Infections that last

August 2009

Clinical

Motherhood and mental illness

Part 1 – toward a general understanding

Volume 38, No.8, August 2009 Pages 594-598

Jacqueline Frayne

Thinh Nguyen

Suzanna Allen

Jonathan Rampono

Background

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.

Objective/s

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 health disorders.

Discussion

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.

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Correspondence afp@racgp.org.au

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