Impact of Mental Health Services on Prenatal Care Adherence [19M

Abstract

INTRODUCTION: Pregnancy is an opportunity to identify and begin treatment for mental illness, yet obstetric clinics aren’t always equipped to diagnose and treat mental illness. The Obstetrics Mental Health (OBMH) clinic provides integrated mental health services in an academic, safety-net medical center’s prenatal care clinic. We evaluated whether adherence to OB Mental Health appointments increased adherence to prenatal medical care. METHODS: Data was retrospectively abstracted from the electronic medical record from July 2014 to October 2016. Included in the study were non-incarcerated pregnant women over 18 years of age who had attended an OBMH intake appointment. Engagement with OBMH care was defined as attending at least one OBMH appointment after the initial intake appointment. Adherence to prenatal care was defined per the ACOG recommended visit schedule. RESULTS: Of the 138 women that met the inclusion criteria, 50.7% were prenatal care adherent, 55.1% were OBMH adherent, and 35.8% were adherent to both. Fisher’s exact test demonstrates an association between OBMH adherence and increased prenatal care adherence with a two-tailed p value of 0.0396. CONCLUSION: Our results show a significant association between women who were OBMH adherent and increased prenatal care adherence compared to women that were not OBMH adherent (p<0.05). This suggests that addressing women’s mental health needs in a prenatal care setting encourages them to comply with prenatal medical care. Women receiving mental health care may be more emotionally and cognitively able to comply, more trusting of providers, or motivated by the convenience. Further research of collaborative care models can explore postpartum outcomes.