title: The preconception needs of women with severe mental illness: a consecutive clinical case series.
abstract: BACKGROUND
  Women with severe mental illness (SMI) are having babies at an increasing rate, but continue to face many challenges across the perinatal period. There is little research into the preconception needs of women with SMI and the aim of this study was to investigate the social circumstances, general health, mental health and reproductive health care needs in these at risk women.
  
  
  METHODS
  Women with SMI referred for specialist preconception counselling at a tertiary obstetric hospital in 2012 were eligible to participate. The data source was a semi-structured study-specific interview schedule with open-ended questions incorporated into the routine assessment protocol.
  
  
  RESULTS
  In a one-year period, 23 women were referred to the service and 22 consented to data from the interview being pooled for the study. All women were taking at least one psychotropic medication at the time of referral. Overall, 40% (n = 9) were aged at least 35 years, 36% (n = 8) smoked cigarettes daily and over half (54.5% n = 12) reported their body mass index as being in the overweight or obese range. Thematic analysis revealed the importance of maternal desire, and concerns relating to age and biological time pressure, the impact of the illness and medication on pregnancy and motherhood.
  
  
  CONCLUSIONS
  Our data indicate that preconception counselling should be routine in the care of women with SMI of reproductive age, and should take into account the potential centrality of motherhood in the woman's rehabilitation, as well as the complex appraisals of risks, general health and support.
authors.affiliation: a School of Psychiatry and Clinical Neurosciences, University of Western Australia , Australia .|b Peel and Rockingham Kwinana Mental Health Services , Australia .
authors.forename: Thinh
authors.initials: T
authors.lastname: Nguyen
authors.affiliation: c Women and Newborn Health Service , Western Australia , Australia .|d School of Women and Infant Health, University of Western Australia , Australia .
authors.forename: Janette
authors.initials: J
authors.lastname: Brooks
authors.affiliation: c Women and Newborn Health Service , Western Australia , Australia .|e School of Primary, Aboriginal and Rural Health Care, The University of Western Australia , Australia , and.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Frayne
authors.affiliation: c Women and Newborn Health Service , Western Australia , Australia .
authors.forename: Felice
authors.initials: F
authors.lastname: Watt
authors.affiliation: f Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University , Australia.
authors.forename: Jane
authors.initials: J
authors.lastname: Fisher
mesh_terms: D000328:Adult; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D001523:Mental Disorders / Q000523:psychology; D016742:Preconception Care; D011247:Pregnancy
keywords: Perinatal metal health; preconception counselling; severe mental illness