Torah Audio Classes on HG

Torah Audio Classes on Why Things Happen

Listen To Our Audio Clip on Management of Severe HG.

Important Notice – The advice on this site is intended to provide useful, generalised information. However, you must not act without consultation with your own doctor who will be able to assess your needs based on your own individual circumstances.

“Women with HG should take the medication that they need. Today, we have very effective options – true, not a total cure, but very effective nonetheless. It is not appropriate, and is often downright cruel, for others (e.g. husbands, mothers or mothers-in-law) to say: “It is selfish of you to take a medication that may make you feel better but may harm the baby” when the risks of medication are very low. The person making that final decision should be the pregnant woman, not someone else who is not going through her suffering. If the medications are judged to be safe by the relevant medical expert, they should be used.” – Rabbi Dr Akiva Tatz

“People worry a lot about taking medications in pregnancy. This is often the case with HG and there are ‘old wives tales’ about the baby being so tiny and needing so little that it gets what it needs from its mother even if she is starving and sick. Evidence now demonstrates that this isn’t the case and that if the mum is malnourished and lacking the nutrients, vitamins and minerals herself, then there can certainly be consequences for the infant.

It is important to remember that women suffering HG aren’t choosing to be malnourished – they are unable to eat and drink and keep the nutrients down. So, if taking an anti-sickness medication enables them to eat and drink more, then those risks are likely to be reduced. – Caitlin Dean, Chairperson Pregnancy Sickness Support

Research the medications currently used to lessen symptoms of HG. www.pregnancysicknesssupport.org.uk is an excellent resource and provides data on the latest studies and a very informative and supportive helpline with individual mentors. We have all made use of it and rate it very highly. We suggest that reading these studies before you call your doctor will allow you to ask for advice, including appropriate medication, on a more informed basis.

The Pregnancy Sickness Support website is a very rich resource; however, please note that this is a secular non-Jewish site, and as such it includes some recommendations and guidelines that do not accord with Jewish Law (Halocha). Please consult your own Rabbinic authority.

MEDICATIONS:

For further information, please review the excellent material at https://www.pregnancysicknesssupport.org.uk/get-help/treatments/

Many women have found Xonvea to be very useful, sometimes in combination/ alternating with the ondansetron group of drugs. Xonvea may be a very useful alternative to cyclizine. Again, discuss with your doctor.

Note : Xonvea does not appear on the above link but you can find out more about it if you click here.

https://www.nice.org.uk/advice/es20/resources/doxylaminepyridoxine-xonvea-for-treating-nausea-and-vomiting-of-pregnancy-pdf-1158169089733

PSS Disclaimer: The Pregnancy Sickness Support website is a very rich resource; however, please note that this is a secular non-Jewish site, and as such it includes some recommendations and guidelines that do not accord with Jewish Law (Halocha). Please consult your own Rabbinic authority.

TIPS FROM FELLOW HG SUFFERERS:

There is evidence that starting medication early, as soon as you see a positive pregnancy test, can make a marked difference to severity of symptoms

HOW TO TAKE XONVEA FOR BEST RESULTS:

Take 1 tablet in the morning, 1 tablet in the afternoon and 2 at night.

This medication works cumulatively as a slow release over 10 hours. If you decrease intake you’ll stop feeling the benefits. It takes 48 hours initially to notice that it’s working.

CYCLIZINE: Can make you drowsy.

ONDANSETRON: Is highly effective, but usually causes constipation, therefore you are likely to need to take a laxative like PEGLAX NEUTRAL which dissolves in water and has no taste or smell. Glycerine suppositories are helpful especially if there is a preference not to take anything by mouth.

OMEPRAZOLE: Lowers acidity and reduces quantity of vomiting and accompanying burning. This medication often completely eliminates heartburn, and therefore it is advisable to continue taking it throughout the pregnancy.

STEROIDS: Are not given readily. If you are in hospital you can ask your Consultant.

If there is any reluctance to prescribe what you feel and know you will need, you will have the information from PSS based on NICE guidelines to back you up.

Important Notice  – The advice on this site is intended to provide useful, generalised information. However, you must not act without consultation with your own doctor who will be able to assess your needs based on your own individual circumstances. 

PSS Disclaimer: The Pregnancy Sickness Support website is a very rich resource; however, please note that this is a secular non-Jewish site, and as such it includes some recommendations and guidelines that do not accord with Jewish Law (Halocha). Please consult your own Rabbinic authority.

HG Pregnancy Team – NW London

All information has been provided by members of the HG Pregnancy Team who have had direct experience with anyone recommended here. However, clearly as we are all different, what works for one of us might not be appropriate for the next person. Therefore, these recommendations should serve not as instructions, but rather as a guideline designed to be easily available at any point when they might be needed.

