Exploring women's experiences and perceptions regarding the pharmacological management of hyperemesis gravidarum: a qualitative study

Abstract Background Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy with potential sequelae including hypovolaemia, electrolyte imbalance, and malnutrition, which can result in adverse maternal–foetal outcomes. Aim To explore Australian women's experiences and perceptions regarding the pharmacological management of HG. Method An online, cross‐sectional survey, conducted in Australia from July–September 2020, captured data on participant demographics, experience of HG, and use and experience of medication treatments. Three survey questions included free‐text response fields. One hundred and eighty‐nine women provided free‐text responses to at least one of these three questions, which provided qualitative data that were thematically analysed. Ethical approval was granted by Adelaide University Human Research Ethics Committee (Reference no: H‐2020‐090) and the study conforms to Australian National statement on ethical conduct in human research . Informed consent was obtained from all participants via the distribution of project information to potential participants indicating their involvement was voluntary and anonymous. Participants confirmed their consent through completion of the survey. Results Three major themes were identified. Theme 1: ‘inadequate recognition and management of HG’ indicated women reported many clinicians lacked suitable training to diagnose patients, were either not aware of, or were not following clinical HG management guidelines, and were not apprised of current safety and side effect profiles of common antiemetic medications. Theme 2: ‘challenging inequities in HG healthcare’ revealed educational and financial status may influence treatment outcomes, and systemic barriers to effective management exist in the Australian healthcare system. Finally, Theme 3: ‘the extensive and unrelenting burden of HG’ demonstrated the severe nature of HG can lead to extreme debility and impaired quality of life, and results in psychological trauma that can extend beyond birth and affect future family planning. Conclusion Opportunities exist to improve experiences and outcomes for women with HG. Well‐structured strategies, such as improved education for health practitioners, changes to the Pharmaceutical Benefits Scheme, and expansion of outpatient care modalities could result in improved recognition and management of HG.