Pregnant women who experience Hyperemesis Gravidarum (HG), a severe form of morning sickness struggle to access anti-emetics that can alleviate the condition, a report by the British Pregnancy Advisory Service and charity Pregnancy Sickness Support has found.
The report, I could not survive another day, found that 1.5% of pregnant women experience HG, with an estimated 10,000 cases each year. The report surveyed 71 women who had ended their pregnancies as a result of HG, and found that 47% had either asked for medication to alleviate the symptoms and been refused, or had not been offered any. Similarly, 66% of women surveyed said they had requested a particular type of medication, only to be told they could not take it for medical reasons.
HG is a potentially life threatening condition, which can cause extreme dehydration, fatigue, vomiting blood and severe weight loss. The report found that 10% of people who suffer from HG terminate otherwise-wanted pregnancies, although other research has put this number between 15% and 20%.
Caitlin Dean, chair of Pregnancy Sickness Support and a registered nurse, said: 'Care in the community is key. Our aim is to see the majority of IV work carried out in community settings. Practice nurses also have a role in supporting women with HG. In particular, they can train partners to help to manage the condition by administering medication.'
One of the women who participated in the report said: 'My GP told me I could only take this one type of anti-sickness medication. This didn't work for me so I continued with my pregnancy for further two weeks. In this time, I couldn't eat or drink and became very unwell.'
The report also examines the reasons for pregnant women being unable to access the medication. It notes that many effective medications are not licensed for pregnant women as pregnant women are excluded from drug trials. A quarter of the women surveyed said that they had been refused a prescription over concerns that the medication would harm the foetus, while another 25% were refused as there was 'no medication suitable for the pregnancy.' The report also suggested that the cost of certain drugs was a factor in the refusal, particularly in the case of Ondansetron, an anti-emetic known to be 'extremely effective' in treating some cases of HG.
The report also notes a disparity in prescribing being primary and secondary care. It cites an article published in the BMJ which said: 'Women will be prescribed these [medications] liberally if admitted to hospital so there is no need to withhold them in primary care.' The report also notes the importance of early detection and prevention of HG in the community, which can help to avoid the condition exacerbating.