Two cases of pregnant women with severe mental disorders, who could continue pregnancy with shared decision making and personalized care planning

Abstract

Perinatal mental disorders are common. However, pharmacotherapy for these disorders is challenging and limited. Therefore, a non-pharmacotherapy approach is required. Shared decision making (SDM) has recently gathered attention with each patient’s and his/her family’s values needing to be supported. On the other hand, owing to psychiatric symptoms, SDM is not often possible. In this study, we evaluated two cases of pregnant women with severe mental disorders who needed urgent pharmacotherapy and required sufficient consideration about decision-making. In each case, limited medication was used and a personalized care plan including social environmental adjustment was developed. Subsequently, SDM could finally be reached, and the two women could continue pregnancy. It is important to carefully consider a personalized care plan with evidence-based pharmacotherapy and social environment adjustment, so that decision- making based on each value can be supported.