One of the most common early symptoms of pregnancy is nausea and vomiting, particularly within the first 12 weeks, and it has treatments as varied as the severity of symptoms, some of which can be found over the counter at your local pharmacy whilst others require prescriptions.
There are a lot of different kinds of morning sickness, some of which are more serious than others and require more than lifestyle changes, ginger and avoiding nausea triggers.
This can make it difficult to treat, but there are a lot of options your doctor and midwife will explore, and by the 20th week it will typically have cleared up. Outside of serious cases of hyperemesis gravidarum, there is little risk of harm to your baby.
All medications are carefully tested and prescribed with the knowledge that they provide as little risk to mother and baby as physically possible, the reason for this being the infamous thalidomide scandal, which was caused due to a lack of testing for potential pregnancy side effects that was not repeated again.
The first revelation on this came thanks to Dr William McBride, an Australian obstetrician working with the findings of midwife Pat Sparrow. However, another morning sickness medication would turn him from a whistleblowing hero to a villain.
Findings To Fakery
Dr McBride published a letter in the long-running medical journal The Lancet in 1961, after investigating the suspicions of Pat Sparrow that thalidomide, then available as an over-the-counter antiemetic called Contergan or Distaval, was causing birth defects in children.
By the time the letter was published, the drug was already being removed from the market, but it provided clear evidence to match a growing suspicion in the medical community, and he received a medal from L’Institut de la Vie for his findings, as well as enough prize money to start his own foundation.
This organisation, known as Foundation 41, aimed to fix the core issue that led to Thalidomide being sold to the group of people most at risk of side effects from it, by investigating the causes of foetal abnormalities and the long-term consequences of conditions during pregnancy and the first week of life.
The prize money set it up, but it was largely funded by philanthropic efforts by the general public and the Apex Clubs of Australia, being seen as an extremely important public good.
Whilst thalidomide would ultimately become an important treatment for leprosy for several decades, it was always prescribed with extreme caution to anyone who was suspected of being pregnant to avoid the same issues happening again.
Dr McBride was an important part of this, finding out through Foundation 41 why thalidomide affected embryos by altering the DNA of their cells whilst they were dividing.
However, whilst Dr McBride made his career through one of the most important and influential acts of medical whistleblowing, he managed to destroy his career through his work on another morning sickness medication.
One of the frontline prescription treatments for morning sickness is Doxylamine with pyridoxine which is usually marketed under the name Xonvea in the UK, as well as Debendox, Bendectin and Diclectin elsewhere.
In 1981, Dr McBridge published a paper that claimed to have evidence that it caused birth defects through experimentation on rabbits with hyoscine, leading manufacturer Merrell Dow to take the case off the market.
He appeared as an expert witness in these cases, but the co-authors of the paper, who claimed they knew nothing about it until they received copies with their names on it, alleged that the data had been manipulated, something that he would later admit to.
After one of the longest medical inquiries in history, the Medical Tribunal of New South Wales concluded that Dr McBride had culled and used selective data methods, an extremely basic form of data manipulation.
A 1989 safety report found that doxylamine/pyridoxine could be safely prescribed, and it is a commonly prescribed treatment for morning sickness to this day, although far from the only one.
Dr McBride was found to have published statements that he knew to be untrue in a private inquiry in 1988 which led to an official medical tribunal that lasted a further five years and finally led to him being struck off the medical register in 1993, his reputation and foundation in abject tatters.
It was not just the data manipulation, something that is a cardinal sin in medical research for obvious reasons and led to similar disgrace for Andrew Wakefield, but much of his conduct during the inquiry, including allegedly blaming a deceased embryologist he worked with for the discrepancy.
Whilst he was returned to the medical register in 1998 and died in 2018 at the age of 91, his legacy is somewhat chequered, even if it ultimately led to major improvements in the safety of morning sickness medication.