Antenatal and postnatal mental health

Summary

The advice in the NICE clinical guideline on mental health problems during pregnancy and after giving birth covers:

• recognising mental health problems during pregnancy and in the first year after giving birth
• the care and treatment (including drugs and psychological treatments) of women who develop a mental health problem during pregnancy or in the first year after giving birth, and women who have a higher chance of developing a problem at this time
• the care and treatment (including drugs and psychological treatments) of women who already had a mental health problem before becoming pregnant
• how families and carers may be able to support women with mental health problems and get support for themselves.

It does not specifically look at:

• the care of women with ‘baby blues’ in the first few days after giving birth (this is covered in the NICE guideline on postnatal care)
• the treatment of physical health problems during pregnancy and in the first year after giving birth
• the treatment of mental health problems at any time other than when planning a pregnancy, during pregnancy and in the first year after giving birth.

April 2007: Since publication, the recommendation on screening questions for depression has been corrected (this is recommendation 1.2.1.3 in the NICE guideline), and the guideline has been reissued. This recommendation now reads:

At a woman’s first contact with primary care, at her booking visit and postnatally (usually at 4 to 6 weeks and 3 to 4 months), healthcare professionals (including midwives, obstetricians, health visitors and GPs) should ask two questions to identify possible depression.
– During the past month, have you often been bothered by feeling down, depressed or hopeless?
– During the past month, have you often been bothered by having little interest or pleasure in doing things?

A third question should be considered if the woman answers ‘yes’ to either of the initial questions.
– Is this something you feel you need or want help with?

The electronic versions of the guideline on this website all contain the correct recommendation on screening. Hard copies of the corrected quick reference guide are being mailed to the NHS.

Documents

For healthcare professionals

• CG45 Antenatal and postnatal mental health: full guideline
• CG45 Antenatal and postnatal mental health: full guideline appendices
• CG45 Antenatal and postnatal mental health: quick reference guide
• CG45 Antenatal and postnatal mental health: NICE guideline
• CG45 Antenatal and postnatal mental health: NICE guideline (MS Word format)

For patients, carers and the public

• CG45 Antenatal and postnatal mental health: understanding NICE guidance
• CG45 Antenatal and postnatal mental health: understanding NICE guidance (MS Word format)
• CG45 Problemau iechyd meddwl yn ystod beichiogrwydd ac ar ôl rhoi genedigaeth

Background information

• 2007/011 NICE issues guidance to help detect and treat women with antenatal and postnatal mental health disorders

Implementing this guidance

Any further information NICE has produced to help the NHS implement this guideline locally is linked to below:

• Antenatal and postnatal mental health: costing template
• Antenatal and postnatal mental health: costing report
• Antenatal and postnatal mental health: presenter slides
• Antenatal and postnatal mental health: implementation advice
• Antenatal and postnatal mental health: audit criteria