The University of Virginia Health System is helping mothers cope with depression during and after pregnancy with its new Perinatal Mood Disorders Clinic, an outpatient mental health clinic led by women’s health and mental health experts within the health system.
UVa Health experts see about 70% of mothers relapse with depression and even more women who relapse with bipolar disorder during pregnancy, said reproductive psychiatrist and clinic leader Dr. Jennifer L. Payne during a UVa Health briefing on Friday. This means that 80-100% of women who stopped their medications for pregnancy will relapse with their diagnosed illness.
“Many people feel very uncomfortable treating women psychiatrically during pregnancy,” Payne said. “This clinic is an attempt to make a commonplace and give smart and intelligent care to women with psychiatric illness during and after pregnancy.”
The clinic will offer pre-pregnancy consultations for women who are considering becoming pregnant who have “trick illnesses” and women who take medications and are looking for the best course to stay mentally healthy during their pregnancy.
“Most psychiatric medications can continue to be taken during pregnancy,” Payne said. “There are a few that should not be, and every case is different, but there are alternatives. There’s psychotherapy; there’s light box therapy; there is transcranial magnetic stimulation for people who have severe depression, for example, but it really depends on the case. This clinic will help people figure out what the best plan is for their pregnancy and then refer them to the resources that they need to make that happen.”
Fellow clinic leaders Ginny Bowers — a certified nurse and midwife who is training with Payne to become a certified psychiatric nurse practitioner — and Dr. Chantal Scott — an OB-GYN specializing in pregnancy and birth — joined Payne to make the announcement on Friday.
The clinic also presents a learning opportunity for nurses to learn about prescribing medication and better methods for caring for patients from experienced leaders Bowers and Dr. Payne.
Most of the obstetricians at UVa are “fairly comfortable” treating patients who have been prescribed “various psychiatric medications,” but “that’s not always the case,” in other medical facilities, Scott said.
While postpartum depression is commonly recognized as a side effect of childbirth, Payne said new mothers also seek psychiatric help for post-traumatic stress disorder from a difficult birth and obsessive compulsive disorder that can occur in the “immediate postpartum” phase.
New mothers are especially vulnerable to psychiatric illness during the first six months after childbirth, known as the postpartum period, meaning even women without a psychiatric history can develop depression during that time, Payne said.
As patients travel to UVa from around the commonwealth and the country with stories of differing responses to their mental health needs with differing qualities of care, the new clinic will create a central location for people to seek mental health care before and during pregnancy.
The clinic currently plans to see patients on Tuesday mornings and Wednesday afternoons, with plans to “eventually” add more appointment times to the schedule.
Bowers said the clinic is developing a referral link within its electronic medical records to make the clinic more accessible to primary care providers, obstetricians and family practice physicians who can refer their patients to the clinic.
Interested patients can call the Perinatal Mood Disorders Clinic at (434) 243-4646 to schedule an appointment.