I Thought My Third Pregnancy Would Be Like My Second. I Was Wrong About Everything.
I thought I had this figured out. I really did. My first pregnancy was a disaster — gestational diabetes at 28 weeks, a 37-week induction, a birth plan that went up in smoke. My second pregnancy was textbook. Unmedicated. Water birth at a birthing center. I walked out of there feeling like a goddess. So when I got pregnant with number three, I assumed I'd just... do that again. Same diet. Same exercise. Same prenatal vitamins. Same outcome.
I was wrong. I was so wrong.
I'm 37 now. Not old, but not 32 either. And my body — this body that has carried three babies, nursed two, and spent nine years working alongside OB-GYNs and midwives at a women's health clinic in Portland — decided that third time was not the charm. The nausea started at week five. Not morning sickness. All-day sickness. The kind where you retch in the parking lot of the Fred Meyer on Hawthorne because the smell of someone's coffee made your stomach turn inside out.
By week 10, I had lost 8 pounds. Not "pregnancy glow" weight loss. Dangerous weight loss. My midwife — the same one who caught my second baby — looked at my chart and frowned. "Emily, you're a dietitian. You know what this means."
I knew. Hyperemesis gravidarum. Severe nausea and vomiting in pregnancy. It affects 1-3% of pregnant people. I had seen it in my clinic. I had counseled women through it. And I had secretly thought, "That won't happen to me. I eat too well. I know too much."
Arrogance. That's what that was. Pure, professional arrogance.
The thing about HG that nobody tells you — or at least that I didn't fully understand until it was my throat burning at 3 AM — is that it's not just "bad morning sickness." It's a medical condition. It can lead to dehydration, electrolyte imbalance, malnutrition, and hospitalization. I was vomiting 8-10 times a day. I couldn't keep water down. I couldn't keep crackers down. I couldn't keep my prenatal vitamin down, which meant I was missing folate and iron and DHA during the most critical weeks of neural development.
I called in sick to the clinic. Something I had never done in nine years. Jake — my husband, the high school biology teacher, the man who has seen me at my worst and still thinks I'm competent — took over everything. Lily and Noah's lunches. The laundry. The dishes. The emotional labor of explaining to a 5-year-old why Mommy was sleeping on the bathroom floor.
I got medication. Zofran. Unisom and B6. Ginger capsules that did absolutely nothing. Acupuncture that helped slightly. And I started eating whatever I could keep down. Which, for three weeks, was plain white rice, applesauce, and occasionally a piece of sourdough bread. Not exactly the prenatal nutrition plan I would recommend to a client.
But here's what I learned, and what I'm passing on because I wish someone had said it to me: survival is the nutrition plan in the first trimester. If all you can eat is white rice, eat the white rice. If all you can drink is Gatorade, drink the Gatorade. The baby will take what it needs from your stores. Your body is not stupid. It has priorities. And priority one is keeping you both alive.
By week 14, the nausea started to lift. Slowly. Like fog burning off the Willamette on a spring morning. I could eat vegetables again. I could drink water without gagging. I could take my prenatal without it coming back up. And I started rebuilding. Not dieting. Rebuilding. Protein at every meal. Folate-rich foods. Iron from grass-fed beef and spinach. Omega-3s from salmon. The things I knew I needed but couldn't stomach for weeks.
I tracked everything. Old habit. Calories, protein, iron, folate, fluid intake. I used my own tools. I ran the numbers. And I realized that even during my worst weeks, I had managed to average 1,200 calories a day. Not enough. But not nothing. The baby was growing. The ultrasounds looked good. I was exhausted and guilty and anxious, but I was also pregnant and functional.
I'm 24 weeks now. The third trimester is approaching. I'm monitoring for gestational diabetes because I had it before, because I'm 37, because I know the risk factors better than anyone. And I'm eating carefully. Not restrictively — I'm not about that life — but intentionally. Balanced meals. Regular walks through Forest Park when the weather holds. Blood sugar checks. The boring, unglamorous work of a high-risk pregnancy.
If you're pregnant and struggling — with nausea, with food aversions, with the pressure to be perfect — please hear this. You are not failing. Your body is not broken. Pregnancy is not a performance. It's a physiological process that varies wildly from person to person, from pregnancy to pregnancy. What worked for your friend may not work for you. What worked for your last pregnancy may not work for this one. And that's okay.
Eat what you can. Survive the first trimester. Rebuild in the second. Prepare in the third. And give yourself grace. I'm a registered dietitian and an IBCLC and I spent three weeks eating nothing but white rice and applesauce. And my baby is fine. I'm fine. We're going to be fine.
— Emily, from a couch in Portland where the rice is cooked and the nausea is finally gone
P.S. Jake has been a superhero. Lily drew me a picture of "Mommy and the baby" where I look like a potato with a smile. It's my favorite thing.
