Brief: If pregnant, consult expert before stopping mental health drugs

Pregnant women with mental health problems should consult with an expert before stopping their medications, state officials said in a report released Wednesday by its Maternal Mortality Review Board.

The recommendation was one of several made in the issue brief as part of a broader statewide effort to focus on maternal health.

Other recommendations included depression screening for pregnant women and better coordination between prenatal care providers and mental health professionals.

“Our findings are striking and clear,” said Dr. Marilyn Kacica, medical director of the State Department of Health’s Division of Family Health. “Based on our most recent data, mental health conditions were contributing factors in 1 in 5 pregnancy-associated deaths… Mental health is a central component of physical health and should continue to be addressed throughout pregnancy and postpartum from a person”.

what to know

  • Women taking psychiatric medications shouldn’t automatically stop taking them after becoming pregnant, according to a new report from the state Maternal Mortality Review Board.

  • Authorities said mental health conditions were the third leading cause of pregnancy-related deaths in New York in 2018.

  • In the topic summary, the review board highlighted recommendations and resources to help health care providers recognize and treat pregnant women with mental health concerns.

Officials said mental health conditions are the third leading cause of pregnancy-related deaths in New York, after strokes and hemorrhages. Those findings were published by the Maternal Mortality Review Board earlier this year in a 2018 study of pregnancy-associated deaths.

That report showed that of 41 pregnancy-related deaths in 2018, 15% were due to mental health issues. It also showed that black and non-Hispanic women had a pregnancy-related mortality rate five times higher than non-Hispanic white women.

The review board determined that mental health-related deaths were “potentially preventable” with the majority occurring between 43 and 365 days after the end of pregnancy.

The issue brief, the first in a series, was released Wednesday to highlight these findings and offer resources and guidance to providers.

Describing the findings as “revealing,” Dr. Kristina M. Deligiannidis, director of Women’s Behavioral Health at Northwell Health’s Zucker Hillside Hospital in Glen Oaks, Queens, said it’s also a reminder that mental health is Physical Health.

“Just as we pay attention to all the other medical things we need to care for in our perinatal patients, from their blood pressure to their blood sugar levels, knowing if that patient is doing well emotionally and behaviorally is just as important,” he said. he said she.

A key recommendation for physicians is that psychiatric medications should not be automatically stopped just because a patient is pregnant. In some cases, pregnant women stop taking their medications out of fear that they may negatively affect the fetus.

“They really need to talk to an expert who knows how the medication they’re taking could affect the pregnancy,” said Karen Boorshtein, president and CEO of the Huntington-based nonprofit Family Service League. “They can also change the medication. Many women have difficulties during pregnancy and that can catapult them into depression.

Boorshtein said that pregnant women often struggle with other difficulties such as food insecurity and unemployment.

“If you’re depressed and you don’t get treatment during your pregnancy, the results could be devastating,” she said.

Another recommendation in the summary was to improve the education of emergency medicine providers so that they can better detect symptoms of mental illness in pregnant patients.

Deligiannidis also serves as the medical director of reproductive psychiatry for the New York State TEACH Project, which helps providers assess, treat and manage mental health problems. He said that providing these types of resources, referrals and other services to providers is especially important for those whose primary training was not in mental health.

“If we had the right screenings, if we had the right care coordination, and we had a sufficient number of providers to care for patients with mood and anxiety disorders and other psychiatric illnesses or substance use disorders … we could have prevented these deaths,” he said.

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