Podcast: Ria Clarke on Hyperemesis Gravidarum

My guest on this episode of the podcast is Ria Clarke, a mum of one and a doctor specialising in women’s health. Three years ago, Ria was suffering from Hyperemesis Gravidarum which causes severe nausea, vomiting and often dehydration during pregnancy. As someone who suffered from fairly bad morning sickness, and struggled to go about my usual day to day business, I find it hard to imagine what Hyperemesis must be like.

But as Ria explains, she had to be admitted to hospital, had to take time off work and is still feeling the after effects from the trauma that the condition caused.

Ria also chats about what it’s like to be a doctor specialising in obstetrics and gynaecology, and talks about why there are five times more black women who are dying in pregnancy and childbirth than white women.

You can follow Ria aka The Doctor Mummy on Instagram and find out more about Hyperemesis Gravidarum at Pregnancy Sickness Support.

Click play below to listen, or head over to Acast,Spotify or iTunes where you can rate, review and subscribe.

Ria Clarke podcast transcript

ALISON PERRY
Welcome back to Not Another Mummy Podcast with me, Alison Perry.

In both of my pregnancies I’ve suffered from morning sickness, but I can’t even imagine what it must be like to suffer from Hyperemesis Gravidarum – extreme morning sickness. My guest today Ria Clark does. She suffered from HG during her pregnancy two years ago and says that her experience has had a very lasting effect on her. Ria is a doctor specialising in women’s health working in obstetrics and gynecology. And she’s on Instagram as @TheDoctorMummy talking about everything from health to women’s issues to racial issues. Here’s what she had to say to me.

So I’m here with Ria. Welcome Ria to the podcast. Hello, so you’re a doctor in women’s health…

RIA CLARKE
I am indeed.

ALISON PERRY
Tell me a little bit about your job and tell me a little bit why you decided that was the career for you.

RIA CLARKE
Okay, so my job involves looking after women during the lifetime of reproductive health and before and after. So that involves everything from something like… problems that can happen when people are children related to reproductive organs. As women get older problems with periods, things like fertility, and people mostly associate it with pregnancy. But, there’s a whole scope of things outside of pregnancy that we deal with. Things like gynecological cancer, cervical cancer, ovarian cancer endometrial and problems associated with the menopause.

ALISON PERRY
So it’s a huge, massive scope of stuff that you must be an expert on.

RIA CLARKE
Oh, I don’t know. I wouldn’t go so far as to say expert, I’m working towards it.

ALISON PERRY
Yeah, yeah. So are you a junior doctor, or are you… What’s your actual job title?

RIA CLARKE
I am a junior doctor, the title of junior doctor’s really misleading because it basically means anybody that isn’t a consultant.

ALISON PERRY
Right!

RIA CLARKE
So I’ve been a doctor for almost eight years.

ALISON PERRY
So it’s not like “Oh I’m the intern.” You’re actually…. you’ve been doing it for eight years, you know your stuff, your experienced…

RIA CLARKE
I’m experienced enough. I’m still, I’m definitely getting there. But yeah, so someone who’s just fresh out of medical school and someone who’s almost a consultant, or both called junior doctors,

ALISON PERRY
That’s really misleading, isn’t it?

RIA CLARKE
Yeah. So there are smaller terms that are used sort of colloquially. And so that would be registrar, which is the grade below consultant and I’m sort of a baby registrar. So just at the beginning of being a registrar, but I think it’s good to be upfront about where you are, in your experience, especially on social media.

ALISON PERRY
Yeah, of course. So are you based in a hospital? Do you have, every day, do you have different people who have been referred to you to or or to your team? How does it work in terms of your day to day workload?

RIA CLARKE
Yeah, so my speciality is mainly hospital based. And it’s very, it’s very varied. So for example, yesterday I was on call on labour ward. So that means looking after women during labour who may need the help of an obstetrician as opposed to those who are midwife led. Tomorrow, in the morning, I am doing gynecological surgery with one of the consultants. And then in the afternoon, I’m doing antenatal clinic with a different consultant. So it’s really, really varied.

