Service use and obstetric outcomes in pregnant women attending a Women’s Mental Health Clinic

Background: Understanding the characteristics of women attending perinatal mental health services, their service utilisation and obstetric outcomes is important to guide planning and improve perinatal mental health services. This study aimed to describe referral patterns, sociodemographic and clinical profiles, mental health service use and obstetric outcomes among pregnant women attending a tertiary Women’s Mental Health Clinic at an academic tertiary hospital in Cape Town, South Africa. Methods: A descriptive study of all women who attended the Women’s Mental Health Clinic service from April 2022 to March 2023 (n = 82). Pregnant women who attended their first appointment during the sampling time frame (n = 67) were then selected for more detailed review. Results: Most referrals received were for managing pre-existing mental illness in pregnancy (72.0%, n = 59), with most women attending their first Women’s Mental Health appointment in the second trimester (58.2%, n = 39). Referrals were largely from the hospital’s high-risk obstetric clinic (61.0%, n = 50). Mood disorders, including depression (43.3%, n = 29) and bipolar disorder (17.9%, n = 12), were the most common diagnoses. Psychotropic medications were used in 80.6% of the sample (n = 54). The rates of substance use (35.8%, n = 24) were lower compared to other South African studies of pregnant women attending specialised maternal mental health services. Referral to and uptake of allied mental health services were variable. Conclusion: The findings underscore the need for earlier identification and referral of women with perinatal mental health conditions, improved service integration and monitoring of obstetric outcomes. Contribution: This study provides context-specific knowledge that may inform clinical care, funding and future research directions for pregnant women attending mental health clinics.