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Clinicians Should Consider Reproductive Health When Treating Women with Psychiatric Illness

In This Article

  • There are substantial mental health risks for women with psychiatric illnesses who receive inconsistent or conflicting care before or during pregnancy
  • Clinicians can help prevent anxiety, depression and other symptoms by considering the impacts of psychiatric medications
  • Maintenance treatment before and during pregnancy can lead to better outcomes in women with psychiatric disorders

When treating women with psychiatric illnesses before or during pregnancy, everyone on a patient's health care team—psychiatrists, obstetrician-gynecologists, nurses and pharmacists—can improve outcomes after delivery by understanding the impacts of various psychiatric medications.

Marlene Freeman, MD, associate director at the Center for Women's Mental Health, recently spoke on this issue at the 2019 Psych Congress. According to Dr. Freeman, there is an enduring need for sensitivity to mental health in reproductive care for women. By age 40, 82% of women in the United States have a child and most psychiatric diagnoses (75%) present by age 24, so it is important that mental health clinicians keep reproductive health in mind when caring for women.

There are substantial mental health risks for women who receive inconsistent care before or during pregnancy. When women get conflicting medical advice from different providers, it can cause or worsen anxiety.

For example, packages for antidepressants include warnings that advise women to stop taking these medications in the third trimester. Dr. Freeman notes, however, that not only are these warnings included without any study or unanimous opinion, but they also endanger women who stop taking antidepressants while at risk of postnatal depression.

It's also important to stay on top of current trends, like marijuana and vaping. Although patients often worry about medication safety, there are many who use marijuana and don't consider its implications. Dr. Freeman recommends that clinicians also ask patients about marijuana use, since a third of women in their 20s using marijuana, sometimes as a substitute for prescribed psychotropic medication.

Overall, Dr. Freeman urged physicians to aim for stability in treatment for women leading up to and during pregnancy. Maintenance treatment can help women live the way they want to live.

of psychiatric diagnoses present by age 24

Learn more about the Center for Women's Health

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