Abstract
Prevention or treatment of most postnatal psychological disorders currently demands the manipulation of psychosocial not biological variables. How we treat women matters in terms of the emotional outcome of pregnancy and ultimately the family outcome. This is confirmed by two types of studies. Firstly, there are the controlled trials of psychological strategies aimed at the prevention or treatment of postnatal mood disturbance. Secondly, there are the studies of the relationship between the type of obstetric and midwifery care and emotional well-being following the birth. There have been far too few of either type of study. Since the rapid advances in medicine which relate to physical outcome have peaked, with mortality rates at an all-time low, the 1990s should see more clinical and research effort devoted to psychological outcomes. Perhaps some progress can now be made in reducing postnatal psychiatric and psychological morbidity.
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