Welsh women denied needed pregnancy medication are getting abortions

Women suffering from hyperemesis gravidarum (HG) are being deprived of a medication that has the potential to save lives along with offering relief — yet is nearly impossible to obtain in Wales, leading some women to undergo abortions out of desperation.

Key Takeaways:

• Xonvea is the only licensed medication available to treat nausea and vomiting in the United Kingdom.

• While it is widely available in England, it is rarely permitted in Wales, able to be prescribed only in "exceptional" circumstances.

• Women suffering from HG and doctors trying to treat them say women have undergone abortions, feeling they had no other option since they were not able to receive treatment.

The Details:

Deeside.com, an independent news outlet serving the county of Flintshire in Wales, shared the tragic story of Georgina Forbes, a doctor who said she committed two abortions on women who wanted their babies but had been suffering from HG. While Forbes was allowed to commit the abortions, she wasn't allowed to give them medication to relieve their symptoms.

Xonvea is the only medication to treat nausea and vomiting licensed for use in the UK, and it costs just £28. Yet it is not included on the routine prescription list, and was rejected for routine use by the All-Wales Medicines Strategy Group (AWMSG) in 2019, with AWMSG expressing doubts — not about whether or not the drug worked, but about its cost-effectiveness.

While women are sometimes able to get Xonvea, it is difficult, and can involve driving hundreds of miles for a supply that lasts less than a month. This has led some women to seek abortions out of desperation.

Forbes noted that both of the women whose babies she killed wanted their children, and that the abortions had a detrimental effect on the women's mental health.

“Both pregnancies were very much planned and wanted. Both had multiple admissions and were on other medical treatments which were not giving adequate relief," she wrote in a petition asking the Welsh government to add Xonvea to the approved prescription list. “For the sake of their physical and mental health, they felt their only option was to terminate their much-wanted pregnancies — inevitably having a further impact on their well-being.”

Zoom In:

Multiple Welsh women have spoken out about their suffering, saying they didn't want abortions, but felt their lives were at risk. Sarah Spooner told the BBC her concerns were dismissed at first before she was eventually diagnosed with HG in her first pregnancy; in her second, it was even worse. "You can't keep water down and then you're tired because you don't eat for days and your head hurts and you're losing weight," she said.

She was able to get a prescription for Xonvea, and found it worked better than any other medication... but she was only given a small supply at a time, and it wasn't available in her area.

"My husband had to drive a 100-mile round-trip, and I'd be being sick, so he'd have to take time off work to get me there," she said. On one of his trips to get the medication, he returned to find Spooner on the ground, vomiting and unable to move because she was in so much pain. He had to call an ambulance, and ultimately, she chose to have an abortion, feeling like she wouldn't survive another seven months.

"To think that, if I lived half a mile down the road, the outcome of pregnancy could have been different, it's just unacceptable," she said. Spooner is one of over 900 people petitioning for the prescription to be more easily accessible.

Jeremy Miles, Wales' health secretary, insisted that the 2019 AWMSG appraisal remains the “most up-to-date and comprehensive evaluation," and that there was no information to justify another one.

Why It Matters:

Numerous studies have confirmed that women with HG routinely consider abortion, as the condition is so difficult to live with.

A 2021 study released by King's College London found that over half of the 5,000 women surveyed who had experienced HG considered having an abortion, with about 5% proceeding with the procedure. Over 67% said their condition was so severe they had been bedridden, and one-third said they had become suicidal.

One of the women who had an abortion said she had done so “to avoid losing my new job and home for my first child, which I had rented after [six] months of homelessness.” The women also said they were routinely belittled by their medical providers, and struggled to receive adequate care.

Another study, this one published earlier this year, found similar results. The researchers found that nearly three-quarters of the women were hospitalized, and over half said they experienced anxiety and depression due to their HG symptoms. Again, women said they did not receive the health care they so desperately needed.

"Our study shows that many women are not getting the support or relief they need, and that's something we must urgently address," Luke Grzeskowiak, associate professor at Flinders University and lead author of the study, said, adding that despite how bad the symptoms are, women are clear about what they want and need. "They want to be heard, believed, and treated with dignity."

Notably, these women do not want abortion; they get abortions because they feel they have no other choice. And unsurprisingly, having an abortion is traumatizing. “With all those motherly instincts you have, to terminate a child’s life you’ve got to be desperate. I really felt as if I was on my last legs,” Lily, one woman who suffered from HG, told the BBC in 2021. “I don’t trust the doctors. They don’t take it seriously enough and it would just lead to another termination.”

The Bottom Line:

Hyperemesis gravidarum is a very real and devastating condition, yet women are often failed by the medical industry. This is especially true in Wales, where women are needlessly denied a medication that could be life-saving. Women deserve legitimate health care options instead of being left to suffer until they are so desperate that they end the lives of their preborn children.