In her poem ‘Matter’, Sinéad Morrissey imagines her ‘love making as a kind of door / to wherever you were, waiting in matter, / spooled into a form I have not yet been shown’. Later, in ‘Returning from Arizona’ she describes the moment when her body spills its secrets and what was waiting now begins to arrive:
Getting too much of what you’ve acutely missed too suddenly — the median notion botched — can render you wary of wishing’s blunt chicanery: like longing for weeks to be sick to prove the baby’s taken, then failing to find a tonic for another being’s foothold in your person.
Like Morrissey, most women now no longer discover they are pregnant from morning sickness. They are waiting for it, half-longing for, half-dreading its confirmation. There are other signs that come before — a missed period, sore breasts, exhaustion — but it is sickness that is so often the unofficial ‘event’ of discerning what it means to be pregnant.
Of the 70% estimate of those who experience morning sickness during pregnancy, there is a good deal of variety as to the exact symptoms and impact of this symbolic and physical ‘foothold in your person’. According to a recent BMJ article, of those who develop morning sickness, 40% suffer mildly, 46% suffer moderately, and 14% suffer severely, although the study does not explicitly describe the particularities and overlaps of these states or define what they take to mean by suffering. What these percentages do show is that there is enough variation in that 70% estimate to divide a room – to have one person swear by ginger while another can’t bear to think of it; to have one woman deigned as ‘weak’ while another ‘powers on’. The umbrella term reminds me of a literary movement. Think of Modernisms, not Modernism, I tell my students. Think of morning sicknesses, not morning sickness.
In the same article, the authors categorise another, fourth percentage, granted its own separate category outside of the 70% umbrella. Only 1.5% of pregnant women suffer from Hyperemesis Gravidarum (HG). This is not a symptom, but rather a complication – a syndrome that often lasts for the entirety of the pregnancy. Yet, like so many ‘women’s’ conditions, diagnosis and treatment vary dramatically between healthcare providers. Often, it is diagnosed retrospectively. A sufferer needs to have lost over five percent of their body weight before they are deemed to have HG rather than severe morning sickness. To get to this point, the woman in question – in her first trimester, vulnerable, often still feeling bound by the vow of secrecy they feel they must keep until the twelfth week – will have already undergone a considerable amount of pain, suffering and psychological turmoil, not to mention financial, personal and emotional strain. They may well have already had to stop working, had to stop leaving the house. If they already have children or caring responsibilities, they will be unable to carry these out. They may have stopped sleeping. They may no longer wish or believe it possible to carry on with the pregnancy.
The experience of HG varies wildly between the 1.5%. One woman may be consumed by nausea and be unable to eat or leave her bed, another may be so frequently and violently sick that she tears open her throat. Through now rarely fatal in developed countries, HG is still listed as a significant ‘cause’ of abortion. Before anti-emetic medication, the risk to the sufferer’s life was great.
‘A wren would have starved’
Newly married to the curate Arthur Bell Nicholls, and expecting her first child at the age of 38, Charlotte Brontë was one such victim. In the final two months of her life she was ‘attacked by new sensations of perpetual nausea and ever recurring faintness’, her ‘dreadful sickness’ increasing until ‘the very sight of food occasioned nausea’. These notes on Charlotte’s condition, provided by her friend and supporter Elizabeth Gaskell, offer an account of a sickness unchecked by drugs, ketone measurements and intravenous drips; ‘a wren would have starved on what she ate during those last six weeks’ laments a witness, perhaps Martha, her maid, the woman tasked with emptying the sick bowl and replacing the untouched water at the bedside. And yet until her death Charlotte remained hopeful, caught in that small space between dread and longing: “I dare say I shall be glad sometime,” she would say; “but I am so ill – so weary” Then she took to her bed, too weak to sit up.’