PSS – Pregnancy Sickness Support

https://www.pregnancysicknesssupport.org.uk/ has an excellent website which is a great resource and worth looking at. All the latest medications are listed and some are available in dis solvable form, as suppositories or in IV form if it’s hard to swallow or keep the tablets down. There is evidence that starting medication early can make a difference to the intensity of symptoms. PSS also offers peer support which could be very helpful.

Medical

Dr Shehata, a consultant obstetrician/gynaecologist runs a Obstetrics and Hyperemesis clinic in Epsom, Surrey.

Tel: 01372 332221 or 0208 401 / https://www.miscarriageclinic.co.uk/profile/dr-hassan-shehata

Other helpful practitioners include Reflexologists, Acupuncturists, Massage Therapists and Yoga Teachers. Please check in all cases whether they work with women in the early stages of pregnancy. The following were recommended by members of our group:

Reflexology

• Julia Freedman: 07748 902411
• Deborah Goldschmidt: 07956 492212 / http://www.gentlebirthmethod.com/consultation/practitioners/wpbdm-category/reflexology/
• Sharon Segal – 07747 695565 / http://www.massage-wellbeing.co.uk/contact
• Lesley Woolfe: 07932 668857

Acupuncture

• Martine and Natalie: 07963 298047 / http://www.heathlandsclinic.com/about
• Barbara Moss: 07974 418448

Pregnancy Yoga

• Jill Miller: 07813 839551

Assistance: Shabbat Walk  https://shabbatwalk.org/team/

Volunteers step in to assist families when the mother is less available because of HG. For example, they can take the children to the park or help them with homework. They will pick up prescriptions and do any grocery shopping that is needed. Should other help be needed, please do ask.

Although their website does not specifically mention helping families where the mother has HG, the founder, Eliezer Gilbert, is aware of this condition, the need for confidentiality and is very willing to provide a bespoke service. Below you will find his contact details as well as a link to their website.

• WhatsApp: 07506 750023
• https://shabbatwalk.org/

For ready-made meals, click here.
Please specify location, number of people and any dietary requirements in your message.

Mental Health and Wellbeing: Menucha https://www.menucha.info/

Menucha offers a confidential information and referral line for Orthodox Jewish mothers experiencing perinatal (from the beginning of Pregnancy to 18 months post-partum) mood disorders.

Financial: Gemach Hasdei Almosnino (Free Loan Society) (Tel: 07973 687456)

Short-term loans (24-30 months) requiring two guarantors and proof of need (bank statements etc)

Note, many Synagogues have their own Gmachim.  You should check with the Rabbi of your own synagogue/Shul

Individual Mentoring and Coaching

Private, personalised sessions with mentors/coaches/health professionals with experience in helping women with HG.

Fee £50 per hour*.  To book, click here

*Some subsidies may be available

N.W. London

There are some wonderful, sympathetic doctors and midwives locally who can help in a number of different ways. One example: referral to EPAGU(Emergency Pregnancy and Gynaecology Unit) without having to go to A & E to receive iv fluids making the process quicker and the system easier to navigate. Be in touch with us directly for information about this or other local services.

Click here to Contact Us

Stamford Hill

AHS (Tel: 07909 256017/0330 3503161) – Advice and support

For Private IVs (Home Treatment): Dr Wetzler (0208 800 5066) will provide IV prescriptions, and Mr Friesel (07929 052669) administers IVs

Israel

Contact Em HaDerech

+972 722 722311

This Israeli HG organisation has great resources in Hebrew (also relevant for Hebrew speakers outside Israel).  They have a list of medical protocols, sympathetic doctors in different regions in Israel, and can also provide a list of services, along with a support network

USA

Resource: https://www.hyperemesis.org/

The Hyperemesis.Org website is a very rich resource; however, please note that this is a secular non-Jewish site, and as such it includes some recommendations and guidelines that do not accord with Jewish Law (Halocha).  Please consult your own Rabbinic authority.  Also, please be aware that some of the medical recommendations and guidelines may be specific to the USA, medical guidance should be sought.

Watch “Sick The Battle Against HG” | Prime Video

Disclaimer: Please note that this is a very rich resource but it is a secular, non-Jewish film and includes some recommendations and guidelines that do not accord with Jewish Law(Halacha). Please consult your own Rabbinic authority.

Rebbetzin Ruthie Halberstadt’s book on HG Coming Soon.

Watch her InstaLive here

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The Torah of Pain – Finding Hashem in Challenging Times

The challenge of difficult times can be enormous. One can feel ‘This is too big for me, I can’t go on.” Real ordeals take us to the very limits – and sometimes beyond, of our endurance.

