antenatal 2

antenatal 2

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Understanding NICE guidance
Information for people who use NHS services
Mental health problems during
pregnancy and after giving birth
NICE `clinical This booklet is about the care and treatment of women with mental health
guidelines' advise problems in the antenatal period (during pregnancy) and in the postnatal
the NHS on caring period (the first year after giving birth) in the NHS in England and Wales.
It explains guidance (advice) from NICE (the National Institute for Health
for people with and Clinical Excellence). It is written for women with mental health
specific conditions problems during pregnancy and in the first year after giving birth, and
or diseases and the their families and carers. It may also be useful for anyone with an interest
treatments they in the condition.
should receive. The booklet aims to help you understand the care and treatment options
that should be available in the NHS. It does not describe mental health
problems or the tests or treatments for them in detail. A member of your
healthcare team should discuss these with you. There are examples of
questions you could ask throughout this booklet to help you with this.
Some sources of further information and support are on page 19. Medical
terms in bold type are explained in the glossary on pages 17­18.
Information about NICE clinical guideline 45
Issue date: February 2007

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Contents
Your care 3
Mental health problems during pregnancy and after giving birth 4
Recognising mental health problems during pregnancy and 5
after giving birth
General advice on treating mental health problems during 7
pregnancy and after giving birth
Advice on treating specific mental health problems during 10
pregnancy and after giving birth
Supporting families and carers 14
Further information about medication 15
Glossary 17
More information 19
About NICE 20
The advice in the NICE guideline covers:
· recognising mental health problems during pregnancy…read more

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Your care
Your treatment and care should take into account your personal needs
and preferences, and you have the right to be fully informed and to make
decisions in partnership with your healthcare team. If you have or develop
a mental health problem while planning a pregnancy, during pregnancy, or
in the first year after giving birth, your healthcare team should give you
information you can understand and that is relevant to your circumstances.…read more

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If you are under 16 and you fully understand the information you are
given, you may be able to decide about your own treatment. If there are
treatments that you do not want, tell your doctor. If you are too young or
you have not fully understood the information about treatments, your
parents or carers may also need to agree to treatment. Sometimes parents
and doctors may go against your decision if they think it is best for you
and your baby.…read more

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Recognising mental health problems during
pregnancy and after giving birth
Pregnancy and the first year after giving birth are periods of great
adjustment. Emotions and social, financial and physical demands can be
difficult to manage. You may feel more anxious and `down' than usual,
so healthcare professionals (including your midwife, health visitor and GP)
should ask you about your mental health.…read more

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If you have, or have ever had, a severe mental illness, your healthcare
professional should develop with you (and if appropriate, your family and
carers) a written care plan in the first 3 months of your pregnancy. The
plan should cover treatment and care during pregnancy, giving birth and
the first year afterwards, and the need to see specialist mental health
services more often.…read more

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General advice on treating mental health problems
during pregnancy and after giving birth
As far as possible you should see the same healthcare professionals at
different stages of your pregnancy and after your baby is born. All the
healthcare professionals involved in your care should keep each other
informed about your mental health problem and its treatment.…read more

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Contraception
If you are taking medication for a mental health problem and are at
an age when you could become pregnant, your doctor should talk
to you about contraception and the risks involved in having a baby.
If you are planning to have a baby you should discuss this with
your doctor.…read more

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Questions you could ask about treatments
· Why have you decided to offer me this particular treatment?
· What will the treatment involve?
· Are there any risks for me or my baby associated with this
treatment, and if so are there ways of reducing these risks?
· How long will I have to take the medication for?
· Might I have problems when I stop taking the medication?
· Can you tell me about the different types of psychological treatment?
· Are there other…read more

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Advice on treating specific mental health problems
during pregnancy and after giving birth
Treatment for mental health problems during pregnancy and after
giving birth will be similar to treatment at other times. Your healthcare
If it appears
professionals should follow the guidelines that NICE has produced on
that treatments specific mental health problems (see page 20 for details) but should adapt
described in this them as explained below.…read more

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