she shares her expertise and personal experiences with managing hyperemesis gravidarum, depression, and anxiety during pregnancy.This practical episode provides a deep dive into mindfulness techniques such as deep breathing, body scanning, and observing sensations to cope with physical and emotional strains.Engage in guided exercises to help control nausea and stress, while receiving personal support. Remember to seek professional help for serious mental health issues. Subscribe to Dr. Rosie's free substack for more insights and resources on mental well-being during pregnancy, and visit www.knowyourmindconsulting.com for additional information.00:00 Introduction to Pregnancy Challenges00:58 Practical Pep Talks for Pregnancy01:28 Mindfulness and Emotional Awareness02:33 Body Scan and Tension Awareness05:12 Understanding and Observing Nausea08:15 Exploring Sensations: Light or Heavy?09:00 Breathing into the Feeling09:54 Allowing the Nausea to Be11:06 Imagining the Feeling as an Object12:27 Healing Hand Technique13:47 Bringing Up the Lights14:48 Reflecting on the Exercise15:10 Final Thoughts and ResourcesCome and find me on Instagram @thepregnancypsychologist. I’d love your feedback on how you found this exercise so come and have a chat with me there. If you found it helpful please do share with anyone else in your life who might need it.Finally, a little disclaimer from me. I’m a Clinical Psychologist registered in the UK but nothing I do on this podcast, my website or social media is psychological therapy. If you need therapeutic support you can reach out to me at www.knowyourmindconsulting.com. If you are facing a mental health crisis or a medical emergency and you are worried about your safety or someone else you should contact your family doctor (GP here in the UK) or go to an accident and emergency.I’d also like to that Russ Harris for today’s exercise. I adapted his words from his excellent book “ACT Made Simple” and very much recommend that you check him out if you want to know more about Acceptance and Commitment Therapy.Thank you for the music!Mindfulness ex backing track music: Soothing Serenade by UNIVERSFIELD -- https://freesound.org/s/719269/ -- License: Attribution 4.0Inrto musicAfter the flu by kjartan_abel -- https://freesound.org/s/611440/ -- License: Attribution 4.0 This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit drrosie.substack.com

* A healthy baby is all that matters (i.e. the mother is just a vessel)* Pregnancy/baby loss is shameful (i.e. it’s probably your fault)* Women should be able to continue “as normal” when pregnant AND they should be able to “bounce back” to “normal” as soon as they give birth.Heard those ones? I bet you have. These are some of the fundamental assumptions that underpin our attitude towards women when they become mothers. Even if people are wise enough not to say them to me directly (anymore) I still hear them in the hushed tones of congratulatory or conciliatory conversations and I still deal with the fallout in my therapy room each week.These assumptions harm women every day. They block them from getting the support they need from loved ones, at work, from the healthcare system and perhaps worst of all they cause women to turn on themselves with the harshest of criticism.This week I wanted to give you something practical that you can share with the people who want to help but feel helpless themselves. It is not our fault that we feel clueless when we see someone struggling. Compassion takes wisdom as well as strength and commitment. In other words, if I want to help you I need to know how to do it and our society hasn’t equipped us well to support women through pregnancy, birth and parenting.Yet compassion turns out to be pretty important. There’s plenty of evidence that giving and receiving true compassion promotes better mental health. We also know that better mental health in pregnancy and early parenthood leads to better life chances for children and better health, productivity and more fulfilling careers for parents. So it makes sense to me that learning how to give and receive compassion should be a priority for all of us. But it can be tricky when we are used to dismissing or avoiding struggles (our own and other peoples’).In this post, I aim to give some simple advice you can follow if you want to show some compassion to someone who is struggling in pregnancy or parenthood. If you are struggling right now, take a moment to share it with the person/people you need to read it most.Caring for them starts with youWhen you care about someone who is pregnant or postnatal and you can see they are struggling it is natural to experience your own stress and anxiety response.If they are your partner you might be frightened about what the future holds, you might be dealing with your own sadness or fear and you might be experiencing many of the same factors that are causing them to struggle such as lack of sleep, financial instability, an unwell child etc.If they are a colleague or a friend you might find you also have strong feelings coming up for you that you didn’t