Incomplete answers to questions about mental health and pregnancy for many

Eighteen US states have passed laws that exclude mental health problems or suicide risk as medical reasons why a woman can have an abortion.

But women who spoke to CQ Roll Call faced obstacles in finding answers to the question of how to manage mental illness during pregnancy, even if they weren’t considering abortion.

The Food and Drug Administration has not approved psychiatric medications during pregnancy. However, they can be prescribed off-label.

Instead, pregnant patients are often advised not to stop taking medications for mental health and substance abuse, due to the risk of worsening symptoms or relapse.

The American College of Obstetricians and Gynecologists advises patients who eventually stop taking medications to restart them after delivery. For example, women with a history of postpartum psychosis have a 66 percent chance of recurrence without medication.

Doctors largely agree that certain medications carry significant risks, especially several medications used to treat bipolar disorder, including Tegretol, Valproate, Lamotrigine, and Depakote.

Other mental health medications with fewer risks may require more careful monitoring or should only be used when other medications don’t work.

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