Pregnant women require greater medication access

Pregnant Australian women are being denied access to medications which treat severe nausea and vomiting by pharmacists and medical practitioners because of misleading labels and a lack of awareness about clinical guidelines.

A new study surveyed 249 Australian women who suffered from severe nausea and vomiting during pregnancy (NVP) or hyperemesis gravidarum (HG) and examined their experiences in accessing medications during pregnancy.

One in four women reported being denied medications for NVP and HG at some stage during pregnancy. This most commonly involved the over-the-counter medicine doxylamine and interactions with community pharmacists.

The research, published in ANZJOG, coincides with International Hyperemesis Gravidarum Awareness day on May 15.

Caitlin Kay-Smith, co-author and founder of the consumer organisation Hyperemesis Australia, has committed her life to improving awareness and supporting women suffering from HG.

“HG is a severe form of NVP and affects 5-10% of pregnancies. Research shows that women with HG have a higher risk of negative maternal and fetal outcomes, but these possible harms are poorly recognised. This means that ensuring women have access to safe and effective treatments is really important.”

The researchers state fresh approaches to identify and effectively address barriers towards the provision of effective treatments for severe NVP and HG while pregnant are urgently needed.

Associate Professor Luke Grzeskowiak, a Hospital Research Foundation Mid-Career Fellow at Flinders University and SAHMRI, says women’s feelings of not being taken seriously or the trivialisation of symptoms is a common finding in studies and needs to be addressed appropriately.

“Underlying explanations for women being denied access to medications can include a lack of provider awareness of clinical practice guidelines, misleading labelling produced by pharmaceutical manufacturers (e.g. most doxylamine packaging states not to use during pregnancy), or genuine concern or uncertainty regarding the fetal safety of specific medications with or without consideration of the benefits of treatment.”

The research highlights the need for the Australian Therapeutic Goods Administration (TGA) to consider following international efforts aimed at improving medication labelling laws, such as the Pregnancy and Lactation Labelling Rule introduced by the Food and Drug Administration in the United States.

“This would require all medication packaging and consumer medicines information to include evidence-based information on use in pregnancy, such that consumers and providers are able to rationally weigh up risks and benefits people,” says Associate Professor Grzeskowiak.

“Further studies evaluating healthcare professional attitudes towards recommending or prescribing medications for severe NVP and HG are warranted.”

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