Saturday, June 23, 2012

Thoughts on "Morning Sickness Is Healthy"

I've recently thought a lot about the beliefs that our culture (and the medical community) holds about morning sickness. There are a lot of them, but they can be summarized thus: "Morning sickness is a natural, normal, and even healthy part of pregnancy." After pondering this for a while, I have decided to question this belief, based on the lines of evidence and thought that I will list below.

I hope that each of my readers will feel free to leave input, either in agreement or disagreement - I'd love to discuss this subject further.

To separate the different parts of this discussion, I'm going to write out different lines of current belief about NVP (Nausea and Vomiting of Pregnancy) and then list why I believe them to be invalid, or at least questionable. Here goes:

"Morning sickness must be healthy because a pregnant woman with morning sickness is less likely to miscarry than a woman who has no morning sickness."

I think that this is one of those situations in which accurate evidence can be used to draw inaccurate conclusions.

To demonstrate, I am going to be wildly unscientific and just make up numbers to demonstrate my point. Both my numbers and my scenarios will be intensely inaccurate, but I hope they will illustrate my point. If you think I've seriously screwed up, please let me know.

Let's say that there are two types of women in the general population - women who, when doused with your average dose of pregnancy hormones, will develop some sort of NVP, and women who will be blithely unaffected when given the same (i.e. during pregnancy).

Let us also say that viable pregnancies will present with normal levels of pregnancy hormones, while non-viable pregnancies (pregnancies in which the baby is doomed to die very small and which will end in an early miscarriage) present with lower-than-normal levels of pregnancy hormones. In most cases, this is true - there are non-viable pregnancies that present with normal hormone levels, and vice versa, but one indicator of a coming miscarriage is lower-than-normal hormone levels. This is why I only experienced very low-level nausea with our first pregnancy, which was a blighted ovum pregnancy - lower hormone levels.

Now, let's just do some (very) basic math, assuming (just for the purposes of illustration - this is not real life) that 50% of women are NVP-type, and 50% of women are non-NVP-type, and that 50% of pregnancies are viable and 50% of pregnancies are non-viable. Here's how it would come out:

NVP-type woman + viable pregnancy = NVP (25%)
NVP-type woman + non-viable pregnancy = no NVP (25%) - will end in miscarriage
non-NVP-type woman + viable pregnancy = no NVP (25%)
non-NVP-type woman + non-viable pregnancy = no NVP (25%) - will end in miscarriage

In this highly hypothetical situation, you would have a 0% change of miscarriage with an NVP pregnancy (or in reality, just a low chance), and a 67% chance of miscarriage with a non-NVP pregnancy. Thus, doctors and other caregivers will say, "It's better to have NVP because that means the pregnancy is healthy."

Well, yes.... but no.

What is really means is non-viable pregnancies are included in the "non-NVP" group so that the chance of miscarriage looks artificially high. The statistics may be true for non-NVP pregnancies as a whole (i.e. averaged), but in individual cases, the chance of miscarriage is either certain due to non-viability, or very low because this is a healthy pregnancy in a non-NVP woman/pregnancy.

Have I succeeded in making any coherent point yet?

My point is that morning sickness is not an inherently healthy state. Both NVP and non-NVP pregnancies produce healthy babies. Pediatricians do not ask, "Did you have morning sickness? No? That's bad... we can expect your baby to have health problems." No, babies derive no (known) benefit from having been gestated by NVP-type mothers. But when non-viable pregnancies are grouped in with viable non-NVP pregnancies, the risk of miscarriage looks artificially high for those viable pregnancies and makes morning sickness look (mistakenly) like it is a healthy or desired state.

If anyone out there is thinking, "This woman's methods are madness! She should be brought up before the National Academy of Sciences and shot!" - I know all that. This is just supposed to be the jumping-off point for thought. I'd love to hear everyone's input on this.

Next on the list....

"Morning sickness is a beneficial characteristic that keeps the developing baby safe from dangerous food-borne toxins."


