Pregnant women with mental health issues should consult with an expert before weaning off their medications, state officials said in a brief released Wednesday by its maternal mortality review committee.
The recommendation was among several made in the briefing note as part of a larger statewide effort to focus on maternal health.
Other recommendations included screening pregnant women for depression and better coordination between prenatal care providers and mental health professionals.
“Our findings are shocking and clear,” said Dr. Marilyn Kacica, medical director of the State Department of Health’s Division of Family Health. “Based on our latest data, mental health issues were contributing factors to 1 in 5 pregnancy-associated deaths…Mental health is an essential part of physical health, and it must continue to be addressed throughout throughout an individual’s pregnancy and postpartum.”
What there is to know
A woman taking psychiatric drugs shouldn’t automatically stop taking them after becoming pregnant, according to a new filing released by the state’s Maternal Mortality Review Board.
Officials said mental health issues were the third leading cause of pregnancy-related deaths in New York City in 2018.
In the briefing note, the review panel highlighted recommendations and resources to help healthcare providers recognize and treat pregnant women with mental health issues.
Officials said mental health issues are the third leading cause of pregnancy-related deaths in New York City, after embolisms and hemorrhages. These findings were published by the Maternal Mortality Review Board earlier this year in a study of pregnancy-related deaths from 2018.
This 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 death 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 briefing note – the first in a series – was released on Wednesday to highlight these findings and offer providers resources and guidance.
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 was also a reminder that mental health is physical health.
“Just as we pay attention to all the other medical things we need to take care of in our perinatal patients, from their blood pressure to their blood sugar levels, it’s just as important to know if that patient is doing well emotionally and behaviorally,” he said. she declared. said.
A key recommendation to clinicians is that psychiatric medications should not be automatically discontinued simply because a patient is pregnant. In some cases, pregnant women stop taking their medication because they fear it will harm the fetus.
“They really need to talk to an expert who knows how the medications they’re taking could impact pregnancy,” said Karen Boorshtein, president and CEO of the nonprofit Family Service League based in Huntington. “They can also change medication. Many women struggle during pregnancy and this can catapult them into depression.
Boorshtein said pregnant women often struggle with other challenges such as food insecurity and unemployment.
“If you’re depressed and left untreated during your pregnancy, the results could be devastating,” she said.
Another recommendation from the brief was to improve the education of emergency medicine providers so they can better spot symptoms of mental illness in pregnant patients.
Deligiannidis is also the Medical Director of Reproductive Psychiatry for New York State’s TEACH Project, which helps providers assess, treat, and manage mental health issues. She said 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 screening in place, had the right coordination of care in place, and had enough providers to care for patients with mood and anxiety disorders and other illnesses psychiatric or substance use disorders…we could have prevented them. dead,” she said.
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