An estimated one in five childbearing persons in the U.S. experience a mental or substance use disorder before, during, or after pregnancy each year. With support from the CDC Foundation, APA has developed a series of educational materials for addressing perinatal mental health. This toolkit includes four fact sheets for patients: for people planning to become pregnant, for pregnant persons, for postpartum people, and suggestions for preparing for medical appointments.

Planning to become pregnant. If you have a mental health condition, like depression or anxiety or a substance condition, such as tobacco or alcohol dependence, and are planning to become pregnant, you should talk with your doctor. Tell your doctor about your condition, history, circumstances and concerns, and ask about what to expect and treatment options. See more in the fact sheet for Persons with Mental Health and Substance Use Conditions Who are Planning to Become Pregnant (.pdf).

Pregnant. If you have a mental health or substance use condition and are pregnant, there are important steps that you can take to have a healthy pregnancy and baby. These conditions can be treated with counseling, medicines, and recovery support during pregnancy, along with good prenatal care. Regular communication between the healthcare professionals treating your mental health and substance use conditions and those supporting your pregnancy is very important. Read more in the fact sheet for Pregnant Persons with Mental Health and Substance Use Conditions (.pdf).

Postpartum People. About 15% of mothers experience postpartum psychiatric conditions like depression, anxiety or psychosis. Early diagnosis and management of postpartum mental health and substance use conditions are vital for the health of the mother and the baby. These mental health conditions can significantly impact all aspects of a mother's life and interactions, including with the infant, partner and family. Read more in the fact sheet for Persons Who Develop Mental Health or Substance Use Conditions Within a Year of Giving Birth (.pdf).

Preparing for a Medical Appointment

Preparing ahead of time for an appointment can help you to better advocate for yourself and have greater participation in your treatment, and lead to better outcomes. Some suggestions to help you prepare include:

• Learn more about mental health conditions. Some useful and reliable websites include:
  • American Psychiatric Association – Patients and Families
  • National Institute on Mental Health – Health Topics
  • National Institute on Drug Abuse - Substance Use in Women
  • National Institute on Alcohol Abuse and Alcoholism – Alcohol’s Effect on Health
• Assemble your complete medical history, including prior diagnosis, symptoms and a list of current and past medications and over-the-counter supplements with doses and side effects.
• List your questions and concerns ahead of time.
• Ask for a shared decision-making approach. You can ask your clinician if they will include your thoughts and priorities when making your treatment plan.
• Tell your clinicians about your hopes and goals for treatment.
• If there is anything you do not understand about your diagnosis or recommendations for treatment, ask questions and ask for clarification.
• Tell your clinician if you are concerned that you may not be able to follow certain treatment recommendations for any reason, such as cost or inconvenience, so you can find solutions together.

The toolkit also includes resources aimed at mental health practitioners, comprising four factsheets, a white paper, and a series of four webinars. The white paper highlights the link between untreated perinatal mental health issues and adverse outcomes for both parent and child. It stresses the need for better screening, prevention, and treatment for perinatal mental and substance disorders. Training gaps in behavioral health professionals affecting perinatal outcomes are highlighted, with recommendations for improved education and credentialing to build a skilled and self-assured workforce for perinatal care.This initiative was informed by a 21-member advisory panel of psychiatrists and other mental health practitioners such as psychologists, nurse practitioners, social workers and counselors (under the leadership of Diana Clarke, Ph.D., Managing Director, Division of Research who is the Principal Investigator of this initiative) with expertise in perinatal mental health.

All of the patient and clinician resources are available at Perinatal Mental Health Toolkit. See more about Perinatal Depression.

Note: The project described above (Mental Health Needs Assessment in the Management of Perinatal Psychiatric Disorders) is partially supported by funding from the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) grant #NU38OT000288. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of, nor an endorsement by HHS/CDC or the CDC Foundation.