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Mental health awareness is essential during pregnancy because these common disorders can complicate the hormonal and emotional roller coaster that is pregnancy. A woman may never again in her life experience the highest highs and lowest lows that she will when she is expecting. Mental health awareness is crucial to the safety and health of mom and baby. Support systems, healthy coping mechanisms, proper healthcare and health practices, mental health awareness, and possible medications can make a world of difference in the life of a woman during her pregnancy.
With mental health awareness at the forefront of so many people’s minds these days, we simply cannot forget about pregnant women and their mental health and wellness. If this pandemic has taught us anything, it is to pay attention to the hidden healthcare concerns of those around us.
The mental health balancing act, that of allowing an individual to function on a somewhat normal basis with the assistance of medicine, is an individualized process that is never easy, especially during pregnancy. Individuals suffering from mental health issues are often seen by psychiatrists who have the daunting task of finding the correct medicine to balance that individual’s moods. This takes multiple appointments over multiple months to find the right balance of the right medication and the process is never over. When pregnancy, and in turn another life, are then thrown into the mix, the challenges can seem daunting.
Prescription changes have to be made any time that an individual has a change in mental stability. These changes are typically triggered by a traumatic event in the person’s life, changes in the person’s routine, or an absence of a support system for that individual. Adding a pregnancy to the mix makes it that much harder to manage a person’s medicine due to the changes in body chemistry throughout this time. Here is what you need to know about mental health, medication, and pregnancy.
Mental Health Awareness and Your First Prenatal Visit
The first thing a person suffering from a mental illness should do when they find out they are expecting is set up an appointment with their OBGYN and psychiatrist to discuss the safety of their baby as it relates to any medicine they are taking. This sounds simple, but it’s not. It takes a great deal of mental health awareness, discussion, and research to find a medicine that helps pregnant women with their mental health but is also safe for their unborn baby. While mother’s clearly don’t want to take anything that may harm their unborn baby, it is also unsafe for them to simply stop taking their mental health medication cold turkey which could result in both short and long-term negative side effects.
Medication And Mental Health Awareness
Whether to continue taking psychiatric medication, to try a different psychiatric medication, or to discontinue psychiatric meds is a decision that has to be made on a case by case basis. A doctor’s role in this process is advising a person on the risks and benefits of a particular medicine, but it is ultimately the mother’s choice as to whether to continue taking psychiatric medicines at all. For that reason, each person should do their own research to determine what side effects their psychiatric medicine could have on their unborn baby and whether they feel comfortable continuing their medicine in light of that research.
Studies show that up to 20% of pregnant women suffer from mood or anxiety disorders during their pregnancy, some of which are their first mental health onset. In one study of pregnant women suffering from mental illnesses, 21/82 women who stayed on their psychiatric medication relapsed during their pregnancy. In the same study, 44/65 women who discontinued their psychiatric medication relapsed during their pregnancy. Relapses are frequent whether a person continues or discontinues their psychiatric medicine, but are five times more likely for women who discontinue their medicine altogether.
Medication Safety During Pregnancy
There is really no list of “safe” psychiatric medicines to take while you are pregnant. Information regarding the risks psychiatric medicines pose to an unborn baby is incomplete which is why many women avoid taking psychiatric medicines during pregnancy. The Food and Drug Administration has not yet approved a psychotropic drug for use during pregnancy making mental health awareness and medication administration such a difficult subject. That is the reason for researching and weighing the risks and benefits of taking each specific psychiatric medicine yourself.
There are currently two systems for categorizing the risks of medicines to unborn babies. The original system for categorizing the risks to an unborn baby involved in taking psychiatric medicine consisted of letter classifications based upon data derived from both animal and human studies. The system was confusing, to say the least.
Reading the classification, you probably wouldn’t want to take anything that is not classified as either an A or B. Medicines classified under “A” are reviewed in human studies where no problems relating to the medicine were reported in the children after birth. Medicines classified under “B” are reviewed in animal studies where the babies showed no problems related to the medicine, but there are no adequate well-controlled studies in pregnant women. Studies of medicines classified under “C,” “D” and “X” show adverse effects in animal reproduction studies with no adequate and well-controlled studies in humans.
The newer system for categorizing the risks to unborn babies of taking psychiatric medicines is the Pregnancy and Lactation Labeling Rule “PLLR” which requires the disclosure of information for each prescription medicine to include potential risks to the unborn baby and registry information from data collected regarding the effects that medicine has had on other pregnant women. The PLLR was meant to abolish the letter categories. However, if you research psychiatric medicines online, it always pulls up the letter system. It is more difficult to locate the PLLR labeling information, so it is not really helpful when you are doing your own research.
Medication Decisions During Pregnancy
Depending on the article you are reading, you may or may not feel safe taking a specific medicine. It is hard to make a fully informed decision regarding whether to continue or discontinue a psychiatric medicine during pregnancy with the conflicting data you find online. Let’s take Lamictal, also known as lamotrigine, for example. The data collected by the International Lamotrigine Pregnancy Registry showed no elevated risk of malformations associated with lamotrigine exposure during pregnancy.
However, data from the North-American Anti-Epileptic Drug Registry shows that 2.7% of the 564 children studied who were exposed to lamotrigine during pregnancy had major birth defects. Of those 564 children studied, five had a cleft lip. How do you reconcile the two studies to make a decision on whether you believe the medicine is safe to take during your pregnancy? Which study do you trust?
Facing the conflicting data regarding psychiatric medicines, a lot of women will want to stop taking their psychiatric medications during the life of their pregnancy to best ensure the safety and development of their unborn baby. However, whether stopping medicine is a safe alternative depends specifically on each person’s circumstances and life experiences. A healthy pregnancy strongly depends on the health of the mother which includes the mother’s mental health awareness and well-being.
Medication Benefits vs Risks
There are many risks associated with untreated mental illnesses and those risks can be exacerbated by the hormonal imbalance pregnant women experience. Sometimes, the risks to the unborn baby do not outweigh the benefits of the medicine to the expecting mother’s mental health. There are going to be women who cannot make a decision to stop taking medicine, and they will instead have to weigh their options on which medicine they do continue to take. Women who cannot make a decision to stop taking psychiatric medicine are women who have had relapses in the past when they discontinued medications, have suicidal or homicidal thoughts when they are not medicated, or have a history of self-harm.
Pregnant women without significant mental health history, who stop taking their psychiatric medicine, may even experience suicidality or a lack of desire to care for themselves resulting in a significant health risk to the unborn baby. High levels of stress during pregnancy due to failure to take psychiatric medicine can also cause a pre-term delivery and low birth weight which carry their own level of complications for the unborn baby. Discontinuing or reducing psychiatric medicine is also known to cause and exacerbate postpartum depression.
Read More: The Difficulty Of Living With Anxiety
Mental health awareness including understanding risks and making yourself fully informed is the best way to determine your specific needs. Meeting with your doctor and psychiatrist is essential because they know your mental health history and know what signs to watch for. Lean on them for advice, but make sure you ask questions and do research so you can make the best decision for your health and the health of your unborn baby. In your risk-benefit analysis, weigh your need for medicine, the risks posed if your mental health goes untreated, and the risk the medicine could pose on your unborn baby. In the end, a healthy mama is a necessity for a healthy child.
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