Sick of pregnancy

Women suffering from extreme morning sickness may find little more than tea and sympathy on offer, says Sally Williams

When Sandra Smith first threw up, she was delighted. "I thought, brilliant, this is a touch of morning sickness, I'm really pregnant."

Two weeks later, and gagging at the smell of cooked food, toothpaste, and even the sight of condensation on the window, she thought she must have flu as well. Two months later, and able only to sip water and eat tinned pineapple chunks, she was desperate. "I was losing weight when I should have been putting it on. All I wanted to do was lie in bed and hide. I would go through the birth 100 times rather than go through that again."

About 70 per cent of pregnant women suffer from morning sickness (and "morning" can be taken to mean any time of day or night). Most of them feel better by the fourth month, but between 1 and 5 per cent may spend the whole nine months throwing up. In severe cases the woman can become dehydrated and develop hyperemesis gravidarum, a potentially harmful condition for both mother and baby. Nobody really knows why some women suffer more than others; hormones, thyroid changes and psychological factors may all play a part. While treatment for hyperemesis is hospital, for "normal" three- or even nine-month vomiting and nausea, very little is available.

Celia Walser suffered from bad morning sickness throughout both her pregnancies. "I was really shocked by how dreadful I felt. I heard people say they struggled into work and did this and that, but this was like having the worst gastric flu, for weeks and weeks." She went to the doctor and he suggested barley sugar. Likewise, Gail Gough had little sympathy from her GP. "I was made to feel as if I was a bit soft or something. I was desperate to have a baby - for months it was the only thing on my mind - but when I did get pregnant I wished I'd never bothered. I was unable to socialise, work or even go to the supermarket. I was just too ill. Three months of my life were ruined. I just cried all day."

Friends, she says, didn't take it seriously. Nor, it seems, do the pregnancy books. "Suck peppermints or nibble dried fruits or biscuits," suggests Miriam Stoppard in Pregnancy and Birth. "A cup of tea and a few biscuits or dry toast immediately on waking," recommends Sheila Kitzinger in The New Pregnancy and Childbirth, while Janet Balaskas and Yehudi Gordon in The Encyclopedia of Pregnancy and Birth urge women to "sit on hard, upright chairs to stop yourself from slouching." Acupuncture, arrowroot, travel sickness wristbands and ginger biscuits are other recommended remedies. Gail found that her only relief came in the evening, after having a bath. "I would wash my hair and dry it and just lie on the bed, and would think, well, that's another day over."

As many as 8.6 million working hours are lost each year in England and Wales through morning sickness, and yet little more than tea and sympathy is offered to sufferers. "Morning sickness is under-treated," admits Kathryn Nelson Piercy, senior registrar in obstetric medicine at Queen Charlotte's Hospital, London. The reason is thalidomide - the "completely safe" morning sickness drug marketed in the Fifties and early Sixties and later found to be associated with deformities in some 8,000 children world-wide. More recently the anti-sickness drug Debendox also stood accused of causing birth deformities, and was taken off the market in 1983 in a flood of litigation. The fact that the evidence against the drug was later discredited has done little to reassure the medical world and, more important, the drug companies, that Debendox or any morning sickness drug is worth the potential litigation, loss of income and public disgrace. Drug companies now cover themselves by slapping a pregnancy caution on most drugs, and even if women ask for anti-sickness drugs (they are still available, and both Celia and Gail did), they are not readily prescribed. "GPs don't dish out drugs willy-nilly any more," says Nelson-Piercy. "They are now rightly conscious of the fact that when we treat a pregnant woman with a drug, that drug is almost certainly crossing the placenta."

The knock-on effect of thalidomide has been to instil an awareness of the potentially harmful effects of just about everything on the unborn child. Many of today's pregnant women are terrified of eating Brie, let alone taking a drug.

Thalidomide is also responsible for a shift in attitudes both to morning sickness and to pregnancy in general. Professor Philip Steer, Professor of Obstetrics and Gynaecology at Chelsea and Westminster Hospital, says, "Before thalidomide doctors used to prescribe drugs to try to reverse some of the changes of pregnancy. Now that we understand more about why these changes occur, we understand that many of them are necessary if the baby is to grow properly." Common pregnancy problems such as morning sickness, water retention, fatigue and shortness of breath, says Professor Steer, are in fact not problems at all, but a sign that the pregnancy is going rather well and the baby is thriving. "Pregnancy is a conflict between the mother's needs and the baby's. The more she adjusts her body to suit the baby, the less it suits her. The whole point of being pregnant is to grow a healthy baby, not to get the doctor to convert you back to how you felt when you were not pregnant. Pregnant women," says Professor Steer, "should be happy to be throwing up, not upset by it."

So Gail and Sandra and Celia are right. Morning sickness, even the nine- month variety, isn't taken seriously, because it isn't really a problem. The real problem, according to Professor Steer, is that women expect to bloom when pregnant, not feel as sick as a dog.

"Pregnancy isn't always the pleasant or positive experience that the propagandists would have us believe," he says. "It's quite normal to feel terrible. About a third of women feel better than ever when pregnant, a third feel the same, and third feel much worse. Not many pregnant women know that".