title: Nausea and vomiting in pregnancy: what advice do midwives give?
abstract: OBJECTIVE
  to determine what advice and support midwives give to women experiencing nausea and/or vomiting in pregnancy, with a particular interest in if and how herbal and alternative therapies are prescribed.
  
  
  METHODS
  cross-sectional survey.
  
  
  METHODS
  a public, tertiary maternity hospital in Melbourne, Australia.
  
  
  METHODS
  forty-nine midwives who provide antenatal care.
  
  
  RESULTS
  the advice most commonly given to women experiencing nausea and/or vomiting was to eat frequent small meals and snacks (91%). Other common advice was given by half the midwives or less: avoidance of fatty/spicy foods (53%); eating before rising in the morning, e.g. consumption of dry biscuits/toast (51%); and keeping hydrated (49%). Most midwives (39/46, 85%) included some form of vitamin or herbal supplement in their advice for nausea and vomiting in pregnancy; however, many were unaware of potential harmful side effects or what would constitute appropriate doses.
  
  
  CONCLUSIONS
  advice for nausea and vomiting in pregnancy was generally consistent with that documented in the literature. The findings suggest that it is likely that herbal medicines and alternative treatments are often included in common advice given for nausea and vomiting of pregnancy; however, there is little evidence to guide practice in this area. Similarly, common advice for nausea and vomiting in pregnancy is based more on anecdotal evidence than rigorous scientific evidence, highlighting a need for more research in this area.
  
  
  CONCLUSIONS
  it is crucial that midwives support women experiencing nausea and vomiting in pregnancy, and that the issue is not treated as merely something women need to 'cope with' as part of pregnancy. Advice given to pregnant women needs to include what is known about the safety and efficacy of various treatments in pregnancy, so they can make informed choices. There is a need for increased awareness of the issues around the safety and efficacy (or otherwise) of herbal supplements and alternative treatments when prescribed or used during pregnancy, and midwives need to be aware of the evidence for any treatment or supplement they suggest to women. Due to the small size of this study and the lack of other literature on this topic, further research would be of benefit.
authors.affiliation: Mercy Hospital for Women, 163 Studley Rd, Heidelberg 3084, Australia. ggainger@hotmail.com
authors.forename: Gemma
authors.initials: G
authors.lastname: Wills
authors.forename: Della
authors.initials: D
authors.lastname: Forster
mesh_terms: D000328:Adult; D001315:Australia; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D008880:Midwifery / Q000379:methods*; D009325:Nausea / Q000451:nursing* / Q000517:prevention & control; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D015404:Nursing Methodology Research; D011247:Pregnancy; D011248:Pregnancy Complications / Q000451:nursing* / Q000517:prevention & control; D011295:Prenatal Care / Q000379:methods*; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires; D014839:Vomiting / Q000451:nursing* / Q000517:prevention & control