Hyperemesis Gravidarum

Hyperemesis Gravidarum -A-Z Blog Series


“Morning sickness” or periods of nausea and vomiting is a well known factor in the first trimester of pregnancy. Hyperemesis Gravidarum, however, is defined at American Pregnancy Association as: 

“a condition characterized by severe nauseavomiting, weight loss, and electrolyte disturbance. “

How can you tell the difference? Upwards of 50-70% of pregnant people experience some “morning sickness” which typically includes:

  • Nausea sometimes with vomiting
  • Nausea and some vomiting that goes away around 12 weeks
  • Vomiting that does not cause severe dehydration/electrolyte imbalance
  • Nausea/vomiting that allows you to take in nutrition/keep some food down

Hyperemesis Gravidarum complication typically includes:

  • Severe vomiting
  • Nausea/vomiting (severe) throughout the pregnancy
  • Vomiting that causes severe dehydration/electrolyte imbalance
  • Vomiting that may keep you from keeping any food down, preventing nutrition

Additional Symptoms of HG: headache, confusion, decreased urine output, fainting, extreme fatigue, weight loss of 5% more of pre-pregnancy weight, anxiety/depression, rapid pulse, and more.

While some milder versions of Hyperemesis Gravidarum (HG) can be treated at home with dietary changes, antacids, rest, and prescribed medications, some cases require hospitalization. When someone is hospitalized with HG they can receive IV fluids, nutrition, and medication.

Why does this happen? No one is 100% certain. It is suspected that it is related to the rise of hormone levels. There is no known way to prevent it but there are ways to manage it. If you have HG it is imperative you speak to your pregnancy provider. Because every person who has HG will need a plan from their provider and potentially medication, along with the risks/benefits of such medication, this blog will not offer suggestions on self management.  For more information and resources, please visit Help HER.

HG is difficult to experience. You may have expected to send your partner out for late night runs for cravings instead of feeling sick. You may feel depressed and anxious, worried about you and the baby’s health. You may feel stuck in your house or at the hospital. Ask for help from your circle of support in the form of visitors, housekeeping, other sibling care if applicable — reach out! Rest as much as you can. Speak to your provider about any options available to you for relief. As hard as it may be to believe while going through it, HG will not last forever.

Kimberly Sebeck, HCHD, Knoxville Doula,
All Rights Reserved 2020


Grandparent Tips -A-Z Series


Congratulations, Grandma and Grandpa! Or Mimi and Papa! Or Mamaw and Papaw!
No matter what name you choose to go by you are about to enjoy the wonders of a grandchild. Snuggles, sweet smiles, coos, and then giving the baby back while you get to enjoy a full night’s sleep.

A recent study said that somewhere around 81% of grandparents today are engaged with their grandchildren and that is wonderful news. Studies have also shown that has benefits for everyone — grandparents tend to live longer, children have a wider family circle and tired parents have a support system.

How best to support, though? Read on for some tips!

  1. Times have changed! The “rules” regarding feeding babies, safe sleep practices, feeding methods, and much more are likely different than when your “baby” was a baby. Read up on these changes at American Academy of Pediatrics or take a grandparents class in your area! In East TN Area: 
  2. Car Seat Safety. So much has changed even in recent years concerning the safety and laws surrounding car seats. Be sure to check your state laws and make sure a car seat is installed properly. In Knoxville there is a monthly Child Safety Seat Checkpoint Schedule . Car seats expire and break down, too, Never buy a used/second hand seat — they could have been in an accident and even a minor fender bender can render them ineffective.
  3. Helping the new family adjust. This is not the time to simply be a guest in their home. Offer to do the dishes, bring dinner, or start some laundry while mom rests. Good rest and nutrition help make happy and healthy parents. Speaking of…
  4. Postpartum Mood Disorders. You can help watch for any signs of postpartum mood disorders in the new mom. If you are unfamiliar with the signs or symptoms or concerns you can read about it at Postpartum Support International. 
  5. Listening to and honoring the parents methods. Yes, things are different. No, you are not ancient and obsolete. Things change quickly in the world of babies! As a postpartum doula I am continually updating my information — something I would have recommended five years ago is no longer recommended as new information comes out or a recall is issued. You have the loving touch and heart of a grandparent and the means to bond as no other person can with your grandchild.

Enjoy that grandbaby!

Kimberly Sebeck, HCHD, Knoxville Doula,2010
All Rights Reserved


Finding — A-Z Series


It seems to me that becoming a parent is a lot about Finding.

Finding out you’re pregnant. Finding a childbirth provider. Finding a childbirth education model that appeals to you. Finding how overwhelming the choices are when it comes to breast pumps, pacifiers, bottles, even swaddling blankets– and then making choices. Finding out where every bathroom is when your bladder is full, or if you have to vomit (thanks, “morning” sickness). Finding you cry at the drop of a hat. Finding out every bit of it was worth it when you saw your baby for the first time. Finding out you can go with less sleep than you imagined possible. Finding your village. Finding your rhythm through those first nights, weeks, months.

The Free Dictionary defines the word “finding” as “something that has been found”

You have been found as a mother, a new experience but something that was already in you waiting to come forth. What a beautiful thought.

