Well informed midwives can help: perinatal mental health

The Confidential Maternal and Child Enquiry (CMACE) has firmly put maternal mental health at the forefront of maternity care (CMACE 2011). Twenty nine deaths by suicide were reported and over half of these women were married or in stable cohabitation, 30 years of age or older and had a psychiatric history. Given the predictive nature of psychiatric conditions in pregnancy, midwives need to be enabled to identify women at risk, and assess and refer women appropriately. The aim of this article is to give midwives an overview and understanding of the predictability and detectability of perinatal mental illness; to explore some of the tools available; to enable midwives to assess women appropriately for referral; and to address the issue of medication in pregnancy and whilst breastfeeding.