ALISON PERRY
It must be brilliant that is so varied and that, you know, you just mustn’t ever get bored.

RIA CLARKE
No, it’s really hard to get bored. I think you know you’re in the right speciality if you can look at a majority of the things and go “Yeah, I’m looking forward to that, I can learn something there.”

ALISON PERRY
That’s so nice. And I guess you probably are always learning…

RIA CLARKE
You have to be. If you’re not learning, then you need to get out. I think the older I get and the more I look at senior colleagues, the more I realise that we’re all still learning and watching them talk to other colleagues and go ‘Actually, I wasn’t sure what to do with that case’ is really refreshing.

ALISON PERRY
Yeah, must be. So as well as that you’ve got a two year old son.

RIA CLARKE
I do, he’s two and a half.

ALISON PERRY
Two and a half. How would you describe family life? I mean, it must be… I always feel really bad for asking mums ‘How do you juggle your job and being a mum?’ because it sounds quite patronising. But it’s actually… it can be a struggle to keep those balls in the air and to you know, keep everything going smoothly.

RIA CLARKE
Yeah, it is. I love having family, it’s a great balance to having a really intense job. And that said, I couldn’t do it without the support of my family or I could, but it would be a lot harder. I’m lucky that my husband is fantastic. And it’s a balance talking about this too much because I feel like he’s an equal parent and he does his job in that he looks after my son when I’m at work. And in a way that, probably, some some other dads don’t, in that, if I’m on nights, if my son’s up all night, then he just has to deal with it because he can’t call me and say I don’t know what to do, because I can’t talk him through that he just has to get on with it. So it takes a lot of partnership. And I’m very lucky that I have someone that just takes it on the chin and doesn’t expect a reward for doing it. Yeah. And so yeah, I, I find it a struggle, I’m quite honest about the fact that I do find it really difficult, and that the things I’m able to do, I’m able to do because of sacrifices that I or someone else in my family has to make. But it’s a good balance.

ALISON PERRY
And how do you find social media, kind of, you know, what kind of part does it play because, you know, I follow you on Instagram. And I feel like you’re just you know, you seem very much like the captions. And it’s almost like, I feel like it’s a mini blog posts that he writes. And you cover… you talk so eloquently about so many different subjects, whether it’s your family life, or whether it’s, you know, work things or, you know, issues like women’s issues, like so many different things. How do you find that? Is that a release for you? Is it something that you rely on, you know, to kind of, you know, have almost like a sort of creative element to your life?

RIA CLARKE
I’ve always liked writing, I like it as a creative outlet. I thought about having a blog, but I, I worry that I get sucked into producing content for content sake, rather than it being spontaneous. And just writing about whatever comes into my head, which is very much what my feed is, is a complete mishmash of thing. I come across things I think about..

ALISON PERRY
That’s the best way though. I mean, and I think that even if you blog, that’s the best way to blog. I mean, I, I have got a blog. And quite often people say to me, ‘So, you know, do you blog every day?’ Or ‘do you do you know, X number of posts a week?’ and I’m like, No, I blog when I want to, I blog, when I feel like, I’ve got this thing that I really want to talk about, you know, that’s when you produce something really good. And it’s the same on Instagram, when you have that urge of I want to communicate this even if something silly, like a little something that your son has done, I guess or…

RIA CLARKE
Yeah it’s that balance, like some of the things I write are quite deep, and quite introspective, especially if it’s about something sensitive, like race or about sensitive medical topics. But it’s also about the frivolous things. It’s about, you know, negotiating with my son about having a nap. Because that is real life. And it’s it’s nice for me to have somewhere where I can share these things. It originally started as a secret account when I first got pregnant. And I was going to post about me doing yoga. And like being this Yummy Mummy who did all these amazing things. Really, that just didn’t happen. And it kind of evolved from there. But it was a place where I could talk about how happy I was about being pregnant without people going on. She’s talking about being Pregnant again.,

ALISON PERRY
That’s the funny thing, though, isn’t it, that so many of us go through I think when you become pregnant or become a mum, you don’t want to be that bore who’s always you know, that baby bore, then I think you get to that point where you think actually, I’m just gonna talk about it, because it’s pretty cool. And I’m all right with that.

