Understanding the serious effects nausea and sickness can have on your mental health during pregnancy
Some people look radiant and healthy during pregnancy, with thicker, shinier hair and glowing skin. Sadly, I wasn’t one of them. Not only did I struggle with anxiety and depression, I also felt sick – all day and all night. Every day, I felt like I was on a long, hot bus ride up a winding road, which made working, sleeping, and socialising difficult. And unsurprisingly, it had an impact on my mental health.
Sickness is a common issue that the NHS states affects around 80% of women in pregnancy. Although it’s called ‘morning sickness’, in reality it can occur at any time of day, and can last for months. Like many other challenging aspects of pregnancy – backache and groin pain, to name a few – sickness is often dismissed as just another side-effect that you have to put up with. However, research, such as that from the Imperial College Healthcare NHS Trust, suggests it can have a seriously damaging effect on mental health, and so shouldn’t be overlooked.
Severe morning sickness, known as hyperemesis gravidarum, is a debilitating condition that affects around 2% of pregnant people, in the UK, as highlighted in the aforementioned 2020 study in BMJ Open. Women might find themselves bed-bound for weeks on end, experience dehydration and weight loss, and are often unable to work or care for other children they may have. However, ‘normal’ sickness can be debilitating, too.
Being pregnant is tiring in itself, but the physical symptoms of sickness and nausea can exacerbate this exhaustion. It also makes day-to-day life more difficult. Most of us will know how hard it can be to concentrate at work when you’re feeling unwell, and it’s tempting to withdraw from friends, family, and social situations. Relationships can become strained too, especially if partners don’t realise how much someone is struggling. Here, we’re highlighting a few key considerations around why nausea can have such a negative impact during pregnancy.
Loss of control
Beyond the way sickness can affect your relationships and day-to-day life, another key reason why it can have such an emotional impact is because women can feel they’ve lost control over their bodies, says counsellor Georgina Sturmer.
“A pregnant woman’s body becomes shared property – shared with a growing foetus, medical professionals, friends, family, and with total strangers who comment and ask questions,” she says. “When we’re used to being in control and in charge of our bodies, the experience of sickness and nausea can add to a sense of helplessness and vulnerability.”
If you were previously fit and healthy, you may find it hard to recognise yourself. And although the nausea may be temporary, it can feel like it lasts forever – especially if it continues all the way up to the birth.
A taboo topic
Women wrestling with sickness are often reluctant to tell family and friends, because they’re worried their struggles will be minimised or dismissed. Society tells us that we should feel joyful during pregnancy, but this isn’t always the case. Pregnancy involves huge physical, hormonal, and emotional changes, which can lead to difficult emotions like fear, stress, regret, and guilt. Feeling physically unwell can intensify these feelings – especially if pregnancy isn’t what you imagined it would be. When we fail to live up to this ideal image – feeling happy, healthy, and excited – there may be disappointment or sadness.
“This is an area that is not widely spoken about, and yet it can negatively affect the mental health, quality of life, and functional capacity of women,” says Joanne Jackson, a psychotherapist and spokesperson for the UK Council for Psychotherapy. “The emotional impact of nausea and sickness during pregnancy is complex, and co-exists alongside feelings of anxiety, depression, panic, anger, helplessness, and desperation.”
For some women, sickness can be accompanied by embarrassment or shame. Often, pregnancy sickness is trivialised as being a ‘woman’s problem’, which can mean people suffer in silence or underplay their experiences, instead of speaking up or seeking help.
Lisa Jackson, a mother of three, struggled with sickness during all of her pregnancies. Her nausea and sensitivity to smells affected what she could eat and who she could be around.
“It affected where I went, and I avoided going to people’s houses so I didn’t have to be sick there,” Lisa says. “It did impact my mental health a lot as people thought it was funny or cute that I was so sensitive, and didn’t take it seriously when I couldn’t sit with them for lunch or would avoid the work kitchen.”
Taking sickness seriously is essential, particularly as studies suggest depression linked to severe pregnancy sickness can continue after the baby’s birth. “It can increase the likelihood of postnatal depression,” says Lisa. “Therefore, it’s important to detect if sickness is a problem as early as possible.”
Getting help for pregnancy sickness
If you’re struggling with sickness or your mental health during pregnancy, there are several steps you can take.
First, you should speak to your doctor. They may advise you to take medication to ease the sickness if it is affecting your life. “Be open and honest about your physical symptoms, and about the emotional impact that they are having on you,” says Georgina.
Your GP can also refer you for specialist psychological support via your local perinatal mental health team. However, budget cuts to NHS services mean this service isn’t always available. If this is the case, you may be advised to self-refer for cognitive behavioural therapy – and it’s worth noting that being pregnant will mean you’re bumped up the waiting list.
There are also various private counselling services with qualified therapists who can provide talking therapy, and other psychological services, that are tailored to you. Look for therapists that are registered with professional organisations such as UKCP or the British Association for Counselling and Psychotherapy. Some practitioners specialise in supporting pregnant people and those with chronic health conditions. The charity Pregnancy Sickness Support also offers advice via a helpline and webchat, that you may find useful.
Speaking to trusted friends or relatives is also essential. Find a space where you can share your feelings without fear of judgement, either with loved ones or in a peer support group, which you can find on social media or via your midwife. “It can be incredibly powerful just to know that you’re not alone,” says Georgina. “You can use local or online networks to reach out and build connections with other women feeling the same way.”
It can also help to take notice of any emotional triggers. I once nearly vomited in a Mamas and Papas shop because I felt overwhelmed by what I did and didn’t need. While distraction isn’t a cure for pregnancy sickness, I found stepping away from stressful situations helpful. “If your sickness and nausea are triggering difficult feelings, try to keep track of what helps and what makes things worse,” advises Georgina.
And, finally, being pregnant often comes hand-in-hand with unsolicited advice. While listening to professional advice is essential, ignoring less useful comments is a handy tactic. “If someone tells you that a ginger biscuit will solve all your problems, then feel free to tune it out,” says Georgina. “It’s your body, and everyone’s experience is unique.”
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