Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-26T12:40:27.306Z Has data issue: false hasContentIssue false
  • English
  • Français

Fertile ground: reproductive health consideration in mental health ward policy

Published online by Cambridge University Press:  28 July 2020

E. McGuire Open the ORCID record for E. McGuire [Opens in a new window] ,
C. Curtis  and
R. M. Duffy
E. McGuire*
Affiliation:
Mayo Mental Health Service, Castlebar, Co. Mayo, Ireland
C. Curtis
Affiliation:
Mayo Mental Health Service, Castlebar, Co. Mayo, Ireland
R. M. Duffy
Affiliation:
Specialist Perinatal Mental Health Service
*
*Address for correspondence: Eimear McGuire, Mayo Mental Health Service, Castlebar, Co. Mayo, Ireland. (E-mail: eimear.mcguire4@hse.ie)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

Women of childbearing age often experience mental health problems, receive psychotropic medication and are admitted to mental health units. Approximately 40% of pregnancies are unplanned and many women experience perinatal mental health problems. It is therefore vital that consideration is given to reproductive health in mental health policy. We aimed to evaluate the consideration of pregnancy and breastfeeding in the policies of an inpatient mental health service.

Methods:

The policies of a regional inpatient psychiatric unit were independently reviewed by two researchers. Policies that had implications for pregnancy and breastfeeding for patients were identified. Whether or not these policies considered pregnancy and breastfeeding and the detail of this consideration was evaluated.

Results:

One hundred and thirteen policies were evaluated. Forty had implications for pregnancy but only 10 of these mentioned pregnancy and only 3 in detail. Only 3 of the 28 policies that had relevance to breastfeeding mothers mentioned it and none discussed it in detail. Key areas of omission included prescribing, seclusion and restraint and cultural and religious considerations.

Conclusion:

Pregnancy and breastfeeding were almost entirely absent in the ward policies of our inpatient unit. Their consideration in the acute setting is vital. An individual or group of individuals should be responsible for ensuring that reproductive health is considered in all policies as well as in a larger specific policy suitable for referencing. The rights of the reproductive woman should be comprehensively considered in inpatient mental health care policy.

