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A 26-year-old woman, Chloe, has revealed her decision to pursue sterilisation after struggling with hyperemesis gravidarum (HG), a severe pregnancy-related condition marked by intense nausea and vomiting often lasting until delivery. Her choice comes after she found it challenging to access effective treatments to manage her symptoms. Chloe described how difficult her pregnancies were, saying she could not face going through such an ordeal again.
Chloe’s experience with HG began during her first pregnancy when she was hospitalized due to dehydration. Unaware of the condition at the time, she spent much of that early trimester bedridden and unable to eat or drink. She recalled, “I literally spent the first whole of my first trimester in bed on ice cubes, because I couldn’t eat or drink.” The sickness was so severe that she sometimes couldn’t care for herself, leading her partner to assist with basic tasks like bathing. Despite these challenges, she managed to continue working with reduced duties until her son was born in 2023, which marked the end of her symptoms. However, following such a difficult pregnancy, Chloe was initially reluctant to have another child but became pregnant again unintentionally.
During her second pregnancy, Chloe’s mental health deteriorated further. She was unable to take her antidepressants because of her sickness, and she found herself booking a termination. “I literally said to my partner I’m worried about my own safety,” she revealed. It was only after an ectopic pregnancy scare that she was able to see a gynaecologist who prescribed xonvea, a medication recommended by the Royal College of Obstetricians and Gynaecologists for HG. Although other anti-sickness drugs, such as cyclizine, prochlorperazine, and ondansetron, are more commonly prescribed, xonvea is more costly and not routinely available throughout Wales. Despite this, about 223 prescriptions for xonvea were dispensed by 103 GP practices in Wales in October. Thanks to the medication, Chloe’s condition improved enough for her to cancel her termination and regain some wellbeing. Now, she is arranging to be sterilised as she feels unable to endure another pregnancy.
The prevalence of hyperemesis gravidarum affects roughly one to three in every 100 pregnancies, although it might be underreported. In addition to severe nausea and vomiting, the condition often causes dehydration and weight loss, frequently necessitating hospital care. Dr Georgina Forbes, a specialist in sexual and reproductive health, spoke about the devastating impact HG has on patients. She recounted, “Women were coming for abortions and had not actually been able to access that drug freely, or were struggling to get it, and by the time they come to me, they are entirely at their wits’ end. They are broken.” Dr Forbes and Plaid Cymru MS Lindsay Whittle have called on the Welsh government to improve access to xonvea, arguing that the medication’s cost is modest compared to the expenses associated with hospital treatment for HG. The Welsh government responded by stating that GPs across Wales regularly prescribe xonvea but that decisions about making the drug routinely available rest on advice from independent bodies. Currently, the All-Wales Medicines Strategy Group has not recommended widespread use due to insufficient data regarding cost-effectiveness but has been in ongoing discussions with the manufacturer for over 18 months
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