Second Royal Baby on the Way

“Their Royal Highnesses The Duke and Duchess of Cambridge are very pleased to announce that The Duchess of Cambridge is expecting their second child. The Queen and members of both families are delighted with the news.”

So came the official announcement from Buckingham Palace this morning. It went on to say:

“As with her first pregnancy, The Duchess is suffering from Hyperemesis Gravidarum. Her Royal Highness will no longer accompany The Duke of Cambridge on their planned engagement in Oxford today.

“The Duchess is being treated by doctors at Kensington Palace.”

As you recall, news of her Kate’s first pregnancy “leaked” when she had to be hospitalized for dehydration due to the severe morning sickness she experienced. Looks like this time, they hope to handle her condition at home.

The baby, whether it is a boy or girl, will become the fourth in line to the British Throne (behind Grandpa Charles, Dad Will and Brother George). Uncle Harry has been moved down into the fifth slot.

What is Hyperemesis Gravidarum and how is it different from Morning Sickness?

Morning sickness, which is nausea and vomiting during pregnancy, is very common. It is estimated that 70-80% of women suffer from some degree of morning sickness. Most complain of nausea, and a third will also have vomiting. Despite its name, morning sickness can occur at any time of the time.  It  usually begins during the first month of pregnancy and continues through the 14th to 16th week (3rd or 4th month).

Hyperemesis gravidarum (HG) is a more severe form of morning sickness.   HG is extreme, persistent nausea and vomiting during pregnancy that may lead to dehydration.

It is postulated that both morning sickness and hyperemesis gravidarum are caused by a variety of factors. These include the rise in the hormone human chorionic gonaditropin (HCG), slow emptying of the stomach after eating and genetic factors. Its exact cause is remains unknown. It is more common during pregnancies with multiples (twins, triplets, etc) and in a condition called hydatidiform mole.

The symptoms of HG include:

  • Severe nausea and vomiting
  • Weight loss of 5% or more of pre-pregnancy weight
  • Dehydration
  • Decrease in urination
  • Aversion to food
  • Headaches
  • Fainting

How likely it is to get HG in second pregnancies?

Although studies vary, most find that women who have had HG have a good chance of experiencing HG in future pregnancies. Over 50% will have it with each pregnancy and those with more than one experience of HG have a higher risk of experiencing HG in future pregnancies. It also seems to occur in similar patterns and severity, though it is not always consistent.

How is it treated?

Small, frequent meals and eating dry foods such as crackers may help relieve uncomplicated nausea. Drink plenty of fluids, especially at times of the day when the nausea is less of a problem. Seltzer, ginger ale, or other sparkling waters are good choices.

Severe cases of HG require hospitalization. The pregnant mother will receive IV (intravenous) fluids and may have a small feeding tube placed in the stomach to restore nutrients.

Most cases of HG resolve by 20-21 weeks of pregnancy.

For more information, go to the Resounding Health Casebook on the topic.

Our congratulations and best wishes to the royal couple!

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

1 Comment

  1. Hayley Peoples

    September 11, 2014 at 1:03 am

    Being American, the obsession of the Royal Babies is very interesting. We have celebrities in America, but in England these are the people who help rule the country. Over time they have reduced their actual political power, yet their country still has an ideology about how they are presented in the media and as public figures. Ideologies are a system of belief that exists within all cultures. Monarchy is has been the ideology of England, yet the whole world has become obsessed. The representation of Kate Middleton, as a normal girl who became a princess, appeals to the American ideology of celebrity and the “American Dream,” of going from rags to riches. Representation is defined as the use of language and images to create meaning. Through Kate and William’s courtship, marriage, and pregnancies, they have been represented as the perfect couple to take the throne one day. The images that have been produced from their relationship have become ionic in their own right. From their engagement pictures, Kate’s wedding dress, and the moment they stepped out of the hospital to reveal their newborn baby, Prince George, to the world. Every instance has been played over and over again, with the added layer of importance by comparing these instances to Williams mother, Princess Diana. Both Kate and Diana were wearing polka dots when they reveal their newborns, and both of their wedding dresses were the talk of the world. The representation of the Royal family in the media has produced this worldwide obsession with the ideology of the British.
    Kate had to announce her pregnancy early due to extreme morning sickness called Hyperemesis Gravidarum. As the Dutchess of Cambridge, she has required appearances and engagements that she will miss due her extreme morning sickness. The new baby will be fourth in line to the British Throne. I feel like the representation of Prince George and the new baby evinces the idea that those children are Great Britain’s, not Williams and Kate’s. Kate can’t even keep the pregnancy a secret until her second trimester, because of how public her responsibilities are. It has also drawn attention to Hyperemesis Gravidarum. I’ve seen multiple articles explain in detail the symptoms that accompany Hyperemesis Gravidarum, and why it’s not your normal morning sickness. The ailment is being represented in the clearest way possible with details to possibly show the transparency of the Royal Family. I feel like they want to represent her sickness as not just regular morning sickness, but as something way more serious. The Royal Family is truly fascinating and I hope they are happy with their representation in America, especially when it comes to medical issues.

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