Women experience many changes during pregnancy – emotional, physical, economic, occupational, social- hence need additional support from family and friends.
The effect of pregnancy on psychiatric illness
Most women look forward to pregnancy as a time of emotional well-being, but up to 20% of women suffer from various mood or anxiety disorders during pregnancy. Often women report that their symptoms of bipolar disorder, depression and anxiety disorder relapse during pregnancy.
Who is at risk?
Women with a personal or a family history of mental health disorders may have a higher risk of perinatal mental illness and ideally should plan their pregnancy. Particularly vulnerable are those women with histories of psychiatric illness who discontinue psychotropic medications during pregnancy.
Planned pregnancy with proper education of the client and her family reduces risk of mental illnesses. Educate the woman about early symptoms to watch for during pregnancy and after birth, self care with emphasis on good sleep habits, healthy eating, regular exercise, time for oneself, and establishing a supporting social network. Psychotherapy may be helpful to resoslve emotional and interpersonal issues during pregnancy.
Weighing the Risks
Women with histories of psychiatric illness frequently come in for consultations regarding the use of psychotropic medications during pregnancy. Many pregnancies are unplanned and may occur unexpectedly while women are receiving treatment with medications for psychiatric disorders. Many women may consider stopping medication abruptly after learning they are pregnant, but for many women this may carry substantial risks.
Decisions regarding the initiation or maintenance of treatment during pregnancy must reflect an understanding of the risks associated with fetal exposure to a particular medication but must also take into consideration the risks associated with untreated psychiatric illness in the mother. Depression and anxiety during pregnancy have been associated with a variety of adverse pregnancy outcomes like low birth weight and fetal growth retardation, Preterm delivery, pre-eclampsia, operative delivery, and infant admission to a special care nursery for a variety of conditions including respiratory distress, hypoglycemia, and prematurity.
These data underscore the need to perform a thorough risk/benefit analysis of pregnant women with psychiatric illness, including evaluating the impact of untreated illness on the baby and the mother, as well as the risks of using medication during pregnancy.
What are the Risks of Medication Exposure?
All medications diffuse readily across the placenta, and no psychotropic drug has yet been approved by the Food and Drug Administration (FDA) for use during pregnancy. When prescribing medications during pregnancy, one must consider the following risks associated with prenatal exposure: risk of teratogenesis, risk of neonatal toxicity, and risk of long-term neurobehavioral sequelae.