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Review on borderline personality disorder and pregnancy: Possible interventions to improve outcomes

Background: Borderline personality disorder is the most extensively studied area in psychiatry. Poor pregnancy outcome is evident from studies available. Obstetricians and mental health teams experience multiple challenges due to the nature of this personality disorder. However, effective interventions to manage women with borderline personality disorder in the antenatal and perinatal periods are yet to be formulated. This review emphasizes on challenges faced by care providers and the authors ‘views on forming effective measures to improve the outcomes. Methods: The review was done using the available articles using the keywords “Borderline personality disorder” and “pregnancy”. PubMed, PsycINFO, CINAHL, EMBASE and CENTRAL were used to search the articles. 99,500 articles were found. Only three were selected for narrative review due to their relevance. Results: Early sexual debut and unintended pregnancies were increased. Further, almost all perinatal complications were noted except for post-partum hemorrhage and the need for induction of labour. Parenting issues and separation from children due to safety issues by authorities were noted. Managing women with BPD imposes stress on the healthcare system due to core symptoms of the BPD. Communication strategies and strong liaison with community and hospital teams may alleviate the tension in the healthcare system. Conclusion: Accumulating evidence suggests the complexity of antenatal issues. Perinatal outcomes have consistently been poor in women with a borderline personality disorder. Further, effective strategies to alleviate the outcomes of women need to be designed, focusing on the characteristics of the nature of the disorder.