What should I know about taking psychiatric medication during pregnancy and the postpartum?

Psychiatric medications help to relieve debilitating symptoms associated with mental illness and can significantly improve people's lives. But there is still reluctance in the world of medicine and psychiatry when giving pregnant women medication due to fear of it harming the baby.

Research generally isn’t carried out on pregnant women to get an accurate diagnosis of whether medication is 100% safe during pregnancy. Doctors accept that treatment is necessary for life-threatening conditions such as high blood pressure or diabetes, even if it means exposing babies to unknown medication side effects. This is because the diseases themselves would create an unhealthy environment for both mother and baby. Treating psychiatric disorders, on the other hand, is still seen as something less medically necessary. For many years, women had to “tough it out” when it came to their emotional symptoms. Today, science has shown that untreated psychiatric symptoms can be more harmful to mother and baby during pregnancy and postpartum.

Ultimately, research and our experience prove that when the mother is healthy, it’s not only better for her but for her baby too.

So if you’re taking psychiatric medications during pregnancy or postpartum, let’s take a look at what to expect when you meet with your doctor.

What can I expect when visiting my doctor about psychiatric medications?

If you are taking medication for a psychiatric condition, we recommend setting up a meeting with your doctor, ideally before you’re pregnant or just after you’ve found out. Discuss with your doctor how the medication is helping you and what it’s like to be off medication.

If you have a psychiatric history, your doctor will likely focus on the benefits and risks of the medication that you’re taking. You may have heard of suitable antidepressants for pregnancy, but this doesn’t mean they will be suitable for you. Doctors tend to recommend the lowest dose of medication during pregnancy, but what’s more important is that you take a dose that keeps your symptoms at bay - no more, no less.

If you are taking various medications, your doctor will ideally streamline your medication by treating all your symptoms with one single effective medication because most studies on medication safety look at one medication at a time.

Ultimately, the choice to continue, start or stop medication is yours, but an expert can help to influence your decision by giving you the medical facts and helping you to understand your options.

It’s important to note that medication is not a panacea and usually works best with other treatments.

Whether you’re considering staying or going off medication, one of the biggest questions to ask yourself is: are you doing everything you can in terms of your behaviour and lifestyle to support your mental health?

If you are managing depression or anxiety, it’s important that during pregnancy and postpartum, you put your own well-being first. Do you really need to go to that draining social gathering, or could you use that time to relax? Could you cut a few corners on your daily errands or ask your boss if you could work from home one day a week? These options may not always be available or eleven realistic, but the point is to try and prioritise your own well-being wherever possible.

Talk therapies can also be very helpful whether you’re taking medication or not. For some patients, talk therapy can help relieve symptoms well enough to ease off medication safely during pregnancy and breastfeeding.

What talk therapies are available?

Your doctor may recommend a specific therapy they think would be most suitable for you, but you can also request a type of therapy you think would be most suited to how you like to express yourself.

Psychodynamic psychotherapy: This type of therapy focuses on your blind spots and what prevents you from seeing things clearly and therefore causes you to repeat certain unhealthy patterns and experiences. There is often a focus on understanding your past experiences to help you relate to your current issues.

Psychoanalysis: This type of therapy usually involves the patient lying on a couch. The analyst helps the patient become more self-aware by pointing out how patterns of behaviour play out in therapy sessions. This process is called transference and helps the patient understand their behaviour related to people in their life.

Interpersonal therapy (IPT): This type of therapy helps people after major changes in their life, which is why it can help with new parenthood. It helps the patient become aware of how what’s happening in their life is leading them to stress. The therapist can sometimes use role-play as a way to improve the patient’s relationships.

Cognitive behavioural therapy (CBT): This structured therapy focuses on the patient’s habitual thoughts and behaviours, with the intention of discerning which thoughts and behaviours are helpful and unhelpful.

Behavioural therapy: This therapy uses positive and negative reinforcement systems to change unhelpful patterns of behaviour and encourage healthier choices. It often includes exercises such as relaxation techniques, stress management and changes in diet and physical exercise to support healing.

What should I know about taking psychiatric medication during pregnancy and the postpartum?

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