Perinatal mental illness is a significant complication of pregnancy and the postpartum period. These disorders include depression, anxiety disorders, and postpartum psychosis, which usually manifests as bipolar disorder. Perinatal depression and anxiety are common, with prevalence rates for major and minor depression up to almost 20% during pregnancy and the first 3 months postpartum. Postpartum blues are a common but lesser manifestation of postpartum affective disturbance. Perinatal psychiatric disorders impair a woman’s function and are associated with suboptimal development of her offspring. Risk factors include past history of depression, anxiety, or bipolar disorder, as well psychosocial factors, such as ongoing conflict with the partner, poor social support, and ongoing stressful life events. Early symptoms of depression, anxiety, and mania can be detected through screening in pregnancy and the postpartum period. Early detection and effective management of perinatal psychiatric disorders are critical for the welfare of women and their offspring.

Types of perinatal disorders

Perinatal depression

Perinatal depression is defined in various ways. At one end of the spectrum, perinatal depression is defined symptomatically as exceeding a threshold on a screening measure, such as the Edinburgh Postnatal Depression Scale.

Postpartum anxiety disorders

A wide range of anxiety disorders are prevalent in the perinatal period. These include generalised anxiety, obsessive–compulsive, panic, and social anxiety disorders.

Postpartum psychosis: bipolar disorder

The obstetrician–gynecologist may be the first healthcare professional that a woman with postpartum psychosis, or more likely her distressed family, contacts. The incidence of postpartum psychosis is one or two per 1000 births. The symptom patterns in women with postpartum psychosis have consistently been reported to differ from women with psychosis not related to childbearing.

Postpartum blues

In the first week or so after delivery, it is common for women to experience a variety of physical discomforts and symptoms that have been characterized as the ‘postpartum blues’ or ‘baby blues’. Prevalence estimates for the blues range from 26% [46] to 84% [47], reflecting more or less stringent criteria.