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More help needed for women with severe morning sickness

Duchess of Cambridge's pregnancies have raised profile of hyperemesis gravidarum

Mark Gould

Monday, 20 April 2015

Half of women who suffer from severe morning sickness fail to get any help and up to 1,000 women a year are having abortions as a result, a report claims.

Around 10,000 women are thought to suffer with hyperemesis gravidarum (HG), a complication of pregnancy which can result in extreme nausea and vomiting, each year but many are not being offered the entire range of treatments, two charities warned.

It is estimated about 30% of pregnant women suffer from pregnancy sickness that interferes with their ability to go about their daily lives and a further 1-1.5% will be diagnosed with HG. With nearly 1m pregnancies in the UK in 2013, it is estimated that around 10,000 women per year would suffer HG.

In their joint report "I could not survive another day", the British Pregnancy Advisory Service (BPAS) and Pregnancy Sickness Support (PSS) said research had shown 10 per cent of sufferers decide to terminate their pregnancy as a result.

It said: "Our research suggests that a significant proportion of women who have ended wanted HG pregnancies were not offered the full range of treatment options, but expected either to put up with the sickness or undergo an abortion."

They say that there is more awareness of the condition because of the Duchess of Cambridge's well-publicised experience with HG during the early stages of both her pregnancies. In the report, 71 women who ended their pregnancies while suffering with HG were interviewed. "While the experience of the Duchess of Cambridge has dramatically raised awareness of HG, the coverage inevitably did not reflect that many sufferers unfortunately struggle to obtain comparable treatment," the report says.

The condition, although rarely fatal now, was the leading cause of death in early pregnancy before the development of intravenous fluids for rehydration in the 1930s.

Six women in the UK died due to complications associated with HG between 2006 and 2012, the report said. Women interviewed for the report described vomiting blood and being too ill to get out of bed.

Women said they were often expected to either tolerate their symptoms or terminate their pregnancy. Nearly half of the women surveyed described difficulty obtaining appropriate medication, with specific treatments refused. In particular, women reported being denied some of the more effective treatments because of concerns about cost but also the impact on the foetus, even though there is a broad body of evidence indicating these treatments are safe.

A possible unwillingness on the part of doctors to prescribe medication may be due to the Thalidomide disaster, some 60 years ago, when babies were born with deformities after mothers were given the drug to ease morning sickness, the report warns.

Clare Murphy, BPAS director of external affairs, said: “Any woman who needs an abortion should have straightforward access to one. No woman should ever feel stigmatised or judged for doing what is right for her and her family. But misplaced concerns about the impact of medication on the foetus should not prevent a woman accessing the care she needs to continue a wanted pregnancy. Women who need medication must be able access this, safe in the knowledge that abortion is there as a back-up should they not sufficiently ease her sickness and enable her to get on with her life.”

The report says that there are a number of treatments now available for severe pregnancy sickness, and clear guidance from NICE’s Clinical Knowledge Summaries on what can safely be offered to women which provides the reassurance healthcare professionals and women need. 

"As well as alleviating the suffering such sickness causes women, early treatment in the community may prevent sickness leading to serious illness and dehydration, which requires hospital admission," the report says. It called for better awareness of the condition and its impact on women.

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