March of Dimes: Treating Mental Health Concerns During and After Pregnancy

Jun 5, 2013, 2:14 PM

file Siobhan Dolan, March of Dimes and Montefiore Medical Center/Albert Einstein College of Medicine

Each year, the March of Dimes National Communications Advisory Council, which includes journalists from many websites and magazines that cover pregnancy and early childhood, holds a reporters’ luncheon to share information that can lead to healthier births, babies and mothers. This year’s luncheon, being held tomorrow, focuses on treating mental health conditions in mothers during and after pregnancy. The issue is important for many reasons, in particular because many women have been taking prescription medications for depression, anxiety, panic attacks, ADHD, and other mental health issues since adolescence and may need to change or stop the medicines in order to have a healthy baby, yet run the risk of a relapse or worsening of their health condition.

NewPublicHealth recently spoke with, Siobhan Dolan, MD, a consultant to the March of Dimes and an obstetrician gynecologist and clinical geneticist at Montefiore Medical Center/Albert Einstein College of Medicine about communicating information about treating mental health during pregnancy to both mothers and health care professionals.

NPH: For the upcoming luncheon, the March of Dimes has singled out mental health medications. Why that area of health?

Dr. Dolan: There is a huge overlap between women of reproductive age who are dealing with becoming pregnant and having families and caring for families and women who have mental health issues and may be entering their reproductive years already on medication.

And we know that bonding and creating a family and getting your family life off to a good start in the early postpartum period is much, much better when a woman is in a balanced mental health state. So if there’s either a preexisting depression or a postpartum depression, we need to pay attention to that.

These are critical issues that are important for women’s health, for family health, and we wanted to bring attention to the fact that there are safe medications in pregnancy and postpartum and others that might not be the best choices for that period of a woman’s life.

NPH: Are there any absolutes? 

Dr. Dolan: There are some medications used to treat mental health conditions that are associated with cardiac defects in some studies, but usually the risk is relatively small and doctors and patients need to weigh the risks and benefits. The takeaway message is that one size does not fit all and that there are many medications available and doctors and patients have to discuss what works best and is also safest.

NPH: That suggests that women need to be thinking about this, if they can, before they get pregnant?

Dr. Dolan: Absolutely. We learn again and again that the best way to achieve a healthy pregnancy is even before a woman conceives. So preconception care makes such a difference. With the Affordable Care Act more women will be able to see a doctor sooner and we can build on women’s opportunities to plan for their pregnancy in a way that can improve pregnancy outcomes.

And this is also important information for the teams of health care professionals who care for women. It’s not just the OB/GYN or the midwife or the psychiatrist or the social worker. We’re all working together. It is hard to be pregnant, it can be very stressful. It can be a difficult time; not for every woman but for many women.  Circumstances change, it puts stress on the partner relationship, and work may change. Women are often under a lot of stress and then adding pregnancy adds stress, so we want to support women in a pretty comprehensive way and having your providers talking to each other, talking to you, being able to access the system and set that all up before you become pregnant is really important.

>>Bonus Links: The Food and Drug Administration has comprehensive information for women taking medication drugs during pregnancy, including questions to ask your doctor.

This commentary originally appeared on the RWJF New Public Health blog.