The preconception needs of women with severe mental illness: a consecutive clinical case series.
INTRODUCTION
Women with severe mental illness (SMI) are having babies at an increasing rate, but continue to face many challenges across the perinatal period. There is little research into the preconception needs of women with SMI and the aim of this study was to investigate the social circumstances, general health, mental health and reproductive health care needs in these at risk women.


METHOD
Women with SMI referred for specialist preconception counselling at a tertiary obstetric hospital in 2012 were eligible to participate. The data source was a semi-structured study-specific interview schedule with open-ended questions incorporated into the routine assessment protocol.


RESULTS
In a one-year period, 23 women were referred to the service and 22 consented to data from the interview being pooled for the study. All women were taking at least one psychotropic medication at the time of referral. Overall, 40% (n = 9) were aged at least 35 years, 36% (n = 8) smoked cigarettes daily and over half (54.5% n = 12) reported their body mass index as being in the overweight or obese range. Thematic analysis revealed the importance of maternal desire, and concerns relating to age and biological time pressure, the impact of the illness and medication on pregnancy and motherhood.


CONCLUSION
Our data indicate that preconception counselling should be routine in the care of women with SMI of reproductive age, and should take into account the potential centrality of motherhood in the woman's rehabilitation, as well as the complex appraisals of risks, general health and support.
['Nguyen|Thinh|T|', 'Brooks|Janette|J|', 'Frayne|Jacqueline|J|', 'Watt|Felice|F|', 'Fisher|Jane|J|']
D000328:Adult D005260:Female D006301:Health Services Needs and Demand D006801:Humans D001523:Mental Disorders D016742:Preconception Care D011247:Pregnancy
severe mental illness preconception counselling Perinatal metal health