Q&A with Charlotte Howden, Producer of Sick: The Battle Against HG

Charlotte Howden is the Presenter and Producer of Sick: The Battle Against HG, the first documentary to tackle the subject of hyperemesis gravidarum (HG) – severe pregnancy sickness. Having suffered with the condition herself while pregnant with her son, Charlotte campaigns for improved support and access to treatment for those affected by HG.

She spoke to Hysterical Women about the experiences she hears about from members of her online support group, and how healthcare professionals can better support these patients.

SG: What are the most striking common factors you’ve found in women’s experiences with HG? 

CH: A complete breakdown in communication in the patient-doctor relationship, and an insistence on not believing women, is how I would characterise the similarities between the stories I hear on an almost daily basis from women suffering with hyperemesis. Doctors – GPs in particular – are either ignorant to the condition or neglectful in their care.

I don’t make these statements lightly and I do constantly find myself in the position where I have to add in the caveat, “not all doctors”. But I do wonder what the doctors who are excellent at recognising this condition, and who respond easily and with sincere validation of a woman’s experience, are doing to engage with their colleagues on the mistreatment of women with hyperemesis.

What are the biggest misconceptions and barriers to women getting treatment?

In my opinion, as someone who has experienced this condition, health care providers – or anyone who might come in to contact with a pregnant woman with hyperemesis – tend to err on the side of extreme caution. They do this by either inferring, or in some instances quite bluntly describing, their symptoms as “really bad morning sickness” that will pass by itself; in no way do they accept that this woman in their care has hyperemesis.

Alternatively, they recognise the disease and simply tell them there is nothing they can do for them. The latter is just not true. There is now extensive and robust research available to provide any doctor with the satisfaction they need to prescribe women with anti-sickness medication during pregnancy.

As I write this we are in the 60th anniversary year of the Thalidomide tragedy. The legacy of that scandal is still indirectly affecting women with HG today, with doctors reluctant to prescribe anti-sickness medication during pregnancy as a result. It is time to move on from this and proactively look at including pregnant women in research and future studies. In the meantime, doctors can and must lean on the research and studies that do already exist.

What do you wish more people understood about the condition?

The link between the disease and regular pregnancy sickness. Recent studies have shown that hyperemesis is very likely a genetic condition. It is not a welcome or expected part of pregnancy and it is not a “really bad” version of morning sickness.

Whilst I appreciate there is a similarity, HG is a disease and deserves to be treated in that way. This is a physically debilitating and mentally life changing condition that ultimately can take away a woman’s choice about how many children she can have. It is also really important to know that both the mother and child can have poor outcomes from hyperemesis if it is not treated adequately and with immediacy.

How can doctors – both at GP surgeries and in early pregnancy units – better support women with HG?

In three simple steps: Validate, Treat and Care. I listen to hundreds of stories, via my podcast, social media and through emails. Every single bad story starts with: “they just didn’t believe me”, followed by: “I wasn’t offered any treatment”, and finally: “my care was below standard.”

As a campaigner on behalf of the HG community, I know that the road to excellent, gold standard care is a possibility for every woman with HG. Health professionals need to educate themselves; resources are easily obtainable, they need to think about how they would want to be treated if they had just found out they had a “rare” chronic disease, and they need to continue to ensure that any treatment they give to women is continued.

You can’t pass the buck with hyperemesis. You can’t expect that medication will solve the problem. A team needs to be in place to help women with their physical needs via medication and easy access to fluids, followed by access to perinatal mental health teams, nutritionists, and national and local support groups.

What support is available for women who are suffering?

In the UK we have Pregnancy Sickness Support – a national charity that can provide advice and support on how to manage this condition. They have a helpline and a live chat facility so women can get direct support.

Women should also reach out to other sufferers online via one of the many groups on social media and I sign post to these on my website.

I would also encourage women to listen to other sufferers’ stories via my podcast, The Hyperemesis Files, and of course my documentary, Sick: The Battle Against HG, which is now available on Prime Video.

Help is there.

You can find Charlotte on Instagram @the_sick_film

The #NotNeurotic series is published in partnership with BetterYou.

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