Rivka Imenu’s pregnancy was unusually painful. She says: “Im kein, lamah zeh anochi – If this is so, why me?” Rashi says this means: “If this pregnancy is so difficult, why did I daven and want it so much?” Ibn Ezra says she asked other women who had given birth if they had experienced this kind of thing and they said no. She then wondered: ‘lamah zeh anochi.’ This is not normal, why is it happening to me? Chizkuni says that if this is the extent of the pain of pregnancy and childbirth, it may be easier to die. Ramban: “Lama ze anochi – Lama zeh anochi baolam.” Halevai eineni – I wish I did not exist.

But she does not stop there. Her response to this experience is: ‘Vatelech lidrosh es Hashem.’ She goes to seek Hashem. Maharal: “Im kein lama zeh anochi” does not mean why am I alive; Hashem gave me life, so there must be a purpose to my existence. But rather: “Why is this me” means why am I sitting still? I must seek Hashem, I must seek the root cause of this and it’s connection to Anochi – my essence. When we experience pain we have a choice. We can say “Why is this happening to me?!” Or we can say “Why is this happening to me?” Pain and discomfort are catalysts for self-searching and spiritual development. We learn the correct response from Rivka. She searches for a spiritual cause and an explanation of what she must do now; what this means to her.

The question to ask is: How can this propel me to greatness? The Gemara (Brachos 5a) says that if something happens to a person he must examine his ways and change his life. When a person understands that something has happened for a reason, pain and negative emotions diminish significantly.

When you suffer, you can kick and scream ‘It’s not fair! Why me?’ or you can say ‘What can I learn and how can I grow from this?’

Tzion sadeh techaresh – Rabbi Moshe Shapira zt”l, in a shiur he gave on 9th of Av, said ”The field which had once been the site of the Temple was ploughed: this is describing the depth of the destruction. But as Rabbi Akiva could discern, this was also the beginning of the redemption. The field is ploughed under; new foundations can now be laid. This is destruction…. but on the other hand, when the ruins are cleared, you can build. Rabbi Simcha Wasserman used to point out that ploughing is the preparation for planting.

These experiences can be unnerving; this is completely new territory. The old rules do not apply here; you need new ones. You can hold onto the ‘old you’ or you can acknowledge that this is beyond anything you have experienced but now that you are here Hashem must want you here and there must be a message in it, something to be gained by making your peace with it and moving ahead.

Hashem is challenging you because he knows what you are capable of. You may not sense that until you arrive – this is like standing on a ladder: on your present rung, you are stable. Standing on the rung above you will be safe too, you know that. But taking your foot off this rung of the ladder to get to that next rung is scary. However if you do that and you find Hashem here and hold tight you will find yourself higher than you could have planned or envisioned. Hashem wants you to get to a place way beyond your present level. He knows what you can achieve and He is inviting you to strive for it. Transition and transform!

Pain is an invitation to grow. Hashem is challenging you to find Him. To trust Him and embark on a deep and intense journey – to the self. That is where Hashem is to be found: “Ani” – “I” is one of Hashem’s names. Your access point to Hashem is through your essential self. Hashem is right here, right now; in this experience with you. This may not be intuitively true – pain is very isolating; if you naturally felt connected to Hashem, you would get no credit for finding Him.

I remember Rabbi Falk zt”l in Gateshead seminary teaching us about checking lettuce for bugs. He said there are two ways you can check lettuce. One approach is to say: “Let’s see if there are any bugs here.” That is not the correct approach. Lettuce is usually highly infested. The correct attitude is to check the lettuce with the motto: “There are bugs here, and I’m going to find them!” In situations of challenge we should adopt the attitude that “There is light here, and I’m going to find it!”

Hashem is the parent holding the child through a painful but lifesaving procedure. Yisurim memarkim – suffering cleanses. We do not invite challenges. Chazal, our Sages, despite knowing the great levels of spiritual cleansing that can be achieved through pain, said to Hashem ‘Lo hem v’lo scharam – keep the pain and keep the reward’! But If Hashem has placed you in this you can and must find the light in it. The pasuk says (Tehillim) Ve’emunascha baleilos – and Your Emunah by night. Our faith is challenged when things are dark, during the night of our life, but it is precisely then that faith can be strengthened and that will carry us through.

Egypt: the final midnight on the eve of redemption. The Jews are instructed to offer the Pascal lamb and celebrate a Seder. But they were still in Egypt – celebrating the Exodus while still in the confines of the place of their Exile. Why not leave and then celebrate? Surely the redemption is only complete when Egypt is well and truly behind us? There is a profound lesson here (Rabbi Nissan Alpert): They were physically in Egypt but emotionally and spiritually they were already miles away. They were celebrating the future as if it were here now. Their faith in the reality of the redemption was so real that the redemption was tangible – it was ‘now’. They celebrated Pesach ‘al shem he-atid.’ We celebrate Pesach ‘al shem he-avar’ – to commemorate the past, but they were celebrating what had not happened yet. This is the message we need to hear. The challenge is to connect to God here and now. There is light here, and I’m going to find it…

Torah Audio Classes on HG

Important Notice – The advice on this site is intended to provide useful, generalised information. However, you must not act without consultation with your own doctor who will be able to assess your needs based on your own individual circumstances.