Underneath it though is this description for the word “findings”:

“Small tools and materials used by an artisan”

You, my dear, are an artisan. You have the tools and materials to create works of art. And as any artist, your skills grow as you use them. Believe in your abilities and capabilities.

Kimberly Sebeck, Knoxville Doula 2020
All Rights Reserved


Expectations – A-Z Series


Expectations — we have many months to build up in our heads the “perfect” birth scenario, the “perfect” baby, the “perfect” postpartum experience. Some of us try to conceive for some time, too, and imagine/long for a “perfect” pregnancy as well. And really there is a benefit to visualizing things going in a positive way. Imagining worst case scenarios isn’t the best way to spend our time or energy while growing our babies and preparing to add to our family.

So how do we balance optimistic expectations with reality?

  • Education — whether that be by experience, classes, reading books or online material, etc. Seek reputable sources.
  • Set yourself up for success for your desires — if you are wanting a natural unmedicated birth, for instance, seek out a provider and birthing facility in line with that goal. Consider hiring a doula. Take a natural childbirth class. Practice any techniques you learn and are taught.
  • Realize that pregnancy, birth, and postpartum are times of great changes and can be unpredictable. Some flexibility may be required. A change in your plans does not equate to failure. Take the time to acknowledge there may be some disappointment at the change without attaching judgment. *
  • All babies are good babies. Some are low key and some are more needing of attention. Some come out with perfect scores and take to feeding immediately and others have multiple doctor visits and require more of a learning curve in their transition to the outside world. All of this falls into a spectrum and you will get the swing of things very soon!
  • Having a new baby, juggling your own healing, lack of sleep, hormonal changes, a different body, can all make us feel like a different person.  This is ok! This is a period of adjustment. Perhaps you aren’t feeling the rush of love for This is othe baby you thought you were or you are just really tired. Again, all of this is new to your new family and give yourself some time and grace.
  • Having flexibility, a plan for some help after baby comes, giving yourself grace/being non judgmental, and injecting some humor when possible are all ways to balance those first few weeks. You’re a new parent! That’s amazing! You’re doing hard work– pat yourself on the back, give yourself some time — oh and take a nap if you can.


*If you find yourself traumatized by an experience, please reach out to someone to talk to, such as an experienced counselor or physician, or even a friend if you are unable to speak to a professional in a timely manner.


Kimberly Sebeck, Knoxville Doula 2020
All Rights Reserved





Due “Date” A-Z Series

Continuing in the A-Z Pregnancy Blog Series we come to the letter D. I bet you thought I was going to write about doulas, didn’t you? Well, I have written previously quite a lot about doulas. Here a few links if you want to read about:

https://knoxvilledoula.wordpress.com/2015/06/12/reasons-to-hire-a-doula-for-cesarean-birth/  Reasons to hire a doula for a Cesarean Birth

https://knoxvilledoula.wordpress.com/2012/01/17/doula-musings-today/ What I can and cannot do as a doula

https://knoxvilledoula.wordpress.com/2010/02/09/hiring-a-postpartum-doula/  Hiring a postpartum doula


So for D I thought I would write about the “due date” or EDD, estimated due date. It is an estimate and some feel it should be more of an estimated due month rather than a date. After you see how it is calculated perhaps you will also feel the same.

In order to calculate your due date, add 7 days to the date of your last period and then add nine months, with the assumption of a 28 day cycle.  But remember that babies don’t know anything about this estimated calendar date and a full term pregnancy is considered anywhere from 37 to 42 weeks.

Due dates are usually calculated on your last period instead of the date of conception because of a number of reasons.

  • Although the average woman ovulates (releases an egg) approximately 2 weeks after her period, the exact time is not always known.
  • Once an egg has been released, it can remain fertile for up to 24 hours.
  • Sperm can last for up to 7 days after intercourse to fertilise an egg.

Nowadays an ultrasound is frequently used for dating but the date can be off by a week or more. Depending on which study/evidence is cited, approximately only 5% of women give birth on their estimated due date. But it’s fun when it happens! Only 35% of women go into labor the week of their EDD.

Keep your due date in mind, absolutely, but don’t panic if baby ends up surprising you. Parenthood is all about surprises! You will soon be holding your baby in your arms.

All Rights Reserved, 2019
Kimberly Sebeck, CLD, CCCE, HCHD
Knoxville Doula


Cravings in Pregnancy


Yes, they’re real. Sometimes they can be fairly tame, like extra pickles on a sandwich or very odd like pickles mixed with ice cream. Yes, some women really do mix some weird combinations. I myself craved artichokes early in my pregnancy in an almost indescribable way. I’ve always wondered if it was because of the vitamin C content. Most of the time, however, women find themselves craving “comfort food” or foods that are a combination of salty and sweet and/or with a higher fat content.

The one caveat would be when someone craves non food items like dirt or clay. This is called pica and is a medical condition and needs to be addressed with your medical provider.  Also an extreme craving for ice could be a sign of anemia so mention that to your medical provider, although they usually check your bloodwork for signs of anemia.

