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'The problem with hyperemesis is not just the suffering – it's the battle to get treatment'

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Caitlin Dean advocates on behalf of women suffering in silence with pregnancy sickness

Nt editorial caitlin dean

Nt editorial caitlin dean

Caitlin Dean has a complex relationship with the word “spew.” For her it symbolises misery and physical discomfort, but it’s a word she also finds amusing.

“’Spew’ is a word that’s been in my life for some time. It makes me smile, even though I’ve now ‘spewed’ well over 2,000 times,” she says.

The reason? Ms Dean has suffered from hyperemesis gravidarum (HG), a condition of severe and prolonged vomiting during pregnancy. But the word also reminds her of silly moments with family quoting the scene from the film Wayne’s World, where character Garth Algar delivers the line, “If you’re gonna spew, spew into this”, while holding a paper cup.

And while Ms Dean finds pregnancy sickness to be no laughing matter, her blog title Spewing Mummy serves as a nod to the word’s role in her life.

After struggling with HG three times, Ms Dean has taken her experience with pregnancy sickness and melded it with her nursing career to develop a HG nurse specialist role. She has dedicated her work towards raising awareness within the medical community about this condition and in improving the availability of supportive care resources so that no women feel they have to go through HG alone.

During her first two pregnancies, Ms Dean was forced to take time off from her work as a practice nurse. When she became pregnant with her third child Ms Dean sought out Pregnancy Sickness Support (PSS), a UK charity dedicated to promoting awareness of HG. After her daughter was born, coincidentally on the first International Hyperemesis Awareness Day, her involvement with the charity grew.

She became chairperson of PSS in September 2011 and helped create a national support network. In addition to providing support to women through the organisation’s hotline, she also advises hospitals and general practitioners.

“The problem with hyperemesis is not just the suffering, and the nausea – that’s like 50% of it,” Ms Dean says. “The other side of it is the battle to get treatment. The lack of knowledge and awareness around the condition.”

As a means of addressing this problem she created her popular blog “Spewing Mummy”, a platform for discussion and a resource for education about the realities of hyperemesis, such as social isolation and its impact on mental health and relationships.

Ms Dean is able to draw on her nursing background and the skills and knowledge she acquired from that field of work to develop her hyperemesis specialist role, a role she explains is multi-faceted.

Her work is a balance between advocating for women with the condition to other healthcare professionals, while also helping those with the condition understand how hard it is for healthcare professionals to treat.

This difficulty for medical staff, according to Ms Dean, lies in a lack of treatment.

“We don’t have an effective treatment for it,” she says. “We have antiemetics, which work to different degrees for different women, but none of them are a cure.”

She says such medication merely “takes the edge off” and for the majority of women does very little to relieve the nausea. Instead Ms Dean says that all too often women visit a doctor and are advised to attempt self-help methods, many of them ‘old-wives’ tales’ such as the use of ginger. Others are told their symptoms are just morning sickness or even told it is ‘all in their heads.’

“It’s not a psychodynamic condition,” she says. “It warrants proper evidence-based treatment.”

And Ms Dean is working hard to make this a reality. She’s currently pursuing a master’s degree in clinical research at Plymouth University, specifically looking at women’s experiences of treatment for hyperemesis. She’s also working with a team in Amsterdam to draft an internationally recognised definition of HG.

She notes that thanks to organisations like PSS raising awareness about HG, great improvements have been made in the quality of care across the UK. Although many people credit the improvements to the fact that HRH the Duchess of Cambridge suffered from HG, she feels the charity has been instrumental in changing attitudes

“Had PSS not been there to provide the voice behind those headlines it would’ve just blown over and no one would’ve thought that much about it,” she says.

Ms Dean says that however traumatic at the time, the 27 months she spent throwing up and bed bound ultimately ended up being a good thing as experiencing the condition first hand made her a better nurse.

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Readers' comments (1)

  • Great piece.

    And thanks to Caitlin and Pregnancy Sickness Support's huge involvement in the new RCOG green top guidelines for HG, there's hope yet that hospitals will establish compassionate, joined-up protocols for the management of HG.

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