Working women are going through stress more when they come back from office-Unaiza Niaz

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Proceedings of Session devoted to Perinatal Mental Health
Working women are going through stress more 
when they come back from office-Unaiza Niaz
Involve Obstetricians, neonatologists while treating pregnant 
women suffering from mental disorders-Munazza Ali
Depression, anxiety, PSTD are quite
common in women-Dr. Felicia Watt

LAHORE: One of the scientific sessions during the “Prescription for Wellness” International Psychiatric Conference held at Lahore from 2-3rd August 2019 was devoted to Perinatal Mental Health. It was chaired by Dr. Unaiza Niaz alongwith Dr. Rukhsana Kausar, Prof.Khalid Mufti, Dr. Sumaira and Dr. Rafia Rashid. The topic of Dr. Unaiza Niaz’s presentation was “Challenges of Urban Working Women’s Mental Health in Pakistan”.

Urban working women, Dr. Unaiza Niaz opined have to face too many problems starting with the traffic congestion, long distance travelling, increased social demands in office. They are also faced with self-image issues, fashion and have to keep themselves abreast of global world. She was delighted to note that in this conference, we see calmness, peace and a wonderful atmosphere. She then highlighted the issues specially faced by working women in office, in the family. These days, she further stated, we see smart educated patients. Our attire is very important and working women must ensure that they have a modest professional look.


Prof. Khalid Masood Gondal VC KEMU presenting memento to Dr. Unaiza Niaz
one of the invited Keynote Speakers at the Perinatal Mental Health Session
durning the Int. Psychiatric Conference on “Wellness for Prescription:
Working Across Boundaries” held at Lahore recently.

Women, she said, have to work with family conflict, face stress at work and it spills over. Working women are going through stress much more when they comeback from office. Looking after of children is not defined. With job spillover, they face many problems because of long working hours, physical behaviour and they suffer from super women syndrome. They are also supposed to be good housewives. They may be good at work but then working with the family costs in the form of stress. She was of the view that we need to ensure that their stress is handled very carefully, avoid burnout otherwise they lose the raise in their pay. On the whole working women, she opined, are underpaid. Women who do not work, are not given respect. Wellness for the women, Dr. Unaiza Niaz said, is more important. Women must do some work, take up teaching as we need good teachers. At times there are questions asked why the women are working? Women who are stressed will not conceive and the gynecologists should know this. She then referred to a study on women physicians which showed high prevalence of depression and suicide. Prevention of these diseases remain relatively ignored. To be suffering from depression is not a weakness. Depression needs to be looked into and treated to avoid burnout.


Royal Colleges in UK, Dr. Unaiza Niaz stated have arrangements where physicians come to seek attention of psychiatrists. All this is kept confidential. We should have this facility in our medical institutions and the problems should be acknowledged. Work place is much better with women if both men and women work together at a work place. Man and women are two sides of the same coin but they think differently. Their dedication to the company will be much higher. Working women love to be recognized as professionals but what happens is that often working women are ignored. Men gossip more than women she alleged. Emotional control, Dr. Unaiza Niaz stated is important and working women should be proud of what they are. Continuing Dr. Unaiza Niaz said that working women love your concern but not your sympathy. At times intimate questions are asked by the employers like marriage, family life. There is more gender bias at working place which is being highlighted these days. She suggested that we must give compliments at what women are doing. We must take care of the women physicians in particular. They must get six months family leave. Institutions need to provide Day Care facilities for the children. She also referred to increasing incidence and prevalence of sexual harassment. Working women physicians suffer from sexual harassment not only from physician colleagues but patients as well. She advised the women physicians to have proper dress while sitting in the OPD and at work place. They must look like a Doctor. Your attire will make you good. Avoid high neck, sleeve less shirts. Deans and VCs of medical institutions should help women to carry on their career. They should get twelve weeks paid family leave and four to twelve weeks child rearing leave. There should be arrangements for on-site child care services. She also supported the concept of career flexibility for women, improvement in mentorship, sponsorship. She concluded her presentation by advising the working women to choose their friends carefully.


