Knowledge and Experiences of Prepregnancy Counseling in Women With Mental Health Disorders [ID 989]

INTRODUCTION: Mental health crises are a known driver of maternal mortality. Patients taking medications for mental health or substance use disorders in pregnancy should be aware of the safety profile of their medication, discuss with their providers the potential effects pregnancy can have on mental health, and have a plan to address worsening mental health symptoms during pregnancy. METHODS: We surveyed respondents assigned female sex at birth with reproductive potential aged 18 to 45 years who self-reported mental health or substance use disorder and resided in Hawaii. RESULTS: Between September 2021 and September 2022, 98 respondents initiated surveys. The average age was 30 and 51.2% of respondents took prescription medication for mental health within 6 months. Respondents reported not knowing whether the medication they took was safe during pregnancy for 36 (42.9%) of 84 medications. Thirteen (14.1%) medications taken were U.S. Food and Drug Administration Category D medications; for six (46.1%) of these, respondents did not know whether the medication was safe during pregnancy. Less than half (46.9%) of respondents previously discussed pregnancy planning with a women’s health care provider, whereas fewer (21.0%) respondents previously discussed pregnancy planning with a psychiatrist. Thirty percent of respondents discussed with their provider how mental health can be affected by pregnancy. Thirty percent of respondents made a plan with a provider if their mental health symptoms worsened during pregnancy. CONCLUSIONS/IMPLICATIONS: Respondents received insufficient prepregnancy counseling regarding mental health medications or the risks of increasing mental health symptoms during and after pregnancy.