RIA CLARKE
Yeah, I was thinking about that on the way here about going I just really, really like being a mum and having a son and to say that sometimes feels a bit nauseated, I guess. But we I guess it’s nice to move beyond the culture where we’re just complaining about things all the time and not just saying, okay, parenting is really hard, but I really like it.

ALISON PERRY
Yeah, and that’s okay, isn’t it? It’s really interesting, actually, because I’ve got eight year old and when she was a baby, I found it really hard. And I had PND, but didn’t realise it. It was never diagnosed. But it’s only when she was 18 months, I looked back and thought, Oh, my goodness, I definitely had PND I’m coming out of it now. But now, I’ve got six months old babies, twins. And I’m like, oh, my goodness, like I’m only know, almost like seeing what everyone else can see in terms of having a baby and the joy that it can bring. And you know, eight years into being a mum, and I’m still learning, I’m still realising actually there is joy to be had in this and it doesn’t have to be all, you know, a struggle and hard and, oh, you know, like complaining about it all the time. And that’s okay.

RIA CLARKE
Yeah, absolutely.

ALISON PERRY
And one thing I saw you writing about on your Instagram recently, which really interested me, was you talking about the death rates of black women during childbirth versus white women? And you were quoted on BBC News talking about this. Tell me a little bit about the research and what’s come out just recently.

RIA CLARKE
So there’s an annual report called The Embrace Report that looks at perinatal mortality and perinatal mortality means deaths and well it looks at morbidity as well, but basically deaths that occur during pregnancy, and for the first year afterwards. And the reason why.

ALISON PERRY
Right, so it’s pregnancy and the first year, not just during childbirth.

RIA CLARKE
Not just, no. And it’s trying to identify causes, any trends that we as medical professionals can work towards to try and reduce those awful outcomes. And there are some things that are identified that aren’t related to factors like race, for example, something called postpartum hemorrhage to bleeding a lot after you have a baby is associated with bad outcomes. So recognising that, increasing training for staff, making people more aware of that, is a good thing. Something that has emerged. And it’s not a new thing, this isn’t suddenly come out of nowhere, just because people have picked up on it this year. But yes, the statistic is that in the UK, black women are five times more likely to die during that period, than white women and Asian women are twice as likely to die.

ALISON PERRY
Which is terrifying, isn’t it.

RIA CLARKE
It’s absolutely terrifying. Yeah, it’s really scary. And yes, the total numbers are small. And so I think it’s really important to highlight that. We don’t want to scare people unnecessarily. But anybody dying at five times the rate of someone else deserves to have that looked into and for the question to be warranted and asked ‘why that happening?’

ALISON PERRY
And how much of that is medical factors? And how much of it do you think is racial bias?

RIA CLARKE
Well, that’s the million dollar question, I think, because what we know is that there are biological factors that black women and Asian women are more vulnerable to.

ALISON PERRY
So what kind of things are they more likely to suffer from?

RIA CLARKE
So a really good example is gestational diabetes. So when you go for your booking appointment in early pregnancy, the midwife will ask you a series of questions to help stratify your risk of different things. And if you come from a group that’s at increased risk. For example, if you have someone in your close family who’s had gestational diabetes, and if you’re high BMI, and if you’re black, or Asian, there are other factors as well, but you will be offered a screen to test for gestational diabetes. Now, that’s not offered to everybody, because we know there are different levels of risk. So that is a biological factor that we know affects people disproportionately. What we don’t know is how much racial bias is involved in the high death rates. But I think it’s really naive to not consider it which is what my point has been, and why other people have been vocal about it. We know in the US, there are lots of examples of the bias in healthcare, and even if they stratify for things like BMI, and income, black women are still more likely to die.

ALISON PERRY
So what can be done? What needs to happen? Is it is it a case of asking the question, why is this happening? And speaking to the health professionals involved, and finding out more? What is it? How can we stop this from happening?

