If a woman is going to suffer from severe morning sickness, it will help if she's got plenty of spare cash, or is perhaps married to a wealthy prince.
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Pregnant Australian women who suffer from debilitating morning sickness-type symptoms can end up spending thousands of dollars on powerful anti-nausea medications designed for chemotherapy patients, in addition to being forced to stop work early.
The hospitalisation of the Duchess of Cambridge this week has sparked a global conversation about remedies for morning sickness and women's ability to soldier on.
Experts say morning sickness is a normal, but unpleasant, part of many healthy pregnancies, but in the worst cases can require urgent medical treatment.
Associate Professor Hannah Dahlen, a spokeswoman for the Australian College of Midwives, said 80 per cent of expectant mothers experienced nausea, with 50 per cent dry retching or vomiting.
But the Duchess of Cambridge suffered from the more severe hyperemesis gravidarum.
''With Kate's case in particular, as a midwife, looking at her you would be a little bit more anxious to get her into hospital because she's very slim if not underweight, she's got no padding, no reserves really. She can't afford to lose much weight,'' Dr Dahlen said.
Canberra obstetrician Professor Steve Robson said women with severe morning sickness sometimes had to be admitted to hospital and rehydrated and could be prescribed powerful anti-nausea medications.
However the Pharmaceutical Benefits Scheme did not subsidise the medications for morning sickness.
''Some women don't respond to anything else and they actually can't function, they can't go to work, they can't do anything without the medication and they end up spending sometimes more than $1000 on the medication over a course of pregnancy,'' Professor Robson said. ''Often they have no choice because they can't function without it.''
Morning sickness is caused by pregnancy hormones triggering receptors in the brain.
Professor Robson said the biological purpose was probably to reduce women's appetite and protect them from food poisoning in early pregnancy.
''Probably in primitive societies when we were developing it was very good if women didn't eat much,'' he said.
Dr Dahlen said morning sickness in early pregnancy still served a useful purpose.
''It's actually a way of protecting the body: making sure you go off coffee, you go off tea, you go off alcohol, you go off cigarettes and you go for very bland, bland food.
''The old Sao becomes your most favoured food group and that's nature's way of protecting you in a very vulnerable period of development.''
Canberra woman Alanna Crawshaw suffered from hyperemesis gravidarum for the first 6½ months that she was pregnant with her daughter Lilly and she was forced to temporarily stop working.
After Maxolon failed to work, she was prescribed wafers of the anti-nausea drug Zofran, which cost $7 each, and needed be taken three times a day.
At one point she was admitted to hospital after becoming extremely ill.
''Apparently there was a lot of ketones in my urine which meant my body had gone into starvation mode and had started using up fat and fatty acid stores for fuel,'' she said.
Although part of the cost was covered by private health insurance, Ms Crawshaw estimated she was left about $2000 out of pocket on Zofran prescriptions.
Morning sickness remedies:
■ Ginger - sliced, in water or in tablet form
■ Acupressure bracelets
■ Vitamin B6
More serious cases:
■ Antihistamines such as Phenergan, anti-nausea medications such as Maxolon
More common in:
■ Women prone to car sickness or migraines, women pregnant with a girl or twins
Source: Associate Professor Hannah Dahlen, Australian College of Midwives
