Preconception counselling components in women with serious mental illness: a scoping review

Women with severe mental illness (SMI) face significant pregnancy-related risks, yet targeted preconception counselling (PCC) remains poorly defined. This scoping review systematically maps existing literature on PCC for women with SMI.

Following the JBI evidence manual for Scoping reviews and the PRISMA-ScR guidelines, MEDLINE, Embase, PsycINFO, and Web of Science databases were searched from inception to June 2025. English-language articles describing PCC interventions or guidelines targeting women with bipolar disorder and psychosis-spectrum disorders were included.

From 1,208 unique records, 33 articles were identified and reviewed, predominantly narrative reviews (n = 23/33, 70%), clinical guidelines (n = 4/33, 12%), and empirical studies (n = 5/33, 15%). Key PCC themes included: Maternal and infant risks and lifestyle education (n = 28/33 articles), medication and treatment options (n = 27/33), planning and preventive care (n = 27/33), history-taking and risk assessment (n = 18/33), and multidisciplinary support/relational aspects (n = 14/33). Structured interventions or standardised frameworks were rare (n = 1/33), and articles infrequently addressed patient-centred factors or Infant Mental Health (n = 2/33).

Current evidence on PCC for women with SMI remains fragmented. The findings support the need for clearer, consensus-based guidance integrating psychiatric, reproductive, and psychosocial considerations, with IMH emerging as an underexplored author-identified area for future PCC framework development. Future research should prioritise prospective studies, development/assessment of structured interventions, standardised PCC frameworks, and expert consensus, to support accessible, stigma-free, and resilience-enhancing care for women with SMI, ultimately supporting optimal outcomes for mothers, infants, and families.