family size had been limited by recurrence of HG
(Pregnancy Sickness Support, 2013).
Maltepe and Koran (2013a) found a significant
reduction in the severity of HG symptoms in
subsequent pregnancies when treatment was
started preemptively compared to controls whose
treatment started after the onset of symptoms. The
principle of early treatment is similar to that of
motion sickness treatment (which is started prior
to commencing travel) and, similarly, in oncology
prophylactic antiemetics are administered to
prevent acute and delayed chemotherapy-induced
nausea and vomiting (Jordan et al, 2007).
For a significant number of women, nausea
and vomiting symptoms can start before a missed
period (Gadsby and Barnie-Adshead, 2011) and
for over half of women with HG, onset is sudden
with rapid deterioration to severe and debilitating
symptoms (Pregnancy Sickness Support, 2013).
For this reason, planning and preparation prior
to pregnancy is better than waiting until sickness
is experienced. Health professionals need to be
aware of the importance of early intervention
and prescribing in advance of symptom onset.
Furthermore, midwives seeing women at the end
of pregnancies affected by HG, or post-partum, can