Conclusion
Obstetricians will frequently be involved in the care of women with the new onset or recurrence of a psychiatric illness. There are significant barriers to care for women with psychiatric disorders in the perinatal period.
Universal screening for the most prevalent disorders, depression and anxiety, but also for eating disorders and substance abuse has been advocated but remains controversial. What is not in doubt, however, is that a woman's mental health is as important as her physical health in pregnancy and all healthcare professionals should be making an assessment of her mental health at each contact. Women with chronic and recurrent psychiatric disorders require monitoring, increased contact, and multidisciplinary, coordinated care, including a specific mental health management plan. Women with psychiatric disorders often present with significant medical comorbidities and environmental stressors that both need to be addressed. Care should be provided in a nonjudgemental, compassionate way, and involve, if the woman agrees, her partner and wider family.
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