What is Reproductive Psychiatry?
Reproductive psychiatry is the specialty of treating mental health issues that occur during the childbearing period or are related to hormonal changes. This includes: Pre-Menstrual Dysphoric Disorder (PMDD), preconception consultation to optimize mental health in preparation for a pregnancy, treatment of mental health issues during pregnancy and the post-partum period, stress related to infertility, grief of fetal loss, and peri-menopausal mood issues.
Are you a womens' health care provider, or know someone who might benefit from Reproductive Psychiatry services? This page is available as a printable PDF. You are free to download and distribute this document without restriction.
What are the unique risks to women during the childbearing years?
Women in their reproductive years experience twice the rate of mood issues compared to men. For some women, hormonal shifts create additional mood instability. Additionally, many women (as well as men) struggle with balancing work, child-rearing, and managing a home, resulting in little time to focus on health and well-being.
Several conditions are more common or have unique manifestations during this time, including: Obsessive Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), anxiety about health issues, and Bipolar Disorder. Bipolar Disorder in particular carries a high risk of serious mood episodes in the first post-partum month if left untreated.
Can I take medications for my mood during pregnancy?
Many women who have experienced mental health issues struggle with the decision about whether to remain on medications during a pregnancy and breastfeeding. Although it is common for all of us to focus on the risks of medication, it is also crucially important to consider the risks of the untreated mental health condition and its impact on the mother, baby, and the rest of the family. It is confusing and difficult to sort through the often conflicting reports about the risks of medication use, and an expert perspective is required to apply this information to each woman’s unique situation. Best-practice guidelines recommend consulting a reproductive psychiatrist about medication use during this important time.
What are the risks of not treating anxiety and mood problems during a pregnancy?
Poor maternal mental health can have a negative impact on a woman’s physical health and on the developing fetus. Maternal depression has been linked to poor nutrition, obesity, lack of engagement in prenatal care, increased smoking and substance use, and complications like low birth weight, preterm delivery, and preeclampsia. Additionally, there is abundant data showing that a mother’s mental health status during the child’s first year of life has a profound and lasting effect on a child’s emotional and cognitive development.
What non-medication treatment options are available?
Making maximal use of non-medication treatment approaches is desirable during pregnancy and breastfeeding. Engagement in psychotherapy can be an effective treatment option for mild to moderate levels of depression and anxiety. Dr. Farrar can offer suggestions about the type of psychotherapy that may be of greatest benefit to you and facilitate a referral to an individual therapist or a peripartum therapy group. Group therapy can create supportive connections to other women struggling with similar issues, encourage good self-care, and support effective communications with loved ones.
Use of regular exercise, bright light therapy, meditation, social support, and optimal nutrition are also very effective low-risk treatment options.
What can I expect at the first appointment with Dr. Farrar?
You can expect to spend more than an hour with Dr. Farrar at your first appointment. She will do a thorough diagnostic evaluation and risk assessment. Together, you will compare the risks of the untreated mental health condition verses the risks of medication and other treatments. Non-medication treatment approaches will be discussed, and the importance of healthy habits and stress management will be emphasized. The aim of the first appointment is to provide you with useful information to support your personal decision making. You are welcome to meet with Dr. Farrar even if you do not wish to consider medications. With your permission, Dr. Farrar will communicate with your care team.
What if I already have a psychiatrist? Can I still see Dr. Farrar for a consultation?
Yes, with your psychiatrist’s consent, Dr. Farrar can meet with you one time and provide recommendations to your current provider. Please ask your prescriber to refer you to Dr. Farrar.
Dr. Farrar's Qualifications
Dr. Farrar completed extensive specialized training in Reproductive Psychiatry during her residency at the University of Illinois in Chicago, studying with a national leader in this field. She continues to attend educational conferences, and stays informed on new findings in this field. She has been practicing this specialty for over 15 years and has helped many families have positive childbearing experiences. She has presented educational seminars on this subject to OB’s, therapists, and primary care providers.
Next Steps: Obtaining a referral
Ask your OB, midwife, primary care provider, or psychiatrist to complete and submit Farrar and Associates' referral form. Please fax referral forms to 833.283.7571.
Please be aware that we are not able to accept some insurance payers, including Medicare, Medicaid, and Network Health.