RIA CLARKE
I think that’s a start, I think we need to be talking about it, which is, which is great. I’m here, we’re talking about it, and listening. So talking is important. Listening is even more important, listening to black women and hearing what they’re saying, and not discounting it and going well, you know, you’re also it’s also because of this, and while you are poor, and you do live in a council flat, yes, that way, may well be truth. But if someone’s telling you that they were told something that they can relate to their experience of being black or Asian, we need to take that on board. We need to think about cultural competency from very early on. So in medical school, and I know that there are some medical schools that look at things like unconscious bias, which we all have, yeah, everybody has that it’s naive to expect us not to, but to think about how that affects us as individuals. How does it affect us as institutional systems? And what impact is that having on the women that we look after?

ALISON PERRY
It’s tricky though, isn’t it, because with that, listening to people and asking these questions, there’s a lot of discomfort involved with that, which is why it’s not happening isn’t it?

RIA CLARKE
Yeah, because people feel awkward. And when you talk about things like privilege, when you talk about racial bias people who think I’m a good person, I care about people, I work really hard in my job. I’m not racist, because racism is someone shouting in the street, someone calling you a horrible name. It’s understanding the scope of racial bias and things like micro aggressions, and how subtle it can be and how people who experienced that every day, can feel when that happens. And you may only see it as an off the risk comment. But if that happens all the time, and it makes you disengage from a service, then no, no one shouted at you. No one’s called you an offensive word. But then if you’re not getting the health care that you need, you might be more likely need to have a bad outcome. So it’s really opening up the conversation. And yes, people will feel uncomfortable. But women are dying. So people just need to get over that.

ALISON PERRY
And this is nothing new. This is just that this research has come out for the first time in the UK. Is that right?

RIA CLARKE
Well, this this report is released annually. And thinking about the report, the year before, I don’t have the numbers off the top of my head, but they weren’t that dissimilar.

ALISON PERRY
Right. Why is it only now being picked up on then? Just because it just happened to be picked up in the news. And it’s kind of had a bit of a snowball effect?

RIA CLARKE
I think people were talking about it before. But I think what has changed is the use of things like social media, and people speaking out. I hesitate to say that celebrities talking about more things has more gravitas. But if someone like Beyonce, if someone likes Serena Williams speaks out about their experience and says, ‘Look, I am a black woman with money with high profile, I was still treated differently, I feel because of my race’. Then that makes people sit up and go ‘Oh Beyonce. I mean, have you seen that face? That happened to her?’

ALISON PERRY
Yeah.

RIA CLARKE
So whilst it’s sometimes frustrating that it takes something like that, for people to pay attention, if people are paying attention, then good, let’s change things while people while people are listening. Because when people forget about this next week, people will still be dying.

ALISON PERRY
Well, I’ve heard people saying quite a few times recently is that diversity is trendy right now. It’s, you know, it’s companies or media, TV shows, it’s all about being seen to be inclusive. And that is kind of worrying if that is the case, because actually, it needs to be a trend that only increases and only build momentum, it shouldn’t be something that there’s people talking about it, and next week, we’re back to the way we were.

RIA CLARKE
Yeah, we have to be careful of tokenism. And so if there’s a bandwagon that people want to jump on in order to seem to pick appear woke, then that’s not going to help anyone. And I think that’s why black and Asian women need to be involved in driving the change forward, because they will unfortunately be invested in it in a way that passers by aren’t. So I think, I think we need to be careful of people about what people’s motivations are. But this is a long term thing. And this is bigger than social media, while social media is helping bring about change. If Instagram explodes tomorrow, and it doesn’t exist. I mean, I’ll be annoyed all my photos have gone.

ALISON PERRY
I know!

RIA CLARKE
But the issues will still be there.

ALISON PERRY
Yeah, absolutely. Now when you were pregnant, two and a half years ago, three years ago, you suffered from… and I’m going to mispronounce this, I’m sure… hyperemesis gravidarum.

RIA CLARKE
I did indeed, and you said it correctly.

