Mental illness is common among women of childbearing age, and
fertility rates of women with mental illness are close to those of
the general population. General practitioners will see most of the
women who may be seeking advice and management of their mental
illnesses before, during or after a pregnancy.
This article reviews the current approaches to the management
of mental illness in and around pregnancy, and provides practical
advice regarding pregnancy related issues in women with mental
The GP is ideally placed to give information and encourage
appropriate treatment choices in women with mental illness. Given
the multifaceted complexities, the optimal approach is holistic
and collaborative. Specialist opinion must be sought early and a
multidisciplinary approach with access to specialist care offered if
possible. Continuity of care, especially in the context of a trusting
therapeutic relationship, is considered optimal.
Although pregnancy and childbirth can be a time of great joy, for some women and their families it may also be a time of turmoil. While the prevalence of serious mental illness such as schizophrenia remains low, it is estimated that up to one in 5 women will experience clinically diagnosable depression or anxiety during pregnancy and the postpartum period.1 Many of these women may be taking medications, and this may be a cause of anxiety for both the patient and their physician. While issues regarding the pros and cons of medication to mother and fetus are important, there are many other factors impacting on maternal, fetal and infant wellbeing that need to be considered.
Download the PDF for the full article.