Keywords

Breastfeedingmental healthpolicypregnancywomen’s health service
Type
Short Report
Information
Irish Journal of Psychological Medicine , Volume 40 , Issue 4: Themed issue on Perinatal Mental Health , December 2023 , pp. 571 - 576
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bearak, J, Popinchalk, A, Alkema, L, Sedgh, CJ (2018). Global, regional and subregional trends in unintended pregnancy and its outcomes from 1990–2014: estimates from a Bayesian hierarchical model. Lancet Global Health 6, 380–389.Google Scholar
Dunning, K, le Masters, G, Bhattachanya, A (2010). A major public health issue: the high incidence of falls during pregnancy. Maternal Child Health Journal 14, 720–725.Google Scholar
du Toit, E, Jordaan, E, Niehaus, D, Koen, L, Leppanen, J (2018). Risk factors for unplanned pregnancy in women with mental illness living in a developing country. Archive of Women’s Mental Health 21(3):323–331.Google Scholar
Dyer, I, Barclay, D (1962). Accidental trauma complicating pregnancy and delivery. American Journal of Obstetrics and Gynecology 83, 907–929.Google Scholar
Gelder, M, Mayou, R, Cowen, P (2001). Shorter Oxford Textbook of Psychiatry, 4th edn. Oxford: Oxford University Press.Google Scholar
Goossens, J, Van Den Branden, Y, Van der Sluys, L, Delbaere, I, Van Hecke, A, Verhaeghe, S, Beeckman, D (2016). The prevalence of unplanned pregnancy ending in birth, associated factors, and health outcomes. Human Reproduction 31(12), 2821–2833.Google Scholar
Higgins, A (2017). Perinatal mental health: an exploration of practices, policies, processes and education needs of midwives and nurses within maternity and primary care services in Ireland, Mind Mothers Study, HSE (www.lenus.ie). Accessed 04 January 2020.Google Scholar
Howard, L, Molyneaux, E, Dennis, CL, Rochat, T, Stein, A, Milgrom, J (2014). Non-psychotic mental disorders in the perinatal period. Lancet 9956(384), 1775–1788.Google Scholar
HSE (2017). Specialist Perinatal Mental Health Services (http://www.hse.ie/eng/services/list/4/mental_health_services/). Accessed 05 November 2019.Google Scholar
Humphries, A, Mirjalili, SA, Tarr, GP, Thompson, J, Stone, P (2019). The effect of supine positioning on maternal hemodynamics during late pregnancy. The Journal of Maternal-Fetal & Neonatal Medicine 32(23), 3923–3930. DOI: 10.1080/14767058.2018.1478958 CrossRefGoogle ScholarPubMed
Kenny, N, Ni Riain, A (2014). Domestic Violence: A Guide for General Practice. Dublin: Irish College of General Practitioners.Google Scholar
Ko, J, Farr, SL, Dietz, P, Robbins, C (2012). Depression and treatment among US pregnant and non-pregnant women of reproductive age, 2005–2009. Journal of Women’s Health 21(8), 830–836.Google Scholar
Ladavac, A, Dubin, W, Ning, A, Stuckeman, P (2007). Emergency managment of agitation in pregnancy. General Hospital Psychiatry 29, 39–41.Google Scholar
Leis, J, Hevon, J, Stuart, E, Mendelson, T (2013). Association between maternal mental health and child emotional and behavioural problems: does prenatal mental health matter? Journal of Abnormal Child Psychology 42, 161–171 Google Scholar
Mental Health Commission (2006). Quality Framework Mental Health Services in Ireland (https://www.mhcirl.ie/File/qframemhc.pdf). Accessed 04 January 2020.Google Scholar
Mental Health Commission (2018). The Use of Restrictive Practices in Approved Centres Seclusion, Mechanical Restraint and Physical Restraint: Activities Report 2016 (https://www.mhcirl.ie/File/restrict_prac2016.pdf). Accessed 04 January 2020.Google Scholar
National Task Force on the Use of Restraints with Pregnant Women under Correctional Custody (2012). Best Practies in the Use of Restraints with Pregnant Women and Girls under Correctional Custody. Rockville: U.S. Department of Health and Human Services. Department of Justice Grant No. 2010-DJ-BX-K080 (http://www.cjinvolvedwomen.org/). Accessed 04 January 2020.Google Scholar
NICE (2018). Antenatal and Postnatal Mental Health: clinical management and service guidance (https://www.nice.org.uk/guidance/cg192). Accessed 05 November 2019.Google Scholar
Niethe, M, Whitfield, K (2018). Psychotropic medication use during pregnancy. Journal of Pharmacy Practice and Research 48(4), 384–391.Google Scholar
Royal College of Psychiatrists Centre for Quality Improvement (2018). Standards for Inpatient Perinatal Mental Health Services, Quality Network for Perinatal Mental Health Services (www.rcpsych.ac.uk). Accessed 04 January 2020.Google Scholar
Schenker, J (2000). Women’s reproductive health: monotheistic religious perspectives. International Journal of Gynaecology and Obstetrics 70(1), 77–86.Google Scholar
Sedgh, G, Singh, S, Hussain, R (2014). Intended and unintended pregnancies worldwide in 2012 and recent trends. Studies in Family Planning 45(3), 301–314. DOI: 10.1111/j.1728-4465.2014.00393 Google Scholar
Stein, A, Pearson, RM, Goodman, SH, Rapa, E, Rahman, A, McCallum, M, Howard, LM, Pariante, CM (2014). Effects of perinatal mood disorders on the foetus and child. Lancet 384(9956), 1800–1819. DOI: 10.1016/S0140–6736(14)61277 Google Scholar
Stewart, D, Rondon, M, Damiani, G, Honikman, J (2001). International psychosocial and systemic issues in women’s mental health. Archive of Women’s Mental Health 4, 13–17.Google Scholar
Stotland, NL (2017). Reproductive rights and women’s mental health. Psychiatric Clinics of North America 40(2), 335–350.Google Scholar
Taillieu, TL, Brownridge, DA (2010). Violence against pregnant women: prevalence, patterns, risk factors, theories, and directions for future research. Aggression and Violent Behaviour 15(1), 14–35.Google Scholar
US government (2019). People at risk: pregnant women. Foodsafety.gov (https://www.foodsafety.gov/people-at-risk/pregnant-women). Accessed 29 November 2019.Google Scholar
Ward, H, Fromson, JL, Cooper, JJ, De Oliveira, G, Almeida, M (2018). Recommendations for the use of ECT in pregnancy: literature review and proposed clinical protocol. Archives of Women’s Mental Health 21, 715–722.Google Scholar
Supplementary material: File

McGuire et al. supplementary material

McGuire et al. supplementary material

Download McGuire et al. supplementary material(File)
File 14.7 KB