Background: Severe nausea and vomiting of pregnancy (NVP) and hyperemesis gravidarum (HG) are serious complications associated with significant maternal/infant morbidity and mortality. Adequate treatment is critical for optimising maternal and infant health, but data on women’s experience in managing their illness with medications is largely absent.
Methods: Online, national survey of women who are currently or have previously experienced severe NVP or HG, distributed through the HG consumer groups, Hyperemesis Australia. The survey was distributed between July and September 2020, with results collected and stored using REDCap.
Results: Among 249 respondents, 242 (97%) reporting taking one or more medications to treat NVP/HG. The majority of women (195; 78%) reported receiving a formal diagnosis of HG, with 163 (65%) being admitted to hospital on at least one occasion. Approximately one in four (n=68; 27%) women reported being denied a medication by a health care professional during pregnancy. Medications most commonly denied included doxylamine (n=45) and ondansetron (n=16) and involved interactions with pharmacists (n=44) and medical practitioners (n=19). Despite presenting a prescription, eight women reported pharmacist refusal to dispense doxylamine, ondansetron, or prednisolone. Reasons for denial included being told the medications were not recommended or safe for pregnant women, or that women were not sick enough to warrant the medication.
Conclusions: Approaches towards identifying and effectively addressing barriers to the provision of effective treatments for severe NVP and HG are urgently needed, including further studies evaluating health care professional attitudes towards recommending or prescribing medications.