The Australian MotherSafe enhanced service for nausea and vomiting in pregnancy and hyperemesis gravidarum: a mixed methods study

BACKGROUND: Nausea and vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG) can have significant physical, psychological and economic impacts on affected women and their families. With the onset of severe symptoms usually occurring in the first trimester and women in Australia typically not engaging in regular antenatal care until beyond this period, there is a gap in access to suitable models of care. In 2023, the MotherSafe teratogen information service introduced an enhanced NVG/HG service that provides medication advice for both over the counter and prescribed medications and psychological support in line with NVP/HG clinical guidelines introduced at a similar time. The aim of this study is to describe service use, patient symptoms and acceptability of the MotherSafe enhanced service for women with NVP and HG in New South Wales (NSW) Australia. METHODS: This convergent parallel mixed methods study involved women and family members who contacted the MotherSafe enhanced NVP/HG telephone counselling service from inception (April 2023) to June 2024. Where available, routinely collected service data was analysed to understand service use and changes in NVP symptoms (PUQE-24 score) between the initial and first follow up MotherSafe counselling call (n = 389). To understand acceptability of the service, semi-structured interviews were conducted with women that had recently accessed the service (n = 11). RESULTS: During the first 15 months of the enhanced NVP/HG service operation, 1194 initial and 534 follow up MotherSafe counselling calls provided NVP/HG information and advice. Changes in NVP symptoms measured by PUQE-24 scores between initial and follow up call were favourable for women where this data was available (n = 389, mean score reduction 2.26, p < 0.001), and interview participants reported overall positive experiences that met their needs. CONCLUSIONS: The service has the potential to address a health service gap for women with NVP/HG. Further research to more rigorously evaluate change in NVP symptoms following MotherSafe counselling and advice is needed to confirm the effectiveness of the service. Service call numbers and feedback from women suggest that more widespread promotion of the service would support increased reach.