necessarily expect. We have all been babies so we have memories and gut reactions to all things pregnancy, birth and parenting that we cannot control and may not always be aware of. On top of that you may have had experiences that you know are directly impacting on your feelings. For example, you might have had a similar experience, I know when I talk to someone struggling with HG a part of my own trauma is activated by it. Or you may have had a very different experience and struggle to relate as a result.These emotional reactions are not wrong. You don’t get to control your emotions, the memories that come up for you or the first thoughts that come into your head. The problem is if you are not aware of them then you will most likely respond with your “default” behaviour. For most of us, that means we will try to avoid uncomfortable feelings. This is because most of us were taught to try to distract ourselves or remove ourselves every time we were faced with a difficult emotion (chocolate buttons to stop a child crying is the best example of this).However, unfortunately, our default avoidance settings can make it hard for us to connect with and show real compassion for someone who is suffering. In these situations, avoidance often looks like:* Trying to “fix” things by focusing on practical problems and refusing to stop for long enough to listen.* Looking for a brightside even when there isn’t one - the words “at least” usually indicate we are doing this.* Trying to “snap someone out of it” by distracting them with “fun.”* Insisting on doing the “same things as always” even when they are obviously not working well.* Spending less time with someone or not listening well when you are with them.Again, if you have been doing these things you should not feel guilty about it. We have been trained to be expert avoiders and it is the default setting for almost all of us. But the brilliant thing about being human is we get to override our default settings when we want to and this is the perfect time to start re-writing our programming.Take a moment for your feelings (before you engage with theirs)When trying to support someone who is struggling it is important to take regular moments to check in with yourself, notice how you feel and show yourself some compassion. Make sure that you have adequate support yourself, a friend or family member to off load to or, in a work context, your own line manager. Recognise the additional energy providing support takes and make space for it in your life where at all possible.This exercise helps you to get in touch with your body and mind and bring some acceptance and compassion to your own experience. Try something like this regularly and you will find it is a little easier to sit with the discomfort of someone suffering. If you are interested in thinking more about this check out the books by Michelle Cree and Paul Gilbert on Compassion Focused Therapy for fantastic self help guides to developing this skill.The colour of compassionBefore we begin I want you to make sure you are on your own, in a comfortable setting when you try this for the first time. It is normal, natural and unavoidable that your mind will wander, and probably criticise what I am asking you to do. The first time I did this type of work my mind would not stop telling me how idiotic the whole thing was. I promise you there is a whole heap of science behind it (go here if you love the data) so please proceed with an open mind and just gently refocus yourself on my voice anytime the mind wanders.Five Stepping Stones to Compassion:* Adopt and alert and dignified posture, it may be helpful to imagine your body as a mountain, strong, stable and powerful. You may wish to close your eyes at this point.* Now begin breathing using a soothing rhythm, this can be in for 7 and out for 7 or any other rhythm you find relaxing.* Now spend a few moments mindfully becoming aware of what your mind is doing. Your mind is like the sky, thoughts pass through and you notice them but do not linger on them.* Now adopt a warm facial expression, perhaps a soft smile. Signalling to your body that you want to activate your soothing system through kindness.* Finally remember to talk to yourself in the same kind tone of voice you would use when talking to your child or a friend who needed your compassion. This will also tell your brain and body to activate your soothing system.Compassionate ColourNow imagine a colour that, to you, symbolises compassion and warmth. It could be a mist or a light.The colour gradually begins to surround you and as it does you feel the warmth and safety of compassion begin to surround, hold and support your body.Just spend a few moments here, breathing in your soothing rhythm and imagining being surrounded by that mist, the soothing, relaxing colour of compassion.Now you watch as the soothing, relaxing mist of compassion begins to flow into your body. You notice it entering your body, first through your heart and then slowly filling your body as it moves outwards.You notice the light of compassion flowing into your