Thousands of women in the UK may be being driven to terminate their pregnancies each year because of a condition that causes severe vomiting during gestation.
A survey of more than 5,000 women with hyperemesis gravidarum (HG), published today, is the largest study ever into the ‘devastating’ illness.
It found that 5 per cent of HG sufferers terminated a planned pregnancy because the symptoms become too overwhelming, while more than half considered it.
A quarter of women surveyed said they experienced suicidal thoughts and 6.6 per cent regularly considered taking their own life.
Up to one in 30 pregnant women suffer from the HG each year in the UK and US. It causes persistent and excessive nausea and vomiting.
Researchers led by King’s College London, who conducted the survey, said it was critical pregnant women can get rapid access to anti-sickness medication.
A study of more than 5,000 woman in the UK who suffered from hyperemesis gravidarum revealed five per cent have terminated a wanted pregnancy because their symptoms were so debilitating, while more than half considered it
The Duchess of Cambridge suffered from the condition when expecting her first child Prince George in 2012 and was admitted to hospital for three days. She
The survey, published today in Obstetric Medicine, revealed 4.9 per cent of women said they terminated a wanted pregnancy because of HG, while 52.1 per cent considered it.
Previous studies have found as many as 15.2 per cent of women with the condition had an abortion.
Women were more likely to get an abortion if HG left them unable to look after their existing children, or felt it was the only way to stop suicidal thoughts, the researchers said.
They survey allowed women to write comments as well as responding to multiple choice questions.
One woman said she doesn’t think she will ‘ever get over it’, but ‘had no other option at the time.’
What is hyperemesis gravidarum?
Hyperemesis gravidarum (HG) is a condition that causes persistent and excessive vomiting during pregnancy.
Sufferers can be sick lots of times every day and be unable to keep food or water down, impacting their daily life.
It is unlikely to harm the baby, but if it causes a women to lose weight during pregnancy there is an increased risk their baby will have a low birth weight.
It is different to sickness during pregnancy — often called morning sickness — which is normal and affects eight in 10 pregnant women. For most, this stops or improves around weeks 16 to 20.
Meanwhile, HG may not get better by this point and can last until the baby is born.
Symptoms of HG include prolonged and severe nausea and vomiting, being dehydrated, weight loss and low blood pressure.
Being dehydrated raises the risk of having a blood clot — deep vein thrombosis — but this is rare.
It is not clear what causes the condition, or why some women get it and others don’t.
Some experts think it may be linked to the changing hormones in the body that occurs during pregnancy.
And there is some evidence that it runs in families and women who suffered it during their first pregnancy are more likely to have in any subsequent pregnancies.
Women suffering from HG can be given medicine to improve their symptoms, such as anti-sickness drugs, vitamins B6 and B12 and steroids.
Some women have to be admitted to hospital if their nausea cannot be controlled with medicines at home.
They may require fluids and anti-sickness drugs to be administered through an IV.
Another described deciding to have an abortion ‘to avoid losing my new job and home for my first child, which I had rented after 6-months of homelessness’.
Meanwhile, 25.5 per cent of women said they experienced occasional suicidal thoughts and 6.6 per cent had them regularly.
Women who had support from family, friends and healthcare providers were less likely to have suicidal thoughts.
The study was developed as a collaboration between the BBC and the Pregnancy Sickness Support charity, who sent it to their members.
Some study participants said death ‘felt preferable’ to constant nausea and vomiting, with 19 women (0.4 per cent) stating that they ‘hoped to not wake up each morning’.
And 184 women said they decided not to have another baby because of the condition.
More than two-thirds of sufferers were ‘bedridden most of the time’ and needed support.
Senior author, Professor Catherine Williamson from King’s College London, said: ‘This study has confirmed the urgent need for further research into this devastating condition.
‘We hope that the work we are currently carrying out at King’s College London will allow us to find out more about the effects that hyperemesis gravidarum has on both the mother and developing child and also about what causes this illness.
‘By answering these questions, we will be able to develop more effective treatments, improving the care of these women.’
HG had a ‘marked and deleterious effects’ on affected women’s daily lives, the researchers said, as they struggled to work, which increased feelings of isolation and financial strain.
Some 85.7 per cent of women took prescribed medication for the condition.
But around half of these women had to actively request the treatments.
Medicines to treat the condition’s symptoms include anti-sickness drugs, vitamins B6 and B12, as well as steroids.
And some women are admitted to hospital to receive hydration treatment through an IV.
Four in 10 women said their experiences with primary and secondary care was ‘extremely poor’, while nearly a third said it was ‘poor’.
Those who reported having bad experiences with healthcare staff were more likely not to have taken medication or received rehydration treatment, compared to those who said they had ‘excellent’ care.
One commented that ‘any requests for help were met with ‘you will have to visit your GP’ which was impossible as I couldn’t leave my bed’.
The researchers noted that many descriptions attitudes from healthcare staff ‘were negative and revealed a lack of knowledge surrounding HG’.
And unanswered questions and a lack of clarity around the safety of medication for HG increased anxiety among women about the health of their babies.
At the time the survey was conducted, 18.6 per cent of respondents were experiencing symptoms and 28.3 per cent had suffered from the condition in the last year.
Some 43.7 per cent of women reported severe sickness in one pregnancy, while the remainder suffered it in multiple pregnancies.
Dr Caitlin Dean, chair at Pregnancy Sickness Support, which runs a helpline for the condition, said: ‘Sadly, while there are pockets of excellent care for hyperemesis gravidarum and individual staff who treat the condition well, this is still not the norm and the experiences of these women are very much representative of the many calls we receive daily to our charity.
‘There remains to this day a persistent stigma around pregnancy sickness which hampers access to treatment and results in women losing their desperately wanted babies.’
The Duchess of Cambridge suffered from the condition when expecting her first child Prince George in 2012 and was admitted to hospital for three days.
In an interview last year, she revealed she was ‘not the happiest of pregnant people’ and turned to meditation and deep breathing to get through the symptoms.