Dr. Anthony McCarthy:

Any doctor seeing any woman of child-bearing age, no matter what her medical or psychiatric condition, should keep in mind that she could become pregnant.

Therefore, when prescribing, for example, a broad pressure, anti-asthmatic or epilepsy tablet, the doctor should be aware of that information. In the mental health area, particularly in complex medical regimes and specifically when there are complicating obstetric issues, women very often want to get specialists' advice. Some of my colleagues will sometimes want me to give specialist advice. To answer the Chairman's question, we see a small number of women before pregnancy specifically to provide this advice. Some women may already have obtained this information when they became pregnant by googling it or looking it up on a website. They may be perfectly happy with the local services available and may not feel a need to see me. Others will definitely want to see me, particularly those who have a bipolar illness and are on lithium. These women need very careful change monitoring. The change dynamics of pregnancy and the change in renal function - all sorts of issue in pregnancy - make the situation much more complicated. It is very much individual to the woman who will make up her mind, with the advice of her doctor, etc., on whether she should come to see us.