chest, abdomen, back, shoulders, arms, fingers. Your thighs, calves, feet, toes, your neck, head, face.As each body part becomes filled with the warm light of compassion you become more aware of it filling you with the qualities of wisdom, strength, kindness and warmth.If you feel any blocks or resistance. Just notice this with a kind smile to yourself.As you bring your attention back to the kind, warm colour filling your body, remind yourself of its intention to support you, to help you develop the compassionate part of your mind.Spend a few moments breathing and imagining the warm light of compassion totally filling your body, growing stronger with each breath.Now that your body could not be more full of the light of compassion, you begin to notice that it is flowing from your body and into the room around you.Imagine the people you care about are in the room with you. Notice the light of compassion flowing from your body, into the room and into their bodies.You see the warm, mist slowly filling them and know that they are feeling its supporting, holding, soothing presence.It is filling them with kindness, strength and wisdomWhen you feel that you and those you care about are totally full of the light of compassion gently bring your attention back to your breathing. Notice the sensation of your feet on the floor or your body in contact with whatever surface you are resting on. Slowly open your eyes but try to hold on to the sense that the colour of compassion remains with you, supporting you in all that you do.OK, so now you are feeling on good form to offer some support let’s dive in to how you can be helpful to someone who is pregnant or postnatal and feeling rough.Open up the conversation (so they don’t have to)During the first trimester of pregnancy, our culture expects us to remain silent even when we are suffering. Having to divulge our pregnancy, let alone ask for support, is seen as a terrible imposition on another adult. “Don’t tell me yet” or “I wish I didn’t know until after the 12-week scan” are all comments I’ve heard others make after the news of an early pregnancy and they fill me with a rage I don’t know how to give voice to. In a similar way women are supposed to cover up the signs that they are struggling throughout pregnancy and motherhood. We expect women to show up for work and seem “professional” even if they are in agony (emotional or physical) and/or having to milk themselves in a toilet cubicle. We expect women to look presentable, get “back into shape” and make us tea when we visit them even if they are dealing with crippling anxiety, no sleep and a dysfunctional pelvic floor. All of this means the person who is struggling is very unlikely to ask you for help unless they are at complete rock bottom. So take that pressure off them wherever possible. Try opening with sympathy and asking a question like:I heard about XXXX that sounds very stressful, how are you feeling?It looks like XXXX is quite painful right now, is it bothering you a lot?I can tell it is really tough right now. Can you tell me about it?We are so used to shutting down emotional experiences that it can feel really strange to ask questions like this and part of you will want to jump straight to practical help but please don’t do that. Just listen and show that you see their suffering.Bring the practical resources to themMany physical health problems in pregnancy and the postnatal period make engaging with the internet very challenging. I could not scroll or use WhatsApp for almost all of my first HG pregnancy. When our mental health starts to suffer we also often lose motivation or become overwhelmed easily. Once you have spent a good amount of time listening doing some research to find answers to the specific problems they mentioned and facilitating them to access support can be very useful.This should begin with making sure they are accessing all the NHS services they are entitled to so checking they have spoken to their GP/midwife/health visitor and helping them to do that if not is important. It can be surprisingly complicated in some areas! If they have done this but are waiting or have exhausted the support available, here are some suggestions of places to go hunting for practical help:If they are suffering with Hyperemesis Gravidarum take a look at the Pregnancy Sickness Support website. If they are not receiving good medical care the pages on diagnosis and medication are likely helpful. If they are feeling lonely or lost the peer support service is the place to go.If they are struggling with birth trauma try The Birth Trauma AssociationIf they have had a baby in the NICU visit Miracle Moon.If they have been through pregnancy or baby loss head to SANDSIf they are dealing with depression or anxiety take a look at PANDASThe key is to go the extra mile. Rather than just telling them to “look up XYZ” do it for them and, if they are keen, do all the tricky bits like registering or writing emails on their behalf. Oh and obviously if you are suggesting something that requires childcare you should offer to provide it!If you are in the