This guideline covers the mental healthcare of women who have, or are at risk of, mental health problems in the antenatal period and the postnatal period, from childbirth to the end of the first year.
The guideline is concerned with a broad range of mental health problems, including depression, anxiety disorders, eating disorders, drug and alcohol-use disorders and severe mental illness (such as psychosis, bipolar disorder, schizophrenia and severe depression)
However, the guidelines should be used in conjunction with other NICE guidance about specific mental health problems.
The revised guideline covers the organisation of perinatal mental health services, psychological and psychosocial interventions and pharmacological and physical interventions. In addition, there are recommendations on recognising mental health problems, assessment and care planning, interventions and considerations for women in the postnatal period.
The RCOG welcomes these updated guidelines highlighting the importance of supporting mothers both before birth and the weeks and months following birth. In particular there is a new section on supporting women and their partners, including families and carers and the potential effect of any mental health problem on the woman's relationship with her partner, family or carer.
Moreover, there is a new recommendation around providing preconception counselling for women with a current or previous mental health problem who may be planning a pregnancy. The RCOG welcomes this since increased support may be needed for these women.
The RCOG supports the need for coordinated care and the guidelines highlight the importance of developing an integrated care plan for women with a mental health problem. This requires closer working between health services with social care providers.
There are also new recommendations around starting, using and stopping treatment for a mental health condition and the benefits and risks associated with this should be discussed thoroughly between the healthcare professional and the woman.
Dr Patrick O’Brien, spokesperson for the Royal College of Obstetricians and Gynaecologists said:
“We welcome these revised guidelines on antenatal and postnatal mental health. They come at a time when perinatal health services are in the spot-light.
“Many women experience low mood following childbirth, however, this is normal and should pass. However, women who have pre-existing mental health conditions, or who develop a more serious mental health condition antenatally or postnatally need specialist attention and care. Mental illness makes a significant contribution to maternal deaths and therefore it is vital these women receive the right support at the right time by the right professional.
“We cannot over-emphasise the importance of early identification and reaching women pre-conceptually, especially because women with pre-existing mental health disorders are at a greater risk. Healthcare professionals need to ensure that these women receive the best possible care.
“There is also a need to consider the training and support needs of professionals in order to develop better services for women. They need to be aware that this group of vulnerable women may not want to tell anyone about their condition and if this is the case, they need to know the correct care pathways to follow.
“An integrated care plan should be developed for a woman with a mental health problem in pregnancy and the postnatal periods that sets out the treatment options and the roles of all healthcare professionals.”
For further information, please contact the RCOG Media and PR team on +44 20 7772 6300 or email email@example.com.
Please see the RCOG’s Good Practice guidance on management of women with mental health issues during pregnancy and the postnatal period.