Preconception Counseling for Women with Schizophrenia

This article outlines guidelines for preconception counseling of women with schizophrenia. Preconception care creates the opportunity to address risky behaviors, change unhealthy lifestyles, enhance the patient's knowledge about the genetics of her disease and the risk for her offspring, improve parenting skills, mobilize resources and the necessary support system in a timely manner and ultimately improve the health and quality of life of both the woman and her offspring. Women with schizophrenia are in particular need of preconception interventions. They are at a high risk of relapse during pregnancy unless their illness is treated. Psychosis during pregnancy can lead to fetal distress, denial of pregnancy, failure to participate in prenatal care and to recognize the signs of labor. Women with schizophrenia are at high risk of fetal malformations, obstetrical and neonatal complications and postpartum psychosis. In addition, schizophrenia is associated with homelessness and low socioeconomic status. Moreover, women with schizophrenia have poor social support and often lose the custody of their children. Identification and treatment of women with severe mental illness prior to conception is essential to reducing negative outcomes.