Psychiatric illness during pregnancy
Early detection, individualized care can promote health for mother and infant
At 26 weeks gestation, Ms. A still is reluctant to try psychotropics, so her therapist works with her to integrate psychotherapy with alternative approaches such as mindfulness meditation and yoga. During therapy, Ms. A learns ways to manage her depressive symptoms, improve her social functioning, adjust to role transitions, and work through her traumatic experiences. Ms. A enrolls in a prenatal yoga class with a mindfulness focus, which allows her to interact with other pregnant women at risk for psychopathology and learn new ways to cope with her depressed mood and chronic pain.
Ms. A delivers a healthy boy at 38 weeks gestation. During labor, she uses many of the yoga poses she learned to manage pain, but elects to have an epidural after 30 hours of labor. Her baby tests positive for hydrocodone, which can cause ongoing mild irritability and occasional jitteriness. He is observed in the hospital for signs of withdrawal for 48 hours and then discharged home with his mother. Ms. A starts breast-feeding in the hospital and plans to continue at home.
Ms. A’s therapist continues to stay in touch with her by phone until she schedules another appointment and assists with referrals to other community resources.
- University of Michigan Department of Psychiatry Depression Center Women’s Mental Health and Infants Program. Women and depression. www.psych.med.umich.edu/wimhc.
- Yonkers KA, Wisner KL, Stewart DE, et al. The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists. Gen Hosp Psychiatry. 2009;31(5):403-413.
- Michigan Families Medicaid Project. Year 1 final report. Includes a list of maternal and child health services similar to Michigan’s Maternal Infant Health Program, for all 50 states. https://1.usa.gov/yCzdca.
Drug Brand Name
- Acetaminophen/hydrocodone • Vicodin
Disclosures
The authors report no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.
