Making decisions in the management of perinatal depression and anxiety

Abstract

SummaryThe care of women with anxiety and depressive disorders in the perinatal period is complex. The literature in this field is vast and may be difficult for busy clinicians to keep abreast of. The first part of this article provides an overview of the potential risks and benefits of treatment options, including no treatment, at various stages in the perinatal period. The second part explores the frameworks which may assist clinicians in decision-making with their pregnant patients, including risk-benefit analysis, ethical considerations, evaluating capacity, and mental health legislation. The common pitfalls and limitations of these approaches are examined to guide good practice.LEARNING OBJECTIVES•Understand the potential risks and benefits of treating, or not treating, maternal mental illness at various stages in the perinatal period.•Understand the limitations of the literature in this field.•Be able to use different frameworks for deciding with patients about the management of mental illness in the perinatal period.

Beyond the ‘normal’ worries: detection and treatment of perinatal anxiety and anxiety disorders

“…This effect is reported to be greater for antenatal anxiety than for postnatal anxiety, and it increases further when there is comorbid depression (Rogers 2020). Thus, perinatal anxiety and depression both pose risks to maternal health, pregnancy outcomes and child development (Wand 2014). Therefore, the conditions should be adequately explored and treated.…”

“…The complexity of these situations requires a careful evaluation that takes into account the clinical, social, ethical and legal context. An exploration of these aspects can be found in Wand (2014).…”