workplace then the same rules apply. Find out what policies you have in place that may benefit them, don’t expect them to know or ask. If they need to apply for something then, if they agree, do as much of the form as you can on their behalf, draft emails for them, work out the details. I remember when I was pregnant and sick I was so often asked to do completely reasonable things that I simply could not achieve, like working out cover for my appointments. This adds hugely to the stress and guilt of the situation. Knowing that you have anticipated their needs and taken it off their plate will mean a lot.Suggest boring socialisingThere is nothing lonelier than struggling at a time you expected to be full of joy. Sadly, due to the default avoidance setting we talked about most of my clients tell me their friends, family and colleagues become distant while they are struggling. People also tend to feel embarrassed if they aren’t able to go out or be as entertaining as usual. Try suggesting low-effort ways to see each other. Maybe just watching a box-set, no conversation needed, or sitting on a park bench together. They are unlikely to suggest these things themselves due to all the social pressures and the overwhelm they are feeling so go ahead and suggest the least taxing way of being together you can think of. If you can add some nice touches then do. I remember when I was at my lowest I was watching a box set, like I did all day every day, when my husband brought me a glass of fizzy water in a wine glass, a fresh box of tissues and sat down to join me. Little things that make you feel human can make a big difference.Remember their prioritiesFinally, I don’t think I have ever seen an article on supporting someone that acknowledges they are a human with a distinct personality. Some people may love bubble baths when they are stressed. Others may want to punch you in the face for suggesting it. Think about what normally matters to this person and try to solve these problems for them as much as possible.For example, if they are a clean/neat person but they aren’t able to keep on top of things do as much as you can to make their environment how they like it. If you know they are usually the family organiser but they are feeling overwhelmed by all the “school stuff” they aren’t able to manage ask if you can go through the school emails or Whatsapps for them and pick out key points/actions they need to take (or that you can take for them).In the work context, this could involve working out how to make tasks, meetings or projects that you know they value easier for them to access rather than removing them completely. Is there a way in which they can play their role without having to do something that isn’t possible right now. For example, could a meeting that usually happens in person become virtual or could they brief a proxy to take part on their behalf.Remember that the things that usually matter to them still do and connecting with their old/usual priorities can help them feel less isolated.I hope this has given you some useful ideas and a bit more confidence to support someone who is pregnant or postnatal and struggling. There is so much more I wanted to say so I am planning posts specifically for romantic partners and line managers soon.If you are struggling please share this post with someone who could help you.Before I go, I just wanted to say thank you so much for reading and please let me know if this was helpful. I’m planning to write regularly and would love to know what you would like to hear more about so please use the comments to tell me!Until next week, take care,RosieThanks for reading Pregnant and Sick with Dr Rosie Gilderthorp! Subscribe for free to receive new posts and support my work. This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit drrosie.substack.com

Last week I flew to sunny California to attend the International Colloquium for Hyperemesis Gravidarum (otherwise known as HG or severe pregnancy sickness). Supporting people through HG is a passion for me because I have been there and the lack of support I experienced honestly wounded my faith in humanity. But it is also a condition that I love to research and write about because it is emblematic of so many of the issues that scupper mental health during pregnancy and parenthood.Because HG is so extreme (the nausea and vomiting are really beyond imagining if you haven’t been there) societal beliefs and assumptions that often hide in the shadows, making us feel rubbish about ourselves but just evading our conscious awareness, are thrown into the spotlight. The ICHG gave me the opportunity to hear the latest developments in the quest to understand the causes of HG and how to support people through it better, medically and nutritionally. It was wonderful to hear what the experts had to say, and to talk to them about our study into mental health and HG, but it left me thinking about all the ways women experiencing HG get hurt by our beliefs and assumptions. I have a feeling it is going to take me a few weeks to get my head around everything I learned