ALISON PERRY
I feel like it sounds like a Harry Potter spell. “Hyperemesis gravidarum!”

RIA CLARKE
If only there was a spell that undid it.

ALISON PERRY
Oh, no, I can imagine. Well, you know, I can only imagine. Tell me what it was like, because some people describe it as being like bad morning sickness. But is that almost like an insult?

RIA CLARKE
I don’t know what bad morning sickness is like, because I’ve only been pregnant once. But I don’t think I don’t feel like that comes close. It’s really hard to describe it to people who have never been there. But if you’ve ever been nauseous, if you’ve ever had food poisoning, and you think about that level of despair, it’s not just the nausea or the vomiting. It’s the impact on your mental and physical health as well. The days I used to spend lying on the bathroom floor, or having a plate next to me in the bathroom, because there was no point moving. And my husband used to carry me up and down the stairs because I couldn’t walk. And the long term impact for lots of women. So lots of women suffer from Post Traumatic Stress Disorder because of hyperemesis and it’s impact, if you look at the gaps between children of women that have hyperemesis, they quite often have a big gap, because either can’t bear to go through it again. Or the logistics that you have to put in place before considering having another child knowing what having one has done are such that it has the consequences beyond just the pregnancy, but it was it was absolutely awful.

ALISON PERRY
And how long did did it go on for for you, how many weeks or months?

RIA CLARKE
So it started when I was eight weeks, which is slightly later than most women, they usually get it a bit earlier. And it lasted, it wasn’t as severe all the way through. But I was off work until I was around 17 weeks.

ALISON PERRY
Wow. Okay. So you just could not work through it? It wasn’t feasible for you to get through a day of work?

RIA CLARKE
No, I just I just couldn’t function. I didn’t get dressed, I couldn’t wash, I didn’t eat. I left the house to go to the GP, to go to the hospital. And other than that, I just didn’t move. I couldn’t, I couldn’t function.

ALISON PERRY
When you describe it like that, you can kind of understand why there are certain percentage of women who have to terminate their pregnancy because of this.

RIA CLARKE
Yeah, yeah, I was very fortunate not to be in that position. But I’ve met women in that position. I hold no judgment towards them whatsoever. I think that there is a huge problem with recognising how serious hyperemesis can be. Women used to die of hyperemesis before we were able to give fluids into women’s veins. And no woman has a termination lightly whatever the reason, but these terminations are often wanted pregnancies. And so to have to deal with that as a treatment, which is what women are doing it for as a therapeutic way to stop how bad this feels, it’s awful

ALISON PERRY
Heartbreaking. And did you ever get the point where you were admitted and had to have intravenous fluids?

RIA CLARKE
Yeah, so I was admitted when I was eight weeks. And I am, I’m one of the few people that is allergic -allergic is the wrong word – that has a reaction to most anti sickness medications. Which means I can’t take most of them. Which, sods law, that is exactly the sort of thing that would happen to me.

ALISON PERRY
Oh, that is just the worst.

RIA CLARKE
So there was one that I could try, a drug called Ondansetron, which is very difficult to get because of a preconception it’s really expensive. And it’s not, but it means it’s really hard to get hold of, I had to beg for it. And that didn’t work.

ALISON PERRY
Do you think that do you think that being a doctor helped you because you were able to have those sort of conversations with a certain level of knowledge?

RIA CLARKE
I think it helped up to a point. But I don’t think I I don’t think I necessarily got better care, I actually found some of my care from colleagues quite disappointing. So I can only imagine what it’s like for women that that can’t advocate for themselves and maybe don’t have insight into what the treatment options are.

ALISON PERRY
Is that because of workload? I mean, I’m one of those people that when I’m in a hospital, and I’m feeling a little bit ignored, or I’m feeling you know, like someone’s forgot to do the rounds or forgotten to give them my pain medication or whatever it is. I’m very forgiving, because I always think they’re overstretched, you know, they’re understaffed, they’re doing their best. Do you think that your experience there was because of that? Or do you think that there were other factors at play?

