New preconception resources for women with serious mental illness

Guest blog by Katie Atmore and Professor Louise Howard, King’s College London

MMHA member Tommy’s has collaborated with Public Health England and King’s College London to develop preconception resources for women with serious mental illness (SMI) and the frontline health professionals who support them.

The outputs from this collaboration include:

• An online tool to assist with pregnancy planning for women with SMI
• A comprehensive web hub covering all the topics they might need to know about if they are in this position
• A guide for health professionals to help deliver preconception care to women with SMI
• An evidence review of existing literature and services for pregnancy planning for women with SMI (launching on PHE website soon)
• A short ‘5 tips’ animation for social with key messages for women from the project

Women with serious mental illness may have specific social, physical, and mental health needs which could impact their pregnancies. They may also encounter conflicting or stigmatising information around their desire for motherhood. The tool and resources help them to think through the issues and signposts them to other sources of help in planning a healthy pregnancy.

Health professionals working with women with SMI should embed conversations in routine care to promote awareness of physical and mental health issues which can contribute to healthy pregnancies and allow women to feel supported and empowered to make reproductive choices. These conversations should be started early, ideally at all routine reviews, whether or not women are planning a pregnancy, so that women can develop an awareness of what steps they can take now, before they stop contraception, to contribute to having a healthy pregnancy and baby.

“Having become ill and ending up in hospital after the birth of my first child I am very aware of how important it is to get good information and advice and prepare yourself as well as you can before having a baby. I did that before my second child and stayed well which was wonderful. This Tommy’s tool is fantastic because it brings all the information you need together in one place”.
– Mum with Bipolar Disorder

Key messages to include in these early conversations are:

1. Encourage women to keep taking their regular medication until they have had a chance to discuss changes with their doctor to ensure the safety of the pregnancy
2. Discuss weight management and nutritional supplementation
3. Encourage women to give up any substances that may harm their baby in advance of becoming pregnant (smoking, alcohol, recreational drugs, caffeine)
4. If possible, pregnancies should be planned during times of mental wellbeing with no recent relapse
5. Women should consider making advance directives in case of relapse during pregnancy or after birth so that relatives and services know their preferences.

“This is a fantastic resource. It will help healthcare professionals feel more confident in proactively discussing the possibility of future pregnancy with women of childbearing age who have had a serious mental illness. It will potentially reduce the chance of unplanned pregnancies, empower women who want to have a family, increase the number of women accessing specialist preconception advice and improve women’s physical and mental health before and during pregnancy.”
– Consultant Perinatal Psychiatrist