Perinatal mental health

Abstract

Pregnancy and the postpartum period are times of elevated risk for mental disorders, which are common and affect up to 20% of expectant and new mothers. Perinatal mental disorders are already the leading complications in the perinatal period, and evidence suggests their prevalence is increasing. Nevertheless, they remain underdiagnosed and undertreated, which is particularly concerning as they are associated with adverse maternal and infant outcomes. Perinatal psychiatry includes conditions that occur outside the perinatal period (e.g. anxiety, depression) and illnesses such as postpartum psychosis. Postpartum depression and psychosis significantly increase the risk of suicide, a leading cause of maternal mortality. Management of perinatal mental illness needs special consideration because of the impact on both the women and their babies. Use of psychotropic medications in pregnancy and breastfeeding requires risk–benefit analysis and careful discussion with specialist multidisciplinary teams and patients. Women tend to be particularly cautious of the potential risks that medication poses to the baby, and less aware of the risks to both mother and infant of untreated mental illness. Screening for mental illness can lead to timely diagnosis, treatment and, if required, specialist perinatal care and admission to a mother and baby unit, which have recently been expanded across the UK.