If you look on just about any article on the subject of morning sickness, some form of the above will be recorded. "Morning sickness develops to keep the mother from eating foods that might harm her baby in the developing stages."

I see several reasons to question this conclusion.

(1) Morning sickness is, to my best knowledge, not seen (or at least not seen often) in the animal kingdom - If morning sickness were so awesome, it seems to me that it would be present among other mammalian mothers.

(2) Morning sickness in itself is disadvantageous to both mother and baby - In the moderate to severe forms, morning sickness prevents a woman from eating, drinking, searching for food, caring for her already-born children, moving, or being able to avoid dangers. In the most severe forms, it can mean absolute debilitation, long-term health effects, or even death for either the baby or the mother and the baby both. This is hardly an advantage. It is much more advantageous for a mother to be able to move, eat, care for herself and her children, and be able to keep herself nourished and hydrated.

(3) When was the last time you heard someone say, "Gosh, I had morning sickness so badly that all I was able to eat was fresh, organic spinach and beet salad with a side of fresh salmon"? That's right, never. You're more likely to hear, "I was so sick all I could keep down was pop tarts and Kool-Aid." The list of "things I could tolerate" during NVP usually runs the gamut of every junk food known to man - candy, slushies, cookies, soda, you name it. During the first half of my pregnancy with our eldest, I consumed primarily Ensure, Slim-Fast, and Jell-O, moving on to bagels and ice cream - that's right, pure junk. And pure junk that was absolutely loaded with toxins. This one just doesn't make sense.

(4) Even if mild morning sickness is advantageous, the same cannot be said of the severe types that cause debilitating nausea, inability to eat, malnourishment, dehydration, permanent adverse health effects, and/or death. There is nothing advantageous about that - quite the contrary.

"Morning sickness is just a normal part of pregnancy."

To me, this statement is utterly disproved by the fact that, historically, there have been some cultures observed by researchers in which morning sickness was rare or almost unknown.


This definitely seems to point toward a causation based on health, diet, or other environmental factors.

And it certainly shows that, somehow or other, NVP is avoidable on a cultural level. The question is how to find out the factors involved in this miracle!

***

I'd love to hear what you all think on the above.

Summary:

Modern science/culture says: Morning sickness is normal. Morning sickness is healthy. Morning sickness is advantageous.

I would question and/or doubt each of those statements.

Thoughts:

My guess is that morning sickness means that something is.... off. Something is not quite right with our bodies. I have no idea what that "something" is. Is it some sort of deficiency? Is it gut health? Is it body alkalinity? Is it some combination of factors? Are there multiple modes of causation?

Hard to tell.

I know that evidence is currently being gathered that shows a genetic link for hyperemesis gravidarum, and that's wonderful. Anything to get to the root of the problem, and also to show caregivers (once and for all!) that this stuff is not in our heads. That's awesome.

But... with many conditions, there are genetic tendencies/vulnerabilities... and there are environmental or health-based triggers that cause the genes to activate. Genes are not always our destinies... but they are our vulnerabilities.

Example 1: Rheumatoid arthritis runs in my husband's mother's family. She developed it when she was 22, and it nearly killed her. Her sister, with the same gene, didn't develop it until her seventies. Why? Because having a certain gene does not always mean that the gene will be activated - it takes environmental triggers, whatever those were.

Example 2: Celiac disease - it's genetic, but it often requires environmental triggers to activate (usually gluten exposure). Celiac rates exploded astronomically in Ireland when the Irish switched from potatoes to wheat as their main food source - a case of genetic susceptibility plus environmental triggers.

All that being said, I believe that there is a cure for NVP and for hyperemesis. Not a drug cure, to cover the symptoms of an already-developed disease (though that would be nice too!), but a pre-conception cure that will correct whatever metabolic or bodily systems have gone awry so that pregnancy becomes a misery (in mild cases) or a threat to our lives and our babies' lives (in severe cases).

What do you all think? Is morning sickness a healthy state, or a pathological one? Any input? I'd love to hear what you all think! As always, input must be civil and polite (or the delete-comment-monster will be released!). Chime in, please!


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