Perinatal mental health issues: early recognition and management in primary care

Abstract

Perinatal mental health is a major public health issue. Around 12% of women experience depression and 13% experience anxiety during pregnancy and up to one in five experience depression and/or anxiety in the first year after childbirth. Fathers, partners or co-parents can also develop perinatal mental health issues, while unrecognised or untreated parental mental health conditions can negatively affect early child development. Most women who experience perinatal mental health issues are managed in primary care, however some require referral to specialist services.This article outlines the role of primary care professionals, such as community nurses, midwives and health visitors, in the early recognition and management of perinatal mental health issues. It describes how symptoms of depression and anxiety may manifest in the perinatal period and the presenting symptoms of postpartum psychosis, and details assessment and referral processes. The author suggests explorative questions that can be incorporated into discussions about mental health with future and new parents and describes a simple mnemonic that may assist primary care professionals in providing emotional support to families.