A call for better hyperemesis gravidarum care | Jemma Martin | TEDxNHS

Key Concepts

• Hyperemesis Gravidarum (HG): A severely debilitating pregnancy condition characterized by violent, relentless vomiting and horrendous nausea, far beyond typical morning sickness.
• Dehydration and Malnutrition: Severe consequences of HG, leading to physical weakness, cracked lips, raw throat, and significant weight loss.
• Mental Toll: The profound psychological impact of HG, including daily tears, suicidal thoughts, and trauma.
• Misdiagnosis and Under-treatment: The failure of some healthcare professionals to recognize the severity of HG and provide urgent, appropriate care.
• Racial Bias in Maternity Care: The disproportionate impact of HG and other pregnancy complications on Black women, exacerbated by dismissal of pain and lack of trust.
• Suicidal Ideation and PTSD: Significant mental health outcomes for HG survivors.
• National Care Pathways: The need for standardized protocols for HG care across healthcare trusts.

Hyperemesis Gravidarum: A Survivor's Account and Call to Action

This transcript details the harrowing experience of Gemma Martin, a midwife and survivor of Hyperemesis Gravidarum (HG), a severe pregnancy complication. Martin contrasts the idealized vision of pregnancy with the brutal reality of HG, describing it as a "fight for survival."

The Devastating Reality of HG

Martin vividly recounts her personal experience, beginning at six weeks pregnant, where she was "stuck to a sick bowl" with "violent, relentless vomiting and horrendous nausea 30, 40 times a day." She describes the physical toll: a "weak, shutting down" body, "cracked lips," a "throat raw from bile acid," and an inability to eat, drink, speak, or move. The condition was so severe that she lost "just over a quarter of my body weight in 3 weeks."

She highlights the lack of understanding and empathy from some healthcare professionals. One doctor's advice to "eat crackers" was met with internal frustration, given her extreme dehydration and near-unconsciousness. Another suggested terminating the pregnancy, a recommendation that caused immense emotional pain, especially for a "wanted pregnancy." Martin also notes the inappropriate recommendation of "ginger" when she could barely keep down saliva, drawing a parallel to how such a suggestion would be unacceptable for other serious medical conditions.

The Mental and Emotional Toll

The mental impact of HG is a significant focus. Martin shares conversations with other women who experienced "daily tears" and "suicidal thoughts" due to the overwhelming mental toll. Another woman struggled to find a medication combination to eat even a "quarter of a sandwich," all while being told by her GP that she "might be harming her baby."

Statistics and Systemic Failures

Martin presents alarming statistics regarding HG:

• It affects up to 4% of pregnancies, though she believes this number is higher due to misdiagnosis and delayed treatment.
• 32% of HG survivors experience suicidal thoughts.
• A staggering 50% will experience trauma throughout their pregnancy.
• The top predictor for HG is postnatal depression, with 18% of survivors meeting criteria for PTSD.

She criticizes the lack of attention to HG in the UK's women's health agenda, leading to a deficit in research funding. This is particularly concerning given the UK's reputation for safe childbirth, yet women with HG are being "failed."

The Intersection of Race and Healthcare Bias

Martin, as a Black woman and a midwife, brings a critical perspective on how race intersects with healthcare experiences. She states that being a Black woman added "another layer" to her experience, as she was not perceived as vulnerable and was expected to be "strong." She cites statistics from the "five times more black maternity experiences report 2025," which found that:

• Black women are just under four times more likely to die in pregnancy, childbirth, and the six-week period after.
• HG was the third highest pregnancy-induced condition among Black and Black mixed heritage women.
• Black women are most likely to have their pain and feelings dismissed.
• They are twice as likely to be hospitalized compared to white women.

Martin argues that this "bias can be deadly" and that Black women are "literally fighting for survival" in maternity care.

The Grieving Process and the Need for Good Care

Survivors of HG grieve the pregnancy they envisioned, their connection to their baby, and the version of themselves that existed before the illness. Despite this, they "keep going barely."

Martin's hope came in the form of Leslie, a midwife who "validated her experience" and provided crucial support. This highlights the importance of empathetic and understanding care.

However, the transcript also shares the tragic story of Jess, a hopeful mother and her baby Elsie, who "lost their lives due to gaps in education, fear of prescribing medication and miscommunication between health care professionals." Martin states, "I could have been Jess."

A Call to Action for Healthcare Professionals

As a midwife, mother of three, and survivor, Martin is driven to prevent others from suffering the same fate. She emphasizes the importance of listening to women's voices, especially those without medical backgrounds who may struggle to have their pain recognized.

Her proposed solutions include:

• Establishing national hyperemesis care pathway standards that all trusts must adhere to.
• Encouraging midwives, clinicians, and healthcare providers to "prescribe the medication confidently" and "push for IV fluids."
• Urging them not to let "fear of expenses cost a woman her hope and her health."
• Advising them to "trust your gut. But trust hers more."

Conclusion

Gemma Martin's account is a powerful testament to the severity of Hyperemesis Gravidarum and the systemic failures in its recognition and treatment. Her personal story, supported by statistics and broader societal issues like racial bias in healthcare, serves as a critical call to action for healthcare professionals to prioritize the needs of HG sufferers, provide adequate care, and advocate for better standards and research. The core message is one of survival, advocacy, and the urgent need for change to ensure no woman is left to fight for her life alone.