Perinatal mental health refers to the biological, psychological and social well-being of women during pregnancy and the first year after childbirth. This period is marked by significant physical, emotional, and social changes, making it a critical time for mental health screening and support. General practitioners (GPs) play a crucial role in identifying and managing perinatal mental health issues, as they are often the first point of contact for expectant and new mothers. Screening for depression and anxiety using tools like the Edinburgh Postnatal Depression Scale (EPDS) is recommended at various stages of pregnancy and the postnatal period.
Perinatal mental health disorders, including depression, anxiety, and post-traumatic stress disorder (PTSD), can have profound effects on both the mother and the child. Considerations of the impact of pregnancy, the birthing process, and motherhood on neurodivergent women/families and those with trauma are important to optimise the necessary care of these women. Untreated mental health issues can lead to poor maternal-infant bonding, developmental delays in children, and increased risk of chronic mental health problems for the mother. GPs should be aware of the risk factors for perinatal mental health issues, such as a history of psychiatric illness, lack of social support, and stressful life events, and provide appropriate referrals and interventions.
Effective management of perinatal mental health involves a combination of psychosocial support, medication, and therapy. The woman may need a supportive inpatient admission, which can occur in public and private settings. GPs should collaborate with and refer to mental health professionals to ensure comprehensive care for affected women. Providing woman-centered care, and maintaining confidentiality, while being sensitive to the role of fathers/co-parent(s) and cultural considerations are essential components of effective perinatal mental health care. By addressing these issues proactively, GPs and mental health professionals can significantly improve outcomes for both mothers and their children.
References
RACGP - AFP  Perinatal mental health Identifying problems and managing medications Volume 43, Issue 4, April 2014
Centre of Perinatal Excellence - Perinatal Mental Health Guideline: Summary for general practitioners
RANZCP Section of Perinatal and Infant Psychiatry - Understanding birth trauma in clinical care - Aug 2023