RIA CLARKE
We are overstretched and, and I get that, and I’m like that too, because I go, I know what it’s like when I’m having a bad day. And I’m trying and I’m juggling and trying to make sure everybody gets good care. I’ve been there. So yes, there’s always an element of that in the NHS all day, every day. But there is also a conception about the kind of illness that hyperemesis gravidarum is, the kind of women that are affected. And…

ALISON PERRY
What is that?

RIA CLARKE
Women are malingers, that they have psychological issues, that it’s their way of expressing that they don’t want to be pregnant, that they just can’t cope with being pregnant, and they just need to get on with it and stop complaining.

ALISON PERRY
And have you heard this? Have you heard these views being expressed?

RIA CLARKE
Yeah, Yeah, very much. So it made it made me angry before I got pregnant. And even when I was in hospital, I mean, my, cannula fell out, which is the instrument that you used into a vein to give fluids and someone was told you can only have it back if you need it. Why wouldn’t I need it? I can’t keep food or fluids down. And I wasn’t that polite when I said it.

ALISON PERRY
Good!

RIA CLARKE
But there is definitely a preconception about high pressure, high premises. And that means women are starting on the back foot. When you’re already vulnerable, you’re having to fight. And I hear, and there’s a charity called Pregnancy Sickness Support, which is absolutely amazing. And they hear all sorts from women about the things that they’ve been told by medical professionals. And it’s such a shame, because whilst drugs aren’t always a magical cure, what can make differences compassion and kindness. And that doesn’t cost anything now.

ALISON PERRY
Do you think then, that is just an area of women’s health that needs more research and more… More time dedicated to it?

RIA CLARKE
Absolutely. Yeah. And there was some research published… I think it was 2017, which was one of the first research articles that showed a possible gene that causes hyperemesis.

ALISON PERRY
Wow.

RIA CLARKE
And one of the biggest things that would change preconceptions is if a cause were found. So if, and that’s a shame, because we should believe women without there having to be a specific gene. But if there is a gene, then there’s hope for therapies that can help cure this. So there are there are new developments in that. And that’s fascinating to think that they might be able to find a reason behind it, and therefore find a way to make it easier.

ALISON PERRY
And do you think that obviously, you know, doing the job that you do? Are you aware that in general, less research has been done over the years, into women’s health issues and conditions?

RIA CLARKE
I think, yeah, I think that’s true. I think that women’s health is… neglected is the wrong word, probably not as invested in as highly as other things. Talk to a woman with endometriosis. And she’ll tell you how long it took her to get diagnosed…

ALISON PERRY
Yep I’m there, I’ve got my hands in the air. Took me years to be diagnosed. And I know so many women with a similar story.

RIA CLARKE
And the stories are really similar. And it’s heartbreaking because there’s a spectrum of endometriosis and it affects women differently, but something I hear a lot is how long they had symptoms for. And I wonder if that I wonder if that would happen if it affected a different population.

ALISON PERRY
Which is so frustrating that, women do have to have that many conversations, that many doctors appointments, you know, to be kind of sent off with misdiagnosis and be suffering. And in pain or discomfort just because of that.

RIA CLARKE
Yeah. So I think we’re talking about it more. And that’s always that’s always a good thing. And again, it’s somewhere where bias comes in. And we need to unpack that and think why are we not taking women seriously? Because a psychologist, once upon a time, said that women with abdominal pain were hysterical. Like, can we not move beyond that? It’s 2019. It’s deeper than that there will be people listening going well, that that’s an oversimplification. Yes, it is. Because it’s a podcast, and I’m not a researcher. But yeah, we need to we need to move forward.

ALISON PERRY
Absolutely. So going back to how you were feeling during pregnancy. You described that your husband was having to help you up down the stairs. What kind of support was he giving you? It must have been really hard for him to watch you…. I mean not as hard as it was for you, don’t get me wrong! But what kind of support were you getting from him or from your family around you?