at ICHG so over the next few weeks I’m going to bring you a post each week talking through a topic we talked about there. The first one is a cultural belief/assumption that all of the HG survivors (including me) talked about with fervour.You should look after yourself during pregnancyAt first glance, this seems straightforward. From the moment you use an online baby name finder and your data is sold to “babycorp” you are flooded with emails telling you exactly what you should eat and when for optimal baby development. I remember devising ambitious but careful exercise regimes and freezing smoothies with the exact nutritional requirements for the entire first trimester in handy cubes. Of course, I took it for granted I was NEVER going to miss taking my pregnancy multi-vitamin. Then week 5 came, HG struck me down and my poor baby bump was fed on nothing but the occasional ice lolly and a salted cracker for the next 12 weeks. It didn’t get much better after that, I think I managed to add the occasional Coke, scoop of ice cream and a piece of toast into the mix in the third trimester but they didn’t stay down long.I 100% knew this diet was bad for my baby and bad for me. In fact, I was begging for help whenever I saw a midwife or doctor. But no one gave me any help (other than a few drugs that didn’t work) and I could not keep any food, or multivitamins, down. So that was reality for me and my baby. I know that this is true for most of the women battling through HG. Not only do you have the excruciating symptoms of an all-consuming illness to contend with but you also have the sense that you are breaking your own rules and disappointing everyone around you.So what should we be doing differently? Well, first we can stop assuming that pregnant women need more education about what they should (and shouldn’t) eat. Everyone should receive some advice when they first register their pregnancy but beyond that we should probably stop believing that telling women who say they can’t eat anything to try a “diverse range of foods” is in any way helpful. I learned at ICHG last week that nutrition in prgenancy IS really important and that poor nutrition is probably leading to some of the difficult outcomes of HG. So, if we know it is important we should be offering real support to achieve it. There were examples of this being done through IV supplementation, delivery of anti-emetic (anti-sickness) medications through IVs and through tube feeding. These treatments are often not offered to women because the belief that they simply need to be “look after themselves” is so strong that doctors, nurses and midwives never consider other options.HG is not the only condition in pregnancy that makes sticking to the “look after yourself” rule hard. It is hard to “look after yourself” when you have multiple children, an absent partner, are living in poverty, are juggling many jobs, have complex health needs, are living with addiction or care for someone with a disability (to name just a few). People with a more straightforward path might lack empathy for many of these situations because they simply can’t imagine a world in which you don’t have time, money or skills to organise taking a prenatal vitamin but if there is one thing I have learned about mothers over my ears as a perinatal psychologist, it is that if they can they will. If they are not doing something they know would be beneficial to the baby it is because they cannot do it and we need to look at the barriers they face and come up with creative solutions that address those rather than judging them.We need to challenge the belief that women should look after THEMSELVES in pregnancy and instead think about how we can all look after them better.If you are struggling with judging yourself harshly or you are troubled by how others may be judging you please know you are not alone. The ICHG was full of HG survivors and each of us had multiple stories to tell of feeling shamed by others for the things we did to survive. I remember vividly an older woman knocking my bottle of Coke out of my hand in the hospital canteen (I was in the third trimester and attempting to work that day). She told me I was killing my baby. I wish I had told her I had been sick 9 times on the way to work and lack of calories was the biggest threat to my baby. But I was so pregnant and sick I just vomited from the stress and cried, partly from anger at being judged but mostly from the deep shame I felt that I wasn’t the kale swilling yoga-mum I thought I was going to be.If we want to free ourselves and our daughters from the shame we have to spread the message of shared responsibility for health in pregnancy, mental and physical so share this article with your support network. You can also find me on Instagram @thepregnancypsychologist where there are plenty of shareable posts and reels to educate your friends/family/health professionals with!Self-help when you are feeling the shameIf you need a “pick me up” yourself I have an exercise for you to try today. It is based on the principles of Compassion Focussed Therapy and