Who Gets to Be a Mother?

"We'd been working together for years to make my medication regimen-treatment for schizoaffective disorder-safe for potential pregnancy. Under her care, I was tapering off an antidepressant known to cause respiratory distress and hypertension in a newborn. I'd been experiencing wild mood swings, even suicidal thoughts. My beloved doctor's eyes were sad. "I'm saying no to a pregnancy, Meg." Even in the moment, I understood her priority as a physician was to keep me safe. Still, part of me hated her."

"My husband and I began trying to conceive-only to experience miscarriage. A social worker told me that any adoption agency would turn us away due to my diagnosis. The Urgent Need for Reproductive Psychiatry Management of psychiatric disorders during the reproductive years is especially complex. Fifty percent of pregnancies in the United States are unplanned, and many women face pregnancy and motherhood while psychiatrically ill."

Women with serious mental illness often face reproductive-care decisions that pit medication-related fetal risks against maternal stability. One patient with schizoaffective disorder struggled when her outpatient psychiatrist advised against pregnancy while she tapered an antidepressant linked to neonatal respiratory distress and hypertension; a perinatal mental health clinic later recommended continuing medications to protect stability. Pregnancy loss and statements that adoption agencies would reject candidates because of diagnosis illustrated social barriers. Half of pregnancies are unplanned, over 10% of pregnant women receive psychiatric medications, and 1.6% take multiple classes. Specialized reproductive psychiatry and shared decision-making improve outcomes and adherence.

Read at Psychology Today