Why do cravings happen? No one is 100% certain of the answer although it seems to be related to hormones. One solid theory is that as hormones shift, dopamine levels can lower which can lead to cravings. Another theory or one that may also work in tandem is that our body is craving certain nutrients. Now ice cream wouldn’t be what anyone would consider a nutrient, however, craving dairy could mean someone is needing more calcium. Salt could mean a need for more magnesium, fatty foods could mean a need for more essential fatty acids, and so the theory goes. Yet another theory is that the baby itself is putting on fat and needs fat to shape and grow its brain.

When you think about food as a source for growing your baby it can help you to think of healthier ways to satiate those cravings. Having smaller meals broken up during the day  can help digestion.  Occasional ice cream or french fries (maybe mixed!) isn’t going to hurt you but having them all the time isn’t the best nutritional choice. Maybe having food with a higher calcium content and magnesium content most of the time followed by a little bit of ice cream sometimes would be better. But I’ve been pregnant, too, and I know Baskin Robbins saw more of me during the last couple months of my pregnancy than they have seen me since!

So yes pregnancy cravings are real. Moderation is the key. And one day you can tell your child how you dipped bananas in ketchup or ordered a salad with triple amounts of artichokes or put hot sauce on absolutely everything.

All Rights Reserved, 2019
Kimberly Sebeck, Knoxville Doula
This is for informational purposes only and is not intended as medical advice



Body Changes in Pregnancy & How to Love It

I know, I know. You were promised a “glow”. Instead you can barely roll over in bed, coffee makes you nauseated, it’s been days since you pooped, and what is going on with your skin?!

This blog isn’t going to minimize the fact that some aspects of pregnancy are really really hard. Hopefully some of the suggestions will give you a deep breath and a reminder that the hard time won’t last forever.

  1. The first and most obvious change is you are growing another human! Whoa! That’s almost mind boggling. Another person (or persons) are taking up residence inside your body. Of course there will be some uncomfortable changes! Yet you are entrusted with this life giving task. Your body was made for it. It’s up to the challenge. You have a mission to grow this other being.
  2. Feel all that stretching? Stretching of the skin, stretching of your breasts, stretching of maybe some inner organs you never thought about before? You are expansive, and in a monumentally good way. You can use this time to think about and practice these stretching sensations as how you will stretch as a mother. Your body, mind, and heart are stretching in ways they didn’t before you were pregnant and the pay off is oh so sweet.
  3. Speaking of your mind and heart, this is a great time to really get deeply in touch with what your body needs. Many jokes are made about cravings but go deeply into what your body is telling you. Are you bone weary today? Your body is telling you to carve out some rest. Are you having trouble settling down to sleep? Is your body telling you to meditate before bed? Cut back on caffeine? Are you feeling anxious? Do you need to reach out to your partner for some cuddles or more help around the house? Begin tuning in to what your body is telling you and make adjustments accordingly.
  4. Constantly peeing. Like.. constantly. Being hungry but only being able to eat a tiny bit. Pregnant bodies do that because the bladder has pressure on it but because your kidney volume can increase by 60%. Your colon is also compressed and your GI system is retaining more water and the whole system is slowed down. That’s the bad news of it but the good news is it’s supposed to work that way. These processes allow for room for your growing baby and uterus, as well as prepare for increased blood volume and retaining nutrients, etc. This allows us to trust that our bodies are doing what they are supposed to be doing. Trust that your body is housing and growing your baby.
  5. While we are talking about nutrients, take this time to nourish yourself! You’ll need some extra calories each day when pregnant — make those delicious, healthy, and nutritious calories! Eat a rainbow of colors, plate your food in an appealing manner, pour yourself a non alcoholic mocktail. You are nourishing and nurturing yourself and your baby, enjoy it! Banish society’s obsession with thin from your mind. Your mission right now is to house, nourish, and nurture yourself and your baby and it can be glamorous, beautiful, creative, anything you want it to be.
  6. Pamper yourself if and when possible. Get a pedicure, get a prenatal massage. Buy some whipped lotion and have your partner rub your feet at night. Have a girlfriend style your hair.  Use a facial scrub. Wear silky robes or sarongs if you love them. Really the options are endless.
  7. Remember to exercise! It is great for you, your body, your mind. Always check with your doctor first but walking is almost always a safe outlet for pregnancy as well as water aerobics. Sometimes feeling how strong and capable our bodies are can make us appreciate and love it more.
  8. Intimacy can be tricky. Sometimes during pregnancy your hormones can make you feel more intimate and sometimes it can make intimacy seem far far away. Talk to your partner about it. Maybe cuddling and massages with each other will fill the space for now. Either way, having an honest conversation and reassuring each other of your love and affection will help your relationship. Your body is going through a lot of changes after all. The changes will be temporary but you want your relationship to last.
  9. As a doula I think pregnant bodies are gorgeous but I do remember having fleeting moments when I myself was pregnant. Worrying if I would lose all the weight or if I was still attractive. It seems so superficial now and yet those are very real concerns for most of us! Try this mantra: My body’s purpose is twofold now – to care for my own health and well-being and to grow and nurture my baby. 

All Rights Reserved, 2019
Kimberly Sebeck, Knoxville Doula