Psychotropic medication in pregnancy: ethical aspects and clinical management

This article explores the dilemma of whether women with mental illness should take potentially teratogenic psychotropic medications during pregnancy, from both the maternal and fetal perspectives. Ethical and social aspects of the dilemma are presented to assist perinatal and psychiatric practitioners to provide holistic and competent care to the mother/fetus dyad. Specific fetal risks involved with maternal psychotropic drug use are described and contrasted with fetal risks of an untreated, psychiatrically ill mother. Nursing and healthcare considerations for the care of this population are presented in general, and specific psychotropics are reviewed for their risk profile in pregnancy. The article concludes with a discussion of actions to reduce maternal and fetal risk for women who are mentally ill and are currently taking, or considering taking, a psychotropic medication.