Intended for healthcare professionals

Letters Nausea and vomiting in pregnancy

Why won’t doctors prescribe antiemetics in pregnancy?

BMJ 2011; 343 doi: (Published 19 July 2011) Cite this as: BMJ 2011;343:d4387
  1. Roger Gadsby, general practitioner and associate clinical professor1,
  2. Tony Barnie-Adshead, retired general practitioner2,
  3. Catherine Sykes, psychologist3
  1. 1Warwick Medical School, University of Warwick, UK
  2. 2Nuneaton, Warwickshire, UK
  3. 3City University, London, UK
  1. rgadsby{at}

In their clinical review of the management of nausea and vomiting in pregnancy Jarvis and Nelson-Piercy state that most women can be managed in primary care, and that various antiemetic drugs are safe during pregnancy.1

This message does not seem to be well accepted by prescribers. Many women with severe symptoms who contact our charity (Pregnancy Sickness Support) say that they feel their condition has been trivialised by their GP or midwife and that they have not been prescribed antiemetics.

The number of admissions to hospital because of hyperemesis gravidarum is increasing each year and has gone from 8637 in 1989-90 to 25 420 in 2006-7.2 One reason is probably that healthcare professionals are not offering safe effective treatment to women with severe symptoms. We hope that the message that antiemetics are safe in pregnancy, and that cyclizine 50 mg three times daily should be considered as initial treatment, will receive widespread publicity and acceptance among prescribers. In this way, women who have severe symptoms of nausea and vomiting in pregnancy will receive the support and help they need from primary care.


Cite this as: BMJ 2011;343:d4387


  • Competing Interests: RG and TB-A are trustees of Pregnancy Sickness Support (charity No 1094788).