Abstract Body

Maternal health cannot be separated from infant, child and adolescent health, which includes mental health as well. Expecting mothers go through a number of changes during their pregnancy. Due to the specific alterations of their physique and immune system, pregnant mothers are more vulnerable to the Covid-19 infection. This highlights the importance of the vaccinations in their cases.

During the pandemic, mental health problems such as anxiety, depression and stress aroused in greater numbers. This affected mothers, and younger children as well. Expecting mothers, without pre-existing mental disorder (>50%) reported a weightier level of anxiety in their first trimester. Also, infants can suffer developmental disadvantages, as their infected mothers are separated from them. Even though evidence is not yet clear in this topic, vertical transmission seems to be fairly uncommon.

Treatment guidelines, that could help Covid-19 infected mothers to handle their infants, are scarce. Hence the importance of telehealth has started to be outlined. Separation from the children might be necessary, while the mental health of mother and infant is continuously screened, since the long-term consequences of the symptoms are still unknown. Hence, prevention is imperative to avoid any negative effects. Even still, WHO advises mothers to breastfeed safely, with good respiratory hygiene, emphasizing the importance of skin-to-skin contact of newborns and sharing the room with them.

On policy level: investment into pre-, peri-, post-natal care, family supporting national programs, inter-sectoral collaborations, monitoring and research are important elements of prevention and treatment efforts during the Epidemic and the post-Covid-19 era.

Abstract Body

Due to the nature of the perinatal period, it affects generations who are more at home in the electronic space, hence some form of telemedicine can be used in a number of areas.

The “Together” Baby-Mother-Father Integrated Program has been running since 2004. Both the condition of those affected and the current epidemic makes it difficult for patients and their families to access adequate perinatal specialist care.

At the beginning of the epidemic, the switch to telemedicinal psychiatric care has been rapid and focused mainly on the use of Phone, Skype, Viber and Email.

To our findings the advantages include, easier access to care, and more frequent contacts. The home environment is accessible and the families are more involved. Also, care does not compete with the scarce resources of time and space. Some of the possible disadvantages are, that more work on intimacy is needed, and the treatability of certain diseases is questionable (e.g., psychoses). Care is less documentable with the current regulations, and funding has not yet been adapted to the changes.

The telemedicinal care and support network in Hungary - among many - contains an online medical system (EESZT) including e-prescription. Online- psychotherapy, consultation, peer-group platforms. There is a non-stop hotline for patients, etc.

In 2021 the total number of our cases increased by 34%, but realistically the visit number was also higher, due to the amount of shorter telephone and e-mail interactions. Depression and bipolar disorder were among the highest proportion by the patients present.

Abstract Body

A notable part of psychiatry is prevention. Our job, as psychiatrists, is not only to treat mental disorders, but also to prevent them. Treating mothers in postnatal period reducing the negative consequence of depression for child development, for example. General adult psychiatrists face the challenge of having patients, who receive psychiatric health care, while also planning to have a child. Many professionals may find themselves in a situation, when they feel clueless on what to advise regarding pharmacotherapy and realistic expectations on having a child.

The presentation will focus on some crucial topics. What should counselling include when planning pregnancy, highlighting differences among first and second or further children. Potentials risks and harms on the fetus / new-born baby will be introduced with emphasis on pharmacological/chemical agents, infectious effects and social, relational and family stressors. What the guidelines are for Covid-19 vaccination and pregnancy. Relative and absolute contraindications of planned pregnancy will be discussed. The crucial question of artificial/therapeutic abortion; are there any psychiatric conditions, when a psychiatrist can/should suggest it?

The advantage and knowledge of perinatal mental health guideline papers, bio-ethical aspects will be discussed, along with the consequences of untreated mental illness. Advantage of breastfeeding and an up-to-date view on what should be psychiatrists’ aim will be introduced. Why is it inevitable to cooperate with GPs, obstetric- and gynecology colleagues and further medical professionals? The essential aspect and advantages of involving fathers and extended family members in this approach also will be explained.