involves imagining a compassionate person responding to you with understanding, strength and a commitment to alleviate your suffering. It is astounding what receiving compassion from another person can do to calm our nervous system and allow us to rest, digest and think more clearly about our situation. We are lucky that our human power of imagination allows us to access some of the healing power of compassion through imagery. Practising in this way also means we find it easier to show ourselves compassion when we find ourselves in a difficult moment. I wish I had built up my self-compassion muscle a bit more before I had to deal with the woman and the Coke bottle. I’ve adapted it from Paul Gilbert and Michelle Cree’s principles so please do go and read their work if you like this approach.Start by getting yourself into a comfortable, supported position. If you are struggling right now that might be lying on your side but if you feel well enough an upright, strong position with your feel pushing into the floor will help you feel alert but grounded. Try to adopt a slight smile as you close your eyes or allow your gaze to settle on an object of focus.Now take some soothing breaths down into the belly. As you breathe in imagine a coffee plunger sending the breath down so your breath inflates your abdomen rather than your chest. We are going to try breathing in a particular rhythm that some people find soothing. In for 4, holding for 4, breathing out for 4 and holding for 4. Try it with me but if the pace isn’t right for you just concentrate on breathing in a way that feels good to you, making sure you fully empty your lungs each time you breath out slowly.Breathe in 2,3,4, hold 2,3,4, out 2,3,4, hold 2,3,4Now the body is feeling more relaxed and the soothing system in the body has had a chance to engage I’d like you to imagine a person or being that embodies strength, wisdom and kindness to you. They understand that we didn’t choose our brains or the world we live in, they are non-judgemental. They are also strong and committed to helping you through your distress. This could be a real person you have known who has shown you these qualities or it could be a character from fiction. It could be a spiritual being, an animal or a creature you have made up entirely.What is it wearing? What are the textures of its clothing? Skin or fur?Spend a moment noticing how its posture and how it moves. How does it relate to you? Does it approach you? Does it show its kindness through reaching out to you or is there another way?What is its facial expression? Notice how it looks at you and how that makes you feelHow do they sound when they communicate with you? How does their tone of voice make you feel?Spend a few moments breathing in a way you find soothing, just enjoying the presence of your compassionate being. Know that even after this exercise is over they are there for you, ready to help you support yourself through difficult moments.Now gently open your eyes and re-focus on your surroundings, take a little stretch and notice how that exercise left you feeling. Compassion is not always easy to receive, especially when we are used to judging ourselves harshly so it might not have been the easiest five minutes of your life but if you can commit to spending time developing compassion for yourself each day you will find the grip that the judgement of others has on your mental health will slowly loosen.Next week I’ll be back here talking about our cultural belief that pregnancy complications are all the mother’s fault. There were some fascinating insights at ICHG into that one!For now, look after each other!RosiePs. I know this can be tricky to navigate alone so if you would like some help showing yourself some more compassion please check out my therapy practice (www.knowyourmindconsulting.com) as we would love to support you through pregnancy.SubscribedKnow someone who needs to read/listen to this? Please share, together we can improve support for pregnancy mental health.Disclaimer - Before you go, I just wanted to add that if you're really struggling, then listening to podcasts or reading blogs isn't a substitute for good mental health support. Please know that if you're feeling really low, or anxious, or like your mental health is interfering with the way you live your life, It's a really good idea to speak to your GP in the first instance and try to get a referral to perinatal mental health so that you can access therapy and the support that you deserve for your mental health.If you prefer to go private and see an independent psychologist, please do come and find me at knowyourmindconsulting.com where we offer specialist therapy to help you through a difficult time in your pregnancy or in parenthoodThank you for the music!Mindfulness ex backing track music: Soothing Serenade by UNIVERSFIELD -- https://freesound.org/s/719269/ -- License: Attribution 4.0Intro musicAfter the flu by kjartan_abel -- https://freesound.org/s/611440/ -- License: Attribution 4.0 This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit drrosie.substack.com