Maternal Mental health This applies for the antenatal and postpartum periods so during pregnancy and after pregnancy
Can exist as:
- A continuation of existing mental disorder
- Relapse in preexisting condition
- A new onset mental disorder
- Baby blues
Importance of maternal mental health
This is an very relevant topic because:
- Some women with preexisting conditions are at risk of relapse bc some cease medication during pregnancy
- Pregnancy can be a stressful time which adds fuel to the fire (family violence is more prevalent during pregnancy)
- There are significant effects of substance abuse (taken for mental illness) on developing foetus
- Mothers ability to care for child can be effected by poor mental health which can have lasting effects for the child
Postpartum Mood affects are a spectrum
50-75% (associated with increased risk of MDD) - Transient and nonpathologic
10% - Serious, disabling
0.1% - Psychiatric emergency
Clinical considerations in pregnancy and breastfeeding women
Medications can effect the foetus and breastfeeding child so this is important to consider when treating mother.
Often you have to weigh risks to child vs risk to mother
- Mood stabilisers and antipsychotics have teratogenic effects
- Antidepressants are safer but there are some effects still
- MAternal depression has adverse effects on children still.
Additional factors to consider in weighing up are:
- Severity of illness
- Psychiatric history
- History of response
- Available safety data in lactation
Paternal mental health
Depression 5-10% overall from 1st trimester to 1 year after delivery Biggest correlation is with depression in the partner Lifestyle change Fathers mental health can effect the child paternal postnatal mental disorders are also associated with next generation effects on behaviour emotional development and educational outcomes
In Summary
• Maternal mental health issues range from baby blues and transient distress through post-natal depression to postpartum psychosis • Can impact self (mother), father or partner, child, family • Can start during pregnancy • Should be screened for by health professionals seeing either mother or baby • Need to consider the risk/benefit analysis of medication in treating pregnant and breastfeeding women • If untreated and chronic or severe, can have immediate risk of suicide or infanticide, and long-term intergenerational effects
Associated Lecture, comments and requirements
Lectures: L12 Psychological Medicine Maternal mental health
Objectives:
- Understand the risk posed to women’s mental health be pregnancy and childbirth
- Understand the impact mental illness can have on the mother, child, and family
- Be able to think about the risk-benefit analysis regarding medication in pregnancy and lactation