Group photograph taken during the Perinatal Mental Health Session at Int. Conference on “Wellness for Prescription:
Working Across Boundaries” held at Lahore form 2-3rd August 2019 shows the speaker’s alongwith the
chairpersons. Prominent from (L to R) are Prof. Yusufzai, Prof. Mazhar Malik, and Prof. Munazza Ali,
Prof.Khalid Mufti, Dr. Unaiza Niaz, Dr. Felicia Watt and others.

Key issues in Women’s
Mental Health

Dr. Felicia Watt from Qatar highlighted the key issues in Women’s Mental Health. She pointed out that some disorders are gender specific. She emphasized the importance of relieving the symptoms, taking care of the known risk factors. There is increased exposure of women to violence, some attempt suicide. Depression, anxiety, Post Stress Traumatic Disorders are quite common. Women have low income, in some countries women are not living with their partners but alone. There is lack of emotions, some women suffer from low level of education, many of them remain unemployed which results in financial strains, and they have greater exposure to poverty. Substance abuse is twice more common in women and there is increased exposure of women to stress as well.


Psychopharmacological
considerations in
pregnancy and lactation

Dr. Syeda Munazza Ali from Qatar discussed psycho pharmacological considerations in pregnancy and lactation. She pointed out that those women who are contemplating pregnancy or already pregnant should consider risk and benefit of taking prescribed medications. These are some of the challenges which women physicians are facing. Pregnant women have several mental health issues with current medication besides non-prescription drugs they are taking. There are issues related with weight management, exercise supplements. No medication, she remarked is safe in pregnancy. Drugs do pass through placenta hence we have to weigh the risk and benefit to women as well as her fetus. We must find out what effects the drugs will have on the fetus if the women are treated and if not treated? Some pregnant women may have late preterm labour, it could also result in low birth weight babies. Up to sixteen weeks of gestation period is high risk for congenital malformations and studies have showed that drugs are responsible for 4% of congenital malformations. Radiation during pregnancy has its own side effects, she remarked.


 Dr. Nadeem, Dr. Ajmal Kazmi, Prof. Imran Ijaz Haider, Prof. Mazhar Malik, Prof. Khalid 
Mufti and other distinguishes guests photographed during the Int. Psychiatric
Conference on “Wellness for Prescription: Working Across Boundaries”
held at Lahore form 2-3rd August 2019.

Continuing Dr. Munazza Ali suggested that while treating pregnant women, the treating physicians must talk to the women and their husband. It is important to involve obstetricians and neonatologists while treating pregnant women suffering from mental disorders. To find out the teratogenicity effects of drugs, women are not part of the research as RCTs are not possible. It is difficult to find out side effects of drugs from behaviour consequences. Depression, smoking, lack of folate, use of alcohol all have their effects during pregnancy. Then there are some physiological changes during pregnancy. Physicians must be aware of general principles of drug prescribing during pregnancy. She stressed the importance of engagement with the patient, collaboration during treatment and avoid switching over of drugs as far as possible. It is also important to avoid the use of high dose of drugs during pregnancy, ensure exclusive breast feeding during the first six months. Psychotropic drugs does pass into the breast milk and these issues needs to be discussed with the patient taking into account the risk and the benefits. Anti-depressant can be prescribed during pregnancy and when used in low dose, they are safe during breast feeding. It is essential that we consider the gestational age as well as co-morbid conditions of the patients.

 Prof. Khalid Mufti along with Prof. Aftab Asif and Dr. Burhan charing the workshop
on “Happiness for Healthcare Professionals” during the Int. Psychiatric 
Conference on “Wellness for Prescription: Working Across Boundaries”

She concluded her presentation by laying stress on monitoring the baby for adverse effects. Pregnant women are a special population, they require different dosage regimen. Change in drug metabolism is observed during pregnancy and fetal exposure to different drugs varies, she remarked.