Dear Media: Kate Middleton Does Not Have “Morning Sickness”
The world’s most famous pregnancy brought overnight visibility to a little-known but serious prenatal complication, when Britain’s royal family announced the Duchess of Cambridge’s hospitalization for treatment of hyperemesis gravidarum (HG) – a debilitating and even life-threatening condition marked by severe, unrelenting vomiting and/or nausea that can lead to rapid weight loss, malnutrition and dehydration, with potentially dangerous health consequences for both newborn and mother.
For thousands of HG survivors and a modest but committed advocacy and research community, a profound opportunity for raising awareness had at last arrived. Yet, a stampede toward competitive edge with one of 2012’s hottest stories created a hysterical media moment. Journalism’s fundamental due diligence took a back seat as coverage perpetuated misinformation and stigma, revealing holes in the competency of popular, mainstream media to report on health and medicine.
The hurried official statement from Prince William’s office on the morning of December 3rd did little to set up insightful, accurate reporting, defining hyperemesis gravidarum as “very acute morning sickness.” This wording – imprecise and understated – likely reflected the limited vocabulary of even many medical professionals attempting to characterize a bewildering, poorly understood condition.
But as the newly-emerging science, a Google search, and an interview with any HG mother will tell you, hyperemesis gravidarum bears little resemblance to normal pregnancy symptoms. (Since his wife’s hospitalization, Prince William has gone on record noting that rather than morning sickness, “it’s all day and all night sickness.”) In fact, hyperemesis gravidarum is a worldwide women’s health problem, particularly threatening to mothers without immediate access to medical care, including low-income women and those in developing nations. It robs pregnant women of what should be a joyful time. Many are haunted by the ramifications for their health, emotional wellbeing, work, and relationships long after giving birth. Some lose their lives. Yet, with the Duchess of Cambridge story, the initial misnomer stuck – substituting for journalistic inquiry and expert sources – resulting in coverage that undermined the HG community’s hopes and the health literacy of us all.
During the initial feeding frenzy, too many outlets took one low road or another. Snark-infested Gawker predictably reported that “Kate was admitted to the hospital today with ‘hyperemesis gravidarum,’ which is what they call regular old morning sickness when you are a princess.” But they weren’t alone. Led by a glib Barbara Walters, reporting live as she read the palace statement from her Blackberry, the women of "The View" openly mocked the condition they couldn’t pronounce and cut off a nurse in the audience who attempted to respond to Walters’ less-than-earnest inquiry into HG’s seriousness. (To date, producers have ignored a deluge of negative feedback on The View’s message boards from HG women calling for a retraction or a conciliatory educational segment.) Stephen Colbert, who might’ve been expected to mock the media’s insensitivity, instead joined the chorus (starting at 11:00). The venerated ABC News ran a ticker headline, “Kate’s condition not serious.” CNN’s Sanjay Gupta appeared to inadvertently conflate the causes and symptoms of ordinary morning sickness with the more complex condition at hand, while his network unself-consciously reported humorous highlights from Britain’s “media frenzy” surrounding the pregnancy.
The mood echoed loudly across national boundaries. In a now notorious example, Australian radio hosts prank-called London’s King Edward VII Hospital as a comedy bit in the wee morning hours, convincing an unwitting nurse to discuss details of Kate’s symptoms. (In the aftermath of this breach, the nurse, Jacintha Saldanha, committed suicide December 6th.)
Days passed and news outlets still struggled to report on the Duchess’s condition with any depth. To their credit, a few – including CBS News and The Katie Couric Show – consulted resources like the HER Foundation. Couric’s segment included the HER Foundation’s Ann Marie King, along with another HG survivor, at last giving a voice to the HG patient community. Yet “keeping it light” remained a rallying cry, with producers and reporters prioritizing entertainment value. Among other failures, most outlets relied upon in-house medical experts not adequately prepared to provide sophisticated reporting on hyperemesis gravidarum.
Such was the case when The Katie Couric Show brought in ABC News staff physician Dr. Jennifer Ashton, who never claimed to have treated an HG patient but spoke perkily about the helpfulness of acupressure and ginger (helpful for morning sickness, but widely known by HG veterans to resemble treating a broken bone with a band-aid). Couric kept the Kate story “positive” and “fun,” which led to speculation about HG and twins, unhampered by the theory’s insufficient evidence base. And as HG-survivor moms shared stories of feeding tubes, hospitalizations and liver damage, Couric deftly steered Dr. Ashton’s interview away from deeper discussion of serious health implications, setting an autopilot course toward feel-good and tone-deaf.
These were real opportunities missed or squandered. As HG dad and blogger Evan Derkacz notes, “The fact remains that [HG] can be a brutal, crippling condition that goes largely ignored and untreated, partly due to its overlap with ordinary pregnancy sickness and partly to our attitude toward suffering, and the suffering of pregnant women in particular.”
At the time of this publication, small glimmers of substantive reporting are just beginning to emerge. Breakthroughs have come from specialized niche media, including a Scientific American story with Dr. Marlena Fejzo, a geneticist at UCLA’s Geffen School of Medicine working to identify the genes responsible for hyperemesis gravidarum’s most severe cases. And bloggers have triumphed on their own terms, seizing the moment to increase public understanding with a grassroots approach mixing personal accounts and emerging science. But these exceptions – and their exceptionality – expose the need for mainstream outlets to reconsider how they approach breaking medical stories specifically, and health literacy generally.
While Kate Middleton’s pregnancy is new, and the severity and duration of her HG remains unknown, those who best understand hyperemesis agree: The gravitas of celebrity has opened the door, and progress is within reach.
Image by Tom Soper Photography via Flickr