| HOW OFTEN DO
WE SEE the elation of pregnancy diminished by the distress
of "morning sickness" Nausea and vomiting in pregnancy (NVP) is
non-specific, it affects approx. 80% of pregnant women, [1] and the range of symptoms extend from
mild nausea through to the extreme of Hyperemesis Gravidarum
[2]. It can last all day, it can
keep recurring in waves. The actual aetiology is still unclear and
there are various theories but NVP is mainly attributed to altered
hormone function, physiological and metabolic changes and genetic
incompatibility [3]. This
preliminary study introduces the ‘Morning Well tape’ in
to the lives of pregnant women and exciting initial findings have
shown a marked reduction of symptoms.
"I can’t eat anything" "I feel
wretched" "I’m nauseated all the time" "I can’t cope
with the family" "I can’t get out of bed and I’ve never
been ill in my life" "I’m struggling to be at work" etc.
These words are so familiar, and what is our response? Sympathy.
This is the one safe option that a midwife can give. We can
support and we can acknowledge their distress. As midwives we
can recommend ginger, dry biscuits, frequent snacks, Travel bands,
and various other helpful hints. All have anecdotal efficacy.
Homeopathic, herbal remedies and acupuncture, can only be
prescribed by a specialist. There is no evidence based cure for
NVP. The historical evidence with systemic medication (thalidomide)
precludes women from wanting to take anything at all, and NVP is a
condition that women expect and tolerate.
When the DAVAL Company approached
the Andover Birth Centre, late last year, to ask if we would be
interested in an audio-tape that might ease morning sickness---we
were intrigued. This was a completely new and radical idea.
Is it a relaxation tape? Is it subliminal messages---"You will not
be sick!" "Is it just pleasant music to take your mind off the
nausea? We wanted to know more.
The MorningWell tape was derived
from TravelWell . TravelWell is a successful travel sickness
product, endorsed by Ellen McArthur. It was developed over a
number of years, working on the physiology of emesis; there is a
recognized correlation between the brain, the vestibular system,
and the gut [4] The audio tape was
devised to react on the vestibular system in such a way that it
interrupted the emesis signals to the gut and stopped the sickness.
The frequencies and pulses are bordering on our recognisable audio
spectrum, but still have a profound effect on the ear. The music
overlaying the sounds just makes for more pleasurable
listening. It has to be used with a personal
stereo.
DAVAL, the Andover company
responsible, had never thought of the tape being used for anything
other than motion sickness, until a couple of women contacted them
to ask if it would help in pregnancy, as their symptoms were just
the same. DAVAL made no claims at all, but the women used the tape
and it worked. Fascinated by this result, DAVAL came to
us.
It was radical, it was fascinating,
and we were cynical!
We looked at the product in depth
with safety, the overriding priority. Safety for the woman and the
fetus. The tape was non- invasive and under the control of the
woman (turned on and off at will).
We undertook this preliminary study
to find out if this tape worked? In order to do this, we
needed to ask the women, and we needed to contact them early enough
to offer the tape. Together with DAVAL we devised a questionnaire,
which was subsequently passed by the Ethics Committee.
|
- QUESTIONNAIRE
FORMAT
- We advertised in GP Surgeries, the
local paper, local radio, NCT magazine, that we were running a
preliminary study on MorningWell - not that we were endorsing it
– but that we were interested in its efficacy. We put a
brochure into every booking pack and the midwives offered a free
tape if NVP was a problem.
We were all very sceptical, but keen
to get the responses.
- Analysis and
Results
- The early feedback from the
questionnaires, though positive, showed that there were some
difficulties understanding the use of the tape. The programme is
made up of 3 phases. The first draws the vestibular system away
from the general acoustic and balancing priority, the second is
focused on preventing the transmission of the emetic signals to the
brain and the gut, and the last phase returns the vestibular system
to normal operation. (There have been no reports of any
problems with balance). The instructions now highlight the
necessity of rewinding the tape prior to each use. It can be
used as often as NVP causes a problem, and used from the onset of
symptoms for at least 20 mins initially, or until sickness eases or
stops.
As we all know, questionnaires are
notorious for—getting lost, getting eaten by the dog, left in
the rain, drawn on by the toddler, etc., but the women of Andover
were very helpful, and the results followed.
- 150 audio-tapes were
offered.
- To date we have had 89
questionnaires returned fully completed, 25 fully completed but
non-compliant. These returns, we felt couldn’t be in the
final numbers, because other remedies had been tried at the same
time, i.e. homeopathic remedies, herbal teas, Travel bands etc. 37
questionnaires were not completed for a variety of reasons, the
most frequent being that the tape was never used.
-
- PIE
CHART
- The results have been excellent.
Originally we thought if it worked for 30% of women that would be
amazing. At the time of writing this article it is 90%. The results
show that of the 89 women that used the tape appropriately only 3
had no benefit at all. The results to date show that the greatest
percentage of efficacy is produced by the 4th day. Some
women found no effect the first time, but subsequent usage produced
increasingly good effects.
-
- %
chart
- The whole mood of the study has
changed. Originally we were all very cynical, and felt that
some of the ecstatic responses we received must be due to other
reasons but gradually the women’s comments, testimonials,
ticks in the box, have made us take it all more seriously. We are
now disappointed if the tape fails to ease the symptoms, and try
and ensure that the tape is being used in the most beneficial way.
A full list of the results, and the testimonials can be seen on the
web site. www.andoverbirthcentre.org.
DAVAL is supporting the NCT charity, with a 50p
donation for each tape sold.
Future developments with the
MorningWell tape, include a double blind trial with NVP, and DAVAL
are already in trials for its use with chemotherapy.
Exciting projects, and looking at
these initial results, midwives could offer not only sympathy but a
sound remedy?
|
The
Royal College of
midwives
conference DVD features our product.
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