LAUSR

Background Depression and anxiety are common disorders, however their occurrence during pregnancy has the potential to significantly impact the health and wellbeing of both mother and child [1, 2]. Negative outcomes of mental health disorders in pregnancy include a variety of serious complications. Inadequately treated depression is associated with a substantial risk of maternal, fetal and neonatal morbidity and mortality [3]. In addition to subjective distress, the impact on relationships can be very significant, particularly when attachment to the newborn is disrupted. This may lead to enduring detrimental effects on the child extending into adulthood [4]. Depression also leads to suicide, with it being the second largest cause of indirect maternal mortality in the perinatal period in Australian women [1]. Unclear messages contribute to pregnant women being reluctant to take psychotropic medication, including antidepressants and anxiolytics with many fearing foetal harm [5–8]. Medical personnel including O&Gs and GPs form an important part of a pregnant woman’s network of information sources during pregnancy and can impact patient decision-making around medications in pregnancy [7–9]. The Australian clinicians’ own perception of teratogenicity of antidepressants (AD) and anxiolytics (AX) may influence counseling and care of vulnerable women and is largely unexplored. It is, however, likely to align with the international community where perceived teratogenicity is overestimated by physicians of all medical specialties, except psychiatrists [10– 12]. Professional bodies such as the RANZCOG publish statements and recommendations to provide advice on management of perinatal anxiety and depression, serious mental illness and bipolar disorder. The target audience is all health professionals who are engaged in providing maternity and mental health care to these patients [13]. This study hypothesised that differences exist in the perception of risk of teratogenicity of AD and AX medication commonly prescribed to pregnant women, by differing clinicians, namely O&Gs and GPs. It also explored medication counselling and prescription practices, clinician resources and base knowledge of risk of AD and AX when used in pregnancy.