Chapter

Obstetric liaison services

Gillian Wainscott and Giles Berrisford

in Oxford Textbook of Women and Mental Health

Published on behalf of Oxford University Press

ISBN: 9780199214365
Published online July 2011 | e-ISBN: 9780199640454 | DOI: http://dx.doi.org/10.1093/med/9780199214365.003.0020

Series: Oxford Textbooks

Obstetric liaison services

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It has been recognized since ancient times that pregnancy is not always associated with psychological wellbeing Recent National Institute for Health and Clinical Excellence (NICE) guidelines for antenatal and postnatal mental health recognized that perinatal mental health service provisions are ‘patchy’ and non-standardized (NICE 2007).

The importance of developing a written care plan during the first trimester for pregnant women with a current or past history of severe mental illness was endorsed and it was recommended that this should be done in collaboration with specialist perinatal mental health services (Guideline's Clinical Practice Recommendations) (NICE 2007). The three key areas of identification, planning, and communication were reinforced. A crucial component is undoubtedly effective liaison between the general medical and the mental health services. An effective method of developing this is through the antenatal mental health liaison clinic.

An antenatal mental health clinic provides an ideal setting for the identification of women either with, or at risk of, developing mental illness. A collaborative, informal, multi-agency working environment promotes closer working and helps reduce the stigma of mental health services for pregnant women. Training of midwives is of benefit in giving confidence to them in their interactions with patients with mental health problems, and easy accessibility to mental health services gives reassurance that any problems picked up will be dealt with promptly and effectively. For those mothers who are unwell, the clinic offers an alternative point of access to psychiatric services which is less intimidating. Medication and other therapeutic options can be discussed with a team confident in the management of a pregnant woman with a mental illness.

An antenatal mental health clinic has recently been established in Birmingham (UK). The success of the clinic is evidenced through the knowledge that no unexpected crisis situations developed and the absence of any fatality due to psychiatric cause. It has also enabled access to continuing psychiatric care where this has been indicated.

Chapter.  4001 words. 

Subjects: Psychiatry

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