Abstract
Mental illnesses commonly occur in the reproductive age. This study aimed to identify the issues that exist within the perinatal mental health care system. A cross-sectional survey was conducted in Aichi Prefecture in central Japan. Questionnaires on the situation between 2016 and 2018 were mailed to the head physicians of 128 maternity care units, 21 neonatal intensive care units (NICUs), and 40 assisted reproductive technology (ART) units. A total of 82 (52.6 per 100,000 births) women were admitted to mental health care units during the perinatal period, and 158 (1.0 per 1000 births) neonates born to mothers with mental illness were admitted to NICUs. Approximately 40% of patients were hospitalized in psychiatric hospitals without maternity care units. Eighty-four (71.1%) and 76 (64.4%) maternity care units did not have psychiatrists or social workers, respectively. Moreover, 20–35% of the head physicians in private clinics, general hospitals, and ART units endorsed the discontinuation of psychotropic drug use during pregnancy. However, the corresponding figures were only 5% among those in maternal-fetal centers. Resources for perinatal mental illness might be limited. Perspectives on psychotropic drug use differed based on the type of facilities where the doctors were working.
Highlights
A total of 155,417 infants were born in 5these mater of 14 nity care units between 2016 and 2018, and 102,027 (66.7%) babies were born in private clinics
More physicians in private clinics endorsed drug use discontinuation than those in MF centers, even if those drugs were not contraindicated during pregnancy
The available professional perinatal mental health care resources were perceived to be insufficient, and the preconception care provided by fertility treatment centers was limited
Summary
10–20% of women worldwide experience mental illness during the perinatal period [1]; growing evidence suggests that mental illness has adverse effects on mothers and their children [2,3,4]. Women with mental illness should receive care from a multidisciplinary team that includes psychiatrists, obstetricians, midwives, psychologists, and social workers [5]. Women with mental illness should be in collaboration with psychiatric service providers during the perinatal period [6]. More research is expected to establish robust perinatal mental health care [7]
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