This document is to provide guidance for health care professionals involved in the care of babies born to women who have taken medication for mental disorders (psychotropic medication) during pregnancy.
Its aim is to optimise and standardise the care of exposed babies and to provide guidance to health professionals (in particular neonatologists, paediatricians and midwives) on the appropriate assessment and management of the risks and needs of the newborn baby.
Any psychotropic medication that has been taken by the mother during her pregnancy and / or delivery should be documented in the baby’s notes. Babies who have been exposed to such medication should undergo a relevant assessment as set out in this document. This assessment will take place in the hospital, birthing unit or home (if home birth). Information on this process should be given to mothers during their pregnancy and at the time of the post-birth assessment, so they can feel confident about their baby’s wellbeing.
This toolkit is designed to offer advice to doctors and informs the multi-disciplinary team of best practice in providing preconception/family planning advice to women with a mental illness. The document contains both information and resources and also recommendations that shift the clinical approach towards a collaborative model of care, using a strengths-based formulation.
Pre-conception advice
Every woman should think about her physical and mental health when planning a pregnancy, to support her health and the health of her future baby. This toolkit aims to provide practitioners supporting women with mental illness with information and resources to help answer the many questions that women and their partners have in relation to this very important decision, such as:
- Do I have to stop taking my psychiatric medication while pregnant?
- If so, will I be able to function without it?
- If I keep taking the medication, what are the risks to my baby?
- What is the chance of my mental health getting worse?
- How might my condition and its treatment affect parenting?
- What are the chances of my mental health affecting my child’s mental health?
- Are there any risks associated with not treating my condition?
- What mental health services are available for pregnant women in my area?
- What kind of support is available after my baby is born?
Ensuring women and their partners are equipped with information and specialist advice when needed, will help them make the choice that is best for them and their family and to avoid rushed decisions that can result in tragic outcomes.
This toolkit provides guidance for health care professionals involved in planning the care of women at high risk of severe postnatal illness.
A pre-birth planning meeting is key to ensuring everyone has a clear understanding of the care the woman will receive in the weeks surrounding the birth of her baby, so everyone knows what to do and whom to contact if there are concerns.
A pre-birth planning meeting
To ensure that pregnant women who have a current or previous severe mental health problem and their families have the best possible care, support and outcomes, many different professionals need to contribute to their care during the perinatal period.
Having a pre-birth planning meeting facilitates this information sharing and the collaborative development of an individualised plan covering all aspects of the woman’s care during pregnancy, birth and the postnatal period.
Doing so helps ensure each woman can be confident that all these professionals have a shared understanding of her and her family during this crucial time, the reasons for any concerns or potential risks and also her strengths.
The toolkit includes guidance on:
- Who to invite to the pre-birth planning meeting
- What to discuss at the meeting
- What to include in the Perinatal Mental Health Care Plan
The following resources are included:
- Sample invitation letters for women and families
- An information leaflet about pre-birth planning meetings for women and families
- A template for recording the meeting and the Perinatal Mental Health Care Plan