RIA CLARKE
It was just an unwavering sense that they were always there, and that they didn’t judge me and that they didn’t expect too much, or asked me to be what I couldn’t be because what I couldn’t be was ecstatically happy about being pregnant all the time, which is what I wanted more than anything. I was so excited. And actually, some of my posts from when I first got pregnant are still on my account. And you can go back and see where I’m like, ‘and now I’ve got vitamins. And now I got this’ before I got sick.

ALISON PERRY
So it was an anonymous account then.

RIA CLARKE
It was!

ALISON PERRY
So you were obviously being quite open very early about your pregnancy.

RIA CLARKE
Yeah. Because I felt like I could be because you know, it was just for me. It was a bit like a diary. So my husband was amazing. Once I went back to work, I couldn’t go in the kitchen and I couldn’t go in the fridge because of smells and things so he used to make my lunch for me every day. Just make a little packed lunch for me. And he used to come to my hospital appointments and never put any pressure on me I guess. And was just… hyperemesis Isn’t nice at the best of times, having someone being sick all the time and saying, ‘Oh no, I don’t want to eat that’ and ‘I don’t want to go there. And can you not wear that aftershave and a friend or the cleaning things in the room because they smell and they remind me of being pregnant’ and that I mean, that’s now we’re talking…

ALISON PERRY
Yeah. I bet. Are there still things that you smell or things that you do that immediately take you back to that time?

RIA CLARKE
Yeah, I can’t eat Mini Cheddars.

ALISON PERRY
I’m the same. I sorry, I didn’t have hyperemesis but just from normal morning sickness. I ate Mini Cheddars loads because it was like the only thing that it was like bland, carby… and now? Can’t touch them!

RIA CLARKE
So yeah. That product placement ad I was going to get is never going to come now!

ALISON PERRY
Dammit!

RIA CLARKE
Mini Cheddars, there’s a brand of yoghurt I can’t eat, there’s some lavender cleaning things that I can’t go anywhere near. So those things are quite triggering. But just even if I feel a bit nauseous because I think maybe I’ve eaten something, automatically all the feelings come flooding back. That has implications for … now I would have loved to… I always said to my husband ‘We’re gonna have four kids’, I mean, he shrivelled up in a corner and cried at that point. But I would have loved a big family, it has an impact on that. I would have liked to have children close together, it’s had an impact on that, it just affects a lot more than I assumed it would at the time.

ALISON PERRY
It’s crazy, isn’t it? Because you do think ‘oh, well, you know, it’s only a few weeks. And once you’re through it, you’re through it and you know, when you have the baby, it’s worth it in the end.’

RIA CLARKE
‘I’m just so grateful to be pregnant and as long as the baby’s okay, as long as the baby’s Okay.’

ALISON PERRY
That frustrates me that ‘as long as the babies okay’ thing because actually it’s kind of like devaluing you, and your feelings and your experience.

RIA CLARKE
Absolutely. And it means that you’re just a vessel for a child. Because if as long as a baby’s okay, that’s fine, then it doesn’t matter what happens to you surely. So why are you complaining? And I hear women saying that a lot at work and coming from the best place possible, and what they mean is ‘Please look after my baby.’

ALISON PERRY
Of course.

RIA CLARKE
And of course you say that because you’re scared and you’re vulnerable. And I always say to them, my job is to look after you and the baby. And if I focus on you right now, then you can continue to focus on the baby. Because that’s all they want to do. But women are not vessels for having babies. Some women never have babies, some women never want to, some women can’t. They are no less women than anybody else.

ALISON PERRY
Absolutely.

RIA CLARKE
So yeah, that makes me mad.

ALISON PERRY
Yep, No I’m with you. I’m with you there. And do you think that in terms of like the long term effects that this has had for you? Do you think that that is something that will fade? Do you think that that feeling I mean, I guess you don’t know? It’s like asking you to look into the future and you know, predict what’s going to happen? I guess all you can do is hope that those feelings will fade.

RIA CLARKE
I hope so. But when I think about other traumatic things I’ve been through through my life and I won’t expand too much because that’s for my autobiography after I win Strictly.

ALISON PERRY
I love it- that’s planning for you!