Charlotte’s death, like her sister Anne’s and all of her siblings before her, was officially recorded as phthisis, or tuberculosis. Yet it is far more likely that she died from malnourishment and dehydration brought on from morning sickness, or even from re-feeding syndrome – a complication first coined at the end of the Second World War among Japanese prisoners of war. After weeks of nothing, food can become a poison as well as a cure.
In her account of Brontë’s final days, Gaskell notes how after a period of weeks where she could keep nothing down, ‘there was a change’:
a low wandering delirium came on; and in it she begged constantly for food and even for stimulants. She swallowed eagerly now; but it was too late.Elizabeth Gaskell, The Life of Charlotte Brontë
Charlotte would have been around four months pregnant and entering the second trimester at this point; a time when sickness and nausea often (but not always) subsides just enough to allow many pregnant women to feel more like their old selves (or at least, their old selves with a new self growing inside them). Estrogen and Progesterone levels continue to increase, but the amount of human Chorionic Gonadotropinthis – or hCG – has now begun to subside after its peak at eleven weeks.
Yet she did not recover and go on to have a healthy pregnancy. At four months pregnant, her hCG levels began to decrease. Yet, as Gaskell notes, without anti-emetics and the proper treatment, it was ‘too late’. Whether from malnourishment or sudden re-feeding, Charlotte Brontë did not follow Jane Eyre, her most famous protagonist, into motherhood. Instead, her ‘abiding-place’ was, like her siblings, an early grave in St Mary’s Church, Haworth.
I had no idea about Brontë’s HG and the circumstances of her death until I became pregnant and sick with the same complication. Rather than feeling scared or further depressed by this discovery, she became a sort of talisman – a way of understanding and articulating my own descent into a world of yellow and toilet bowls and pills and exhaustion. It was through writing her experience that I was able to find the words to articulate something of that surreal and traumatic time. ‘Haworth, 1855’ was the result:
'Haworth, 1855' ‘Martha tenderly waited on her mistress, and from time to time tried to cheer her with the thought of the baby that was coming. “I dare say I shall be glad sometime,” she would say; “but I am so ill – so weary” Then she took to her bed, too weak to sit up … Long days and longer nights went by; still the same relentless nausea and faintness.’ Elizabeth Gaskell It was there already, yes, in those bone cold classrooms, in the chants of homo, hominis, homini drifting out between the iron bars. But this is different. This is slow, this is fragile. This is all sighs and rustlings, retching and sobs. Loneliness, I now know, is guttural. I dare say I’ll be glad when it’s over, but as it is I feel like I’ve been cleaved. Stomach, lungs, throat frayed like a caught seam, mind spooling on the floor. Under night’s cloak, beds slip their posts, sheets tie themselves in knots, pillows calcify and crumble to a fine dust. I wake each morning hot, threadbare, my linen twisted, this makeshift body kept in place by the smallest dart of nerve, this makeshift heart still in my ear. I dare say though, that I’ll be lighter in a month, but in my throat there’s a bitterness that will not shift. My teeth are bird’s eggs crunching under coach wheels, my tongue is torn cocoons on garden lawns, my lips the dull skin of a cobra coiled behind museum glass. But I shall be glad sometime, I’ll forget the smell of an egg yolk, the slimy warmth of butter as it runs across my tongue. I’ll want other things than unripe plums and blackberries green and hard as stone, In two months I’ll see the white heather, the dappled breasts of merlin, sheldapple. My eyes will catch the winchat flushed and bolting from its thicket bed. In a year, I’ll feel the backwards pull of a skirt hem through tangled gorse, the sharp embrace of a bramble hedge. As I lie here soft and raw as dough, I know tomorrow will prove infinitely brighter. Even now, I can almost feel your uncut letter in my hand.
‘Haworth, 1855’ won the 2018 YorkMix/York Literature Festival Poetry Competition. It appears in my forthcoming collection, ‘Speculum’, published by Broken Sleep Books in October 2021. Writing it started me on a much longer, still unfinished project on morning sickness and the pregnant and sick body. This prose in part comes from that.
For more information, guidance and support for HG, head to pregnancy sickness support.