Pregnant women with psych issues -- when do they get their baby?

RNLaborNurse4U · Feb 23, 2005

I'm writing a paper for Civil Law & Psychiatry (Law School) and I used to work postpartum. I got some great suggestions from the psych nurses' forum.
Charlie RN gave me this great topic: (I'll paste it)
Women who are pregnant should not take psych meds. If they or their MD's op to do so what are their responsiblity's re; possible damage to the newborn? Are insurance companies required to pay for months of inpatient treatment while prego/psycho can't be safe without her meds and can't take her meds? What kind legal pressure can be applied to force her out of the hospital? Can she be forced to put her child at risk?
Anyone have any experience with this? Just want to make sure there is research out there for me to base my paper on.
thanks, everyone!

So, according this hypothesis, I should have stopped taking zoloft while pregnant with my last child, and have suffered the consequences of my depression and possible suicidal ideation, in order to limit the (already small) risks to my unborn baby?

I do believe it is up to the woman and her OB to be prudent in deciding what meds and what dosage should be utilized during the woman's pregnancy. Many of the more harmful drugs DO have alternatives to be utilized during pregnancy. After all, a healthy mom (physically and psychologically) will mean a healthy pregnancy and healthy baby, ideally.

Jen

L&D RN

Liddle Noodnik · Feb 23, 2005

I'm writing a paper for Civil Law & Psychiatry (Law School) and I used to work postpartum. I got some great suggestions from the psych nurses' forum.
Charlie RN gave me this great topic: (I'll paste it)
Women who are pregnant should not take psych meds. If they or their MD's op to do so what are their responsiblity's re; possible damage to the newborn? Are insurance companies required to pay for months of inpatient treatment while prego/psycho can't be safe without her meds and can't take her meds? What kind legal pressure can be applied to force her out of the hospital? Can she be forced to put her child at risk?
Anyone have any experience with this? Just want to make sure there is research out there for me to base my paper on.
thanks, everyone!

First suggestion would be to lose the "prego/psycho" ! ZOIKS!

BabyRN2Be · Feb 23, 2005

If you are looking for a reason why a pregnant woman should not take meds such as SSRI's during pregnancy, I had recently received something in my inbox about the SSRI's causing a "withdrawal syndrome" in the neonate. I don't know if I have it any more, but if you are looking for a reason why a pregnant woman should not take SSRI's or the like (maybe the topic statement of your paper) you could Google it. Sorry that I can't be more specific.

I've been gone a while from here, so I'm sort of out of the loop of what's been discussed and what's not.

parteiranagua · Feb 24, 2005

I ahve been a psych nurse for quite a while as well, and I have seen many pregnant women too.... Depending of the diagnosis (depression Vs bipolar etc..) women will have to stay on their meds... They are usually comanaged by the Ob and the Psychiatrist... we all know that meds are not a good combo for the fetus,, but whar r u gonna do if the woman becomes delusional and unstable? risks and benefits balancing should be the primary focus of management..

Now I have also seen many women on SSRI prescribed by primary Physicians and Ob for stress, anxiety, situational depresion, etc who could be better off with counseling... :idea:

Ginny Doula RN SNM

PatricksRNMommy · Feb 24, 2005

I'm writing a paper for Civil Law & Psychiatry (Law School) and I used to work postpartum. I got some great suggestions from the psych nurses' forum.
Charlie RN gave me this great topic: (I'll paste it)
Women who are pregnant should not take psych meds. If they or their MD's op to do so what are their responsiblity's re; possible damage to the newborn? Are insurance companies required to pay for months of inpatient treatment while prego/psycho can't be safe without her meds and can't take her meds? What kind legal pressure can be applied to force her out of the hospital? Can she be forced to put her child at risk?
Anyone have any experience with this? Just want to make sure there is research out there for me to base my paper on.
thanks, everyone!

When I was a tech at a psych hospital... one of our frequent patients was admitted for trying to kill herself because she was pregnant... This was a very tricky situation... She was diagnosed as Bipolar w/ psychotic features.. On meds, she was pretty stable.. She had stopped taking her meds because she was pregnant, but without her meds she was basically a danger to herself and her child... It's kind of an eithical dilemma... Which is more dangerous to the mother and child, being on psychotropic meds or the mother being psychotic or suicidal? She also had a sezuire disorder and without her seizure meds she had violent seizures which sent her to the ER frequently... We ended up keeping her in the facility for another month, basically on 1 on 1 the entire time... although she still managed to hurt herself a couple times due to some policies not being properly followed by staff... I think they did eventually get her on some meds that were less dangerous to the fetus, but she ended up having a miscarraige anyways... it was very sad...

Lawnurse · Feb 24, 2005

I really appreciate everyone's comments. I'm going to talk to my professor this evening (we only have class once a week on thursday night) to see how I should narrow it down.

One thing I remember from nursing is that psych wards get really nervous with pregnant patients and maternity wards get really nervous with psych patients. I myself refused to take one once (she had indicated a desire to hurt the baby.)

If anyone else has had an patients/experiences in the catagory, I'd love to hear about it.

Thank you!

Lawnurse · Feb 24, 2005

Okay, my professor listened to my idea but thought it might not fit the class, but he thought the idea of restraints for patients' safety vs. restraints for nurses' safety was a "hot issue" so that's what i'll be writing about.

Thank you every for your suggestions!

:)

LydiaNN · Feb 25, 2005

I'm writing a paper for Civil Law & Psychiatry (Law School) and I used to work postpartum. I got some great suggestions from the psych nurses' forum.
Charlie RN gave me this great topic: (I'll paste it)
Women who are pregnant should not take psych meds. If they or their MD's op to do so what are their responsiblity's re; possible damage to the newborn? Are insurance companies required to pay for months of inpatient treatment while prego/psycho can't be safe without her meds and can't take her meds? What kind legal pressure can be applied to force her out of the hospital? Can she be forced to put her child at risk?
Anyone have any experience with this? Just want to make sure there is research out there for me to base my paper on.
thanks, everyone!

No experience with it, but curious as to what considerations went into formulating that hypothesis. As with all medications, there has to be a risks/benefits comparison to decide whether a pregnant woman should continue on any given course of treatment. This decision would need to be made by the woman and her physician. Why would insurance companies or hospitals have the right to discriminate against her for using these meds as opposed to someone taking a different type of medication with unknown effects to a developing fetus? How does the question about being "forced to be her child at risk" relate to the hypothesis that she shouldn't take the meds? That seems contradictory, unless you are theorizing that without meds the woman poses a risk to her unborn child.

OOPS- Just notice your post right above mine, and that the subject is no longer on the table.