RIA CLARKE
Absolutely! Dream big. But when I think about other traumatic events in my life, and they’re not sharp, and the memories are more blunt, and with hyperemesis while some of it is faded, I can still remember a lot more of it than I want to. And I think I will always remember when I talked to women who are in their 60s or 70s, for example, who had hyperemesis they can talk about it like it was yesterday.

ALISON PERRY
Wow. Do you think that is something that we should almost be go to therapy to be dealing with all of this?

RIA CLARKE
I think for some women absolutely. Therapy is is really important. And I think if you need to, then you should do that. I’m quite lucky that I can talk to my family about it. I have a couple of friends who have had hyperemesis who now have children who I can talk to about it. I’m quite open about if I’m having a bad day. I guess that’s why social media is good. Yeah, where I can go ‘I feel really nauseous today and it’s all come back’ and it sounds a bit melodramatic almost to go, ‘I feel nauseous today and now I want to hide in bed because it reminds me of how bad I felt.’ But I know there are other people that feel like that.

ALISON PERRY
Yeah, and not even just with hyperemesis. I mean, I spoke on social media, maybe two years ago about walking into Tesco, and seeing a brand of baby food that I had fed my daughter years earlier. And it totally triggering me and taking me back to that kind of early period where, you know, she was she was just weaning and I was obviously in the depths of PND. And just seeing that on the shelf, instantly took me back.

RIA CLARKE
A flashback and just just the memories and associations are so strong. I think for trauma, in whatever package trauma comes recognising that and the impact it can have him and it taking you by surprise, because it often does take you by surprise.

ALISON PERRY
And it throws you doesn’t it, and it kind of almost throws you off kilter for the rest of the day, doesn’t it? I think you’re right. That’s where going on to social media and talking about it can really help because it helps you process it. But also other people might be a bit like ‘Oh that’s happened to me.’ And then you start this conversation, which is helping everybody.

RIA CLARKE
Yeah, I’ve got this network of women who contacted me when I had hyperemesis. And they were they were not talking to me as a doctor, they were talking to me as I’m a woman who’s had high premises or is going through it too. And our kids are now the same ages. You know, there’s someone in Croatia, there’s someone in Australia, there are people in the US. And they’re just women that were like, you know, we’re here to listen, or I know what it’s like. And that was really nice.

ALISON PERRY
Now the first time that I ever came across hyperemesis was when Kate Middleton had it.

RIA CLARKE
Yeah, that’s the same for a lot of people.

ALISON PERRY
Do you think that that was a blessing because it suddenly put it into the public eye? And people knew about it and learned about it? Or has it been a bit of a curse in that people almost dismiss it as being over Kate Middleton had that and it’s just bad morning sickness. And she was fine. Therefore, you’ll be fine, too.

RIA CLARKE
Yeah, I think both. It’s accessible for a lot of people. So if you can say well, ‘That’s what the Duchess of Cambridge had’ then people go ‘Oh, yeah, yeah, yeah. Okay. I I know a bit more about it now’. But then they also go home and have kind of been that bad because, you know, she had all that stuff. And she’s got three kids, so it can’t have been that bad. Yeah, but then you go remember that she missed her oldest son’s first day of school because she felt so sick. How many mums would do that, just because? And she hadn’t spoken about herself and I don’t think she should ever feel under any obligation to because we don’t know how she dealt with the trauma. We don’t know how it’s affected her. And so yeah, swings and roundabouts.

ALISON PERRY
Yeah. Well, I think you talking about it today will have helped lots of people. So thank you very much for being my guest today, it’s been lovely chatting to you.

RIA CLARKE
Not at all! Thank you for having me.

ALISON PERRY
Big respect to Ria for getting through that experience. It does not sound pleasant at all does it? Thank you for joining me today. Please subscribe to the podcast and rate and review because it really helps other people find the podcast and I shall catch up with you next time.

Chat to me on Instagram: @iamalisonperry or on Twitter: @iamalisonperry

Producer: Imogen Hart, Create Productions

Music: Epidemic Sound

Artwork: Eleanor Bowmer

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