Reviewing the effect of hyperemesis gravidarum on women's lives and mental health

Abstract

Background Hyperemesis gravidarum is a condition that affects 1-1.5% of pregnant women, and is characterised by extreme levels of intractable nausea and vomiting. Aims To understand the association between hyperemesis gravidarum and psychological morbidity. Methods A qualitative literature review of the effects of nausea and vomiting in pregnancy and hyperemesis gravidarum was undertaken. An extensive search of multiple databases was undertaken and the results appraised and synthesised. Findings Four main themes and two subthemes emerged in relation to mental health effects. The main themes were: social isolation; unable to care for self and others or change of role; negative psychological effects (depression, anxiety, guilt and loss of self); and sense of dying, suicidal ideation or termination. The subthemes were loss of earnings or employment; and changes to family plans. Conclusion A shift towards an holistic biopsychosocial approach to care for hyperemesis gravidarum is required. Health professionals can help women by allowing them to express their feelings, and validating them. Where required, referral to the perinatal mental health team or a peer support system may be appropriate.