Planning Ahead

You have work to do …… now while you’re feeling good!

HOPE FOR THE BEST, BUT BE PREPARED!

Financial

Points to consider:

Acknowledge the potential financial issues and address  them by saving money in advance weekly/ monthly and/or taking out a loan to cover additional expenses (Many communities offer assistance- Speak to your Rabbi/Rebbetzin Or contact Gemach Almosnino on 07973687456. Two guarantors and bank statements will be necessary).

Think carefully about your work commitments or studying schedules, and perhaps also that of your husband: Is your job flexible? Is your employer compassionate? Is your course/ University open to deferral?

Financial forward planning will help you:

•  Cover expenses if one/ both of you cannot work to full capacity or at all for a number of weeks or months.
•  Pay for private IVs at a local clinic or at home. These can be truly life changing and give a woman relief from nausea and vomiting (which often lead to dehydration). They may have to be administered weekly or more frequently depending on the severity of the symptoms.
•  Pay for private prescriptions if one is unable to procure these on the NHS.
•  Pay for help – cleaning, childcare, take-out food for the family.

Help In The Home

• Consider who would be most helpful to you if you are unable to run the home as you usually do?
• Think about who would give you the most chance of reducing your potential feelings of guilt while as much as possible honoring your particular style of keeping your home and family functioning.
•  You need someone who takes on the role of a Mother’s Help. This person could be a family member, a friend or hired help.
•  Additionally, you might need more than one person as there is cleaning, laundry and cooking to be done. You may need assistance with the morning and evening routines for children, babysitting, help with homework, and possibly rota. If husbands can help with rota, great, but this is not always possible.
• It is especially crucial to plan in advance particularly as many women prefer privacy early on in a pregnancy.

Medical Preparation

Research the medications currently used to lessen symptoms of HG. www.pregnancysicknesssupport.org.uk is an excellent resource and provides data on the latest studies and a very informative and supportive helpline with individual mentors. We have all made use of it and rate it very highly. We suggest that reading these studies before you call your doctor will allow you to ask for advice, including appropriate medication, on a more informed basis.

MEDICATIONS:

For further information, please review the excellent material at https://www.pregnancysicknesssupport.org.uk/get-help/treatments/

Note : Xonvea does not appear at this link but you may wish to discuss it with your doctor.

https://www.nice.org.uk/advice/es20/resources/doxylaminepyridoxine-xonvea-for-treating-nausea-and-vomiting-of-pregnancy-pdf-1158169089733

Many women have found it to be very useful, sometimes in combination/ alternating with the ondansetron group of drugs. Xonvea may be a very useful alternative to cyclizine. Again, discuss with your doctor.

TIPS FROM FELLOW HG SUFFERERS:

There is evidence that starting medication early, as soon as you see a positive pregnancy test, can make a marked difference to severity of symptoms

HOW TO TAKE XONVEA FOR BEST RESULTS:

Take 1 tablet in the morning, 1 tablet in the afternoon and 2 at night.

This medication works cumulatively as a slow release over 10 hours. If you decrease intake you’ll stop feeling the benefits. It takes 48 hours initially to notice that it’s working.

CYCLIZINE: Can make you drowsy.

ONDANSETRON: Is highly effective, but usually causes constipation, therefore you are likely to need to take a laxative like PEGLAX NEUTRAL which dissolves in water and has no taste or smell. Glycerine suppositories are helpful especially if there is a preference not to take anything by mouth.

OMEPRAZOLE: Lowers acidity and reduces quantity of vomiting and accompanying burning. This medication often completely eliminates heartburn, and therefore it would be advisable to continue throughout the pregnancy. Please check with your Doctor.

STEROIDS: Are not given readily. If you are in hospital you can ask your Consultant.

If there is any reluctance to prescribe what you feel and know you will need, you will have the information from PSS based on NICE guidelines to back you up.

It is important to note that very often women with an HG predisposition do not tolerate oral contraceptives well. This is because contraceptives contain hormones to which women with HG are sensitive. It is important to be aware that there are other halachically acceptable contraceptive options that such women can use. Feel free to discuss this with us and your own Rabbi.

jewishvisualisation.com is a unique space created by us and dedicated to providing you with exercises to help you to connect to G-d as well as resources to help you overcome difficulties, all from an Orthodox Jewish perspective.

Click here to read more.

Individual Mentoring and Coaching

Private, personalised sessions with mentors/coaches/health professionals with experience in helping women with HG.

Fee £50 per hour*.  To book, click here

*Some subsidies may be available

Join The HG WhatsApp Support Group.