NVP Counselor
Date: 2004-06-20

Question:
I am in my 9th week of my second pregnancy and my 3rd week of moderate NVP. With my first pregnancy, I was so sick I had to quit my job and stay in bed for the first six months (although I never required hospitalization). Although my NVP is not as severe as with my first pregnancy, I am beginning to feel hopeless and overwhelmed. We had been trying to get pregnant for over three years and are overjoyed that it has finally happened. I was previously very content with my life I have a job that I enjoy, a loving and supportive husband and a wonderful five year old daughter. Lately, though, I wake up in the morning feeling hopeless and just want to stay in bed and cry all day. I experienced some depression with my first pregnancy, but I believe this is more severe and directly linked to my NVP. I am so tired of being sick all the time. I often get sick at night when I wake up to use the bathroom, and feel like I just can not go on another day like this. I no longer feel any joy in my life, not from my job or my family or anything, and it is starting to scare me. My husband and friends tell me to just hang in there, that I know this will pass just like last time, blah, blah, blah. That is not the point. I am so sad! I hesitate to mention this to my doctor, because I do not think it is a chemical imbalance, any rational person would feel depressed when faced with 24 hour nausea that could potentially last another seven months right?

Answer:
Don't assume that this pregnancy (and the NVP symptoms that come with it), will be the same as your first. Every pregnancy is different. You should take steps to deal with your NVP immediately upon the onset of symptoms. Safe treatments for NVP are available and are outlined in our treatment algorithm (February 2002 Motherisk Update).

The first line of treatment in Canada is Diclectin (Vitamin B6 plus doxylamine succinate). Equivalents in other countries are described in other Questions and Answers in this Forum. If you are already being treated for NVP, it is possible that you are not receiving the optimal dose. Talk to your doctor about the amount and frequency of your dosing. You should also not hesitate to discuss your feeling depressed with your doctor -- help and treatment can be beneficial. In fact, all health issues should be addressed, since there are some that may affect your NVP symptoms. For example, some women need medication for digestion and acidity problems, while others are positive for the H.Pylori stomach bacteria. H.Pylori may cause NVP-like symptoms but requires different treatment.

Do not let the NVP take over. Discuss all your symptoms with your doctor, including depression. The risk or safety of different medications can be discussed with a teratogen information specialist at Motherisk by dialing (416) 813-6780, or visit the OTIS website for a teratogen information service in your area. You can discuss your NVP with a Motherisk NVP Counselor at 1-800-436-8477.