Rub shoulders with Kerri Barwick MPS (centre) and other members of team PSA at CPC24[/caption]
The use of insulin, considered a high-risk medication with APINCHs classification,5 Ms Barwick notes, provides justification for a Home Medicines Review (HMR). ‘There’s an advantage to going into the home to observe the patient’s diet, consider potential interactions, and educate patients on the best effects and outcomes,’ she says.
Advice around cleaning blood glucose level (BGL) monitors to ensure accuracy can also be provided. ‘Pharmacists can explain how to put test drops through and clean blood spills on the monitor, common in pregnancy due to higher blood volume,’ says Ms Barwick.
With only 50% of women diagnosed with GDM receiving tests for heart disease and type 2 diabetes post-pregnancy,6 HMRs can be beneficial at this stage of the journey, too.
‘Along with conversations around diet choices, exercise regimes and sleep, I also explain how often testing is required over the next 5–10 years, and how to monitor for signs of the development of diabetes,’ Ms Barwick advises.
Nausea and vomiting in pregnancy
The presence of iron in pregnancy multivitamins may exacerbate symptoms of nausea and vomiting in some pregnancies, according to Ms Barwick.
‘Pharmacists can recommend a trial cessation of the iron component of pregnancy vitamins, often unnecessary in pregnancy,’ she says.
In 2020, photographer Bobbi Lockyer created a Birthing on Country project to highlight and create awareness around birthing issues and outcomes in Aboriginal women. For more, see 
Suzanne Nielsen MPS[/caption]
Case scenario
Raquel, 26, comes into your pharmacy to fill a prescription for lamotrigine for the treatment of bipolar disorder. She picks up a bottle of folic acid 0.5 mg tablets and asks your advice, as she plans to start trying to conceive after her upcoming holiday. Raquel explains that she has not spoken to her GP or specialist about her planned pregnancy, but has an appointment scheduled next week. You recall from previous conversations that Raquel follows a vegan diet.
Introduction
Pregnancy planning and care should include dietary and nutrient considerations to ensure healthy fetal growth and development, and the health and wellbeing of the pregnant person. Food fortification (with micronutrients such as folic acid and iodine) has shown to improve nutrient intake and/or pregnancy outcomes,1 however supplementation with certain essential nutrients is still routinely recommended during preconception and pregnancy.
Pharmacists play an important role in providing information about dietary sources, appropriate product selection, guidance on dosing requirements, and advice on supplements and medicines that pose a risk during pregnancy.
Learning objectivesAfter reading this article, pharmacists should be able to:
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