Consult Psychiatrists’ Views on Evaluating Maternal Capacity to Care for a Newborn

In inpatient postpartum settings, psychiatrists are often asked to evaluate a mother's ability to care for her infant in urgent "maternal capacity consults" before discharge. Due to the high stakes involved, psychiatrists may require support from a multidisciplinary team to determine whether it is necessary to remove a child from its mother's care. A survey was conducted to determine if psychiatrists require additional training and support to conduct these evaluations. The study involved a 17-item survey that was emailed to physicians who self-identified as practicing consultation-liaison psychiatry. The survey asked questions about how often psychiatrists were asked to evaluate postpartum women, what support they received in making these evaluations, and whether they believed additional training was necessary. Of the 74 psychiatrists who responded, 64.9% had been asked to perform maternal capacity consultations, and 75% expressed immediate concerns about the safety of the infant if discharged with the mother. The majority of psychiatrists received assistance from floor social workers, and fewer received support from other services, such as child protective services. Only 6.3% had access to a standardized process for maternal capacity evaluations. Half of the psychiatrists stated they would benefit from additional training, while 52.1% felt that maternal capacity assessments were not an appropriate role. The results indicated differences in opinion among consult-liaison psychiatrists regarding their role as maternal capacity consultants. While proposing a universal protocol may be challenging, providing additional resources could help reduce disparities and biases faced by postpartum mothers during maternal capacity evaluations.