Psychiatry During Pregnancy

Abstract

Psychiatric during pregnancy is increasingly recognized that many women with psychotic disorders have children and that pregnancies of these women are high-risk. Psychotic disorders increase the risk of stillbirth and infant mortality and can affect a woman’s ability to care for herself and her infant. Although women with psychoses are less fertile than the general population, partly as a result of hyperprolactinaemia secondary to antipsychotic drugs, the increasing use of newer atypical drugs such as clozapine and olanzapine, which do not have this effect, is likely to lead to a rise in fertility, particularly in women with affective psychosis. Women come into contact with many healthcare professionals during pregnancy and there are therefore many potential opportunities for prevention or attenuation of these risks. The challenge for health workers caring for women who are pregnant is how to ensure mental health problems, are recognized and adequately treated. The NICE guideline on antenatal and postnatal mental health (2007) recommends that at a women’s first contact with services in the antenatal period, healthcare professionals should ask about past or present severe mental illness, previous treatment by a psychiatrist/specialist mental health team, including inpatient care, and a family history of perinatal mental illness.