By Jane Elliott
Health reporter, BBC News
Five decades after the drug thalidomide caused an international scandal, it still casts a long shadow over pregnancy for many women.
Sickness can blight some pregnancies
Women are now understandably worried about taking medication during pregnancy - even when they are quite ill.
And some doctors are failing to prescribe certain medicines to their patients because of exaggerated fears.
Thalidomide was used by pregnant women to ease sleep problems and pregnancy sickness. But side effects caused more than 400 disabled babies to be born in the UK in the late 1950s and early 1960s, before the drug was withdrawn.
'Good and bad'
Dr Jim Kennedy, the Royal College of GPs' head of prescribing, said the legacy of thalidomide had left its mark.
"Thalidomide has had a good and bad legacy.
"Good, because it has led to a tightening up of the regulations surrounding drugs that could affect the foetus.
"But it has also meant that at certain times we might be being too careful.
"We are being so careful that we might be denying women reasonable medication.
"The women are worried that any drug might affect their pregnancy."
Dr Kennedy said that although caution was needed over drugs in pregnancy, clinicians sometimes exercised too much caution.
"To an extent, if you treated women like this when they were not pregnant, you would not be treating them properly.
"Pregnant women are getting a raw deal."
Two GPs - Roger Gadsby and Tony Barnie-Adshead - agree. They set up Pregnancy Sickness Support, a small charity helping to support women with extreme pregnancy sickness, known as hyperemesis gravidarum (HG), in 2002.
Dr Gadsby said: "Many ladies do not want to take a tablet in pregnancy for anything though they are suffering, and I sure this is because of the thalidomide tragedy.
"And this is why drug companies and professionals are so cautious about pregnancy sickness.
"The pharmaceutical companies are very worried about the risk of abnormalities."
Nausea can start very early in pregnancy
Seventy per cent of pregnant women suffer some sort of nausea and vomiting during pregnancy, and 85% of women have two episodes of nausea per day with 55% having three or more episodes per day.
Dr Gadsby said nearly a third of women needed some time off during pregnancy because of nausea and vomiting.
But despite more than 70% of women suffering from pregnancy sickness, and one in 150 women getting it so severely they are hospitalised, their charity has attracted little financial support.
They run it on a shoestring budget of £2,000 a year from their homes in Nuneaton, Warwickshire.
The cash pays for their website, where women can download helpful information, and get phone and e-mail help.
The two doctors give their time free as does a local midwife and Dr Tony Barnie-Adshead's daughter, who herself suffered from severe pregnancy sickness.
But Dr Gadsby explained that, apart from two educational grants from a drug company in Canada which markets a pregnancy sickness drug and some very small charity donations, no-one seemed keen to fund their work.
He said the thalidomide legacy was to blame for their financial constraints.
"The average woman will have nausea and a few vomits usually between six and 13 weeks, but one lady in our research study had 246 vomits during pregnancy.
"My partner and I discovered that pregnancy sickness was a very common condition, but was largely being ignored.
"The whole condition is under-researched. When you mention pregnancy sickness many ladies and health professionals just say that it is part and parcel of pregnancy, but there are things that can be done.
"If, for instance, women keep a diary of when they feel nauseous they can usually find that there is a pattern - that there is a time in the day when they will be feeling better and when they can take fluids and food and so avoid dehydration."
Dr Barnie-Adshead agreed, adding that even the term used to describe the sickness was inaccurate.
"It is often called morning sickness, but this is a complete misnomer, as it can happen throughout the day. And when ladies start being sick at other times during the day they think there is something wrong."
He said there were safe treatments that doctors could prescribe to avoid the condition becoming critical, such as anti-histamines and vitamin B6.
Some herbal and complementary therapies, such as ginger and acupuncture, might also be safe and effective.
But he said many women either did not visit their doctor for help, accepting it as a normal part of pregnancy, or were fobbed off by their medical practitioner.