By Gabrielle. Empathy cards by Emily McDowell.

Sierra Casillas is a midwife in Washington, DC, and expecting her first baby. But if you’re thinking this is going to be one of those stories where her professional experience has completely and utterly prepared her for her personal challenges, you’re going to be surprised.

I’ll let her tell the story. Welcome, Sierra!


I am a midwife and will soon be a mother.

I have practiced as a midwife for eight years, but in my heart I have been a midwife since I was three-and-a-half years old. I distinctly remember gazing up in wonder at my mother’s swollen belly in our dark, damp basement as she moved clothes from the washer to the dryer. Clothed in a purple patchwork moo-moo, she paused for my little hands to rest on her belly and feel the baby inside of her kick. It felt like magic.

The first time I caught a baby, I felt as though a beam of heavenly light was shining down on me as I sat at that mother’s feet and welcomed her baby. As I have sat, kneeled, bent, and squatted at the feet of women bringing babies and life into the world, I have waited patiently (and not-so-patiently) for my own baby to make its way to my belly and arms. I have envisioned myself carrying and giving birth to my baby ever since I can remember. Those visions always ones of fulfillment, womanhood, triumph, contentment, and joy.

I have accompanied hundreds of women on their journey to motherhood, while waiting longer-than-expected for my own motherhood journey to begin, and I have seen how varied that pathway is. Each pregnancy is unique and each woman is singular in her experience. I have seen women through infertility, picture-perfect pregnancy, loss, first kicks, hyperemesis, smooth water births, hours of pushing, the first successful latch, preterm birth, the first trip to the bathroom after pushing out a baby, unexpected outcomes, the bliss of skin-to-skin, post-partum depression…and even still, I have been completely blindsided by my own pregnancy.

On October 30, 2015 I took a home pregnancy test. I hadn’t even missed my period but I had one in the closet and it was the first month we had actually tried to conceive. I was watching the calendar and paying attention to my body’s signs. As I waited the requisite sixty seconds I told myself it was too early to detect anything and I was wasting a perfectly good pregnancy test.

And then, there were two lines.

I took a few deep breaths, looked again, and hollered for my husband. When he walked in, I had no words — I just handed him the stick with two lines. Others have fun and creative ways of breaking the news to their partner but I’ve never been one of those; sitting on the toilet with my pants around my ankles is how I told my husband. I had also just come home from a run and was sweaty and gross, just so you get the full effect of the precious moment.

The next day was Halloween and my parents, siblings, and nieces and nephews (nearly all of whom I have caught as their mothers’ midwife and helped to have natural childbirths) gathered at my home for trick-or-treating. I remember feeling so dizzy as I watched those costumed children run loops around one another, and I smiled to myself imagining next Halloween with a baby in my arms. My very own.

About a week after I found out I was pregnant, I started feeling sick. A sick I have never experienced before. Every light, every vibration, every noise, every motion, every mention of food, every scent brought a heightened wave of nausea to the constant baseline nausea that would settle in as my norm. For the next four weeks I muddled through my work days and nights by stealing quick moments to sit or lay down and constantly nibbling on something that with every sip or bite became more and more repulsive. I tried ginger, peppermint, crackers, sea bands, meditation, apple cider vinegar, and Chinese herbal cocktails…anything and everything I could think of. Every single thing I had ever recommended to my patients. None of it worked.


On December 4, I finished seeing patients for the day, called my husband to pick me up, and walked out to the car with tears streaming down my face and a huge box of expired anti-nausea medication from the sample closet at work. That would be my last day of work for almost three months. That was the day I first caught a glimpse of what being really, really sick means. I walked into my house, climbed into my bed, and that is where I would stay — with the exception of midwife and doctor appointments, hospitalizations for dehydration, acupuncture appointments, and ultrasounds — for the next ten weeks as my weight dropped, my muscles atrophied, my throat burned from vomiting, my abdominal muscles ached from retching, my bottom bled from constipation and I felt no tenderness or connection to the tiny life that was growing inside of me.

My baby, who I had yearned for and pictured since I was a little girl, was finally on its way and I tearfully fantasized about the relief I would feel if I miscarried and could escape the unrelenting nausea and vomiting. Aside from my immediate family, a couple of very close friends and my employer, I did not tell anyone I was pregnant because I could not muster the strength to pretend I was happy.


I tried every remedy and medication under the sun to get some relief. Some approved for pregnancy, some not.  As I was admitted to the hospital for the first time just before Christmas, I finally allowed myself to admit what I was experiencing was not normal — it was hyperemesis — and I was not being wimpy; I had simply met my match. No amount of willpower was going to win this battle.

I midwifed my sister through a pregnancy with hyperemesis, and even that close encounter did not prepare me for my own struggle. I rang in the New Year violently vomiting, shaking uncontrollably and sobbing in my bed. My best friend started an IV and hung the fluid from my curtain rod. My sister rubbed lotion on my feet. My husband rubbed my back. I called anyone I knew and trusted who would bring me some marijuana. My medications were not even coming close to reaching the depth of my illness and desperation. When the marijuana arrived at my doorstep, I Googled “how to inhale” as I had never touched any drug, alcohol, or cigarette in my life.


I am now 28 weeks and four days into this pregnancy journey and surviving on no less than three different anti-nausea medications (and way beyond the recommended dosage of Tums) and I am only able to work one day a week. My baby moves and kicks and flips all around inside of me, and I have begun to feel some tenderness and connection to him or her. But things are still hard and I am still sick. It’s been three weeks since I came home from my third hospital admission, and three days since my third visit to the ER.

I am sure this long-awaited baby will bring joy to my life and my home, but I am not quite there yet and nobody is more surprised than me at my experience and my emotional response. It is difficult to admit how I have felt, but I know there are other women out there who need to hear my tale, who have suffered through hyperemesis and the guilt associated with it: guilt brought on by taking so many medications that pass through to the baby, or wishing the pregnancy would end so there could be some relief, or feeling nauseated by the baby’s movements rather than thrilled.

To those women I want to say, you are not alone and you are not a bad mother.

The perfect, blissful, organic, pure, uncomplicated pregnancy I have always envisioned and helped other women to achieve is not my story to tell. And though it has been the hardest journey I have ever endured, I trust there are happy days to come. I recognize how blessed I am to have a healthy baby growing inside of me and I do not take that for granted. I am not looking for sympathy and I know there are women whose pregnancies are much more difficult than mine.

But to women reading this: Whatever your journey to motherhood entails, I hope you are able to allow yourself to feel and experience the highs and lows as you bring life into this world. As a midwife and almost mother, I’ve witnessed the strength of a woman and her body. I have shared in the triumph of a new mother as she lifts her baby out and up onto her chest. I am beginning to envision that moment of triumph for myself as I pull myself up, with my constant and supportive husband ever at my side, and journey on into my third trimester.


A huge congratulations to you, Sierra, for not only enduring hyperemesis thus far, but also for thinking of how you can help others who are also experiencing this severe, severe, nausea. Your experience has comforted someone today. And I’m sure you hear this all the time, but it will get better, and we’ll all be thinking of you until it does.

P.S. – Find all the stories in this series here. Do you have a story about birth, pregnancy, adoption or infertility? Send your story to me, will you please?