Before pregnancy
A preconception review can examine current medicines, previous episodes, relapse risk, physical health and the support plan. It is especially important after severe depression, mania, psychosis or a previous perinatal episode.
Pregnancy · after birth · maternal mental health
Mental Health During Pregnancy and After Birth
Pregnancy and the first year after birth can change the presentation, risk and treatment of mental-health problems. Good care weighs the wellbeing of the mother and baby together, including the risks of untreated illness as well as the known and uncertain risks of treatment.
A structured approach
Care should be planned, not improvised
During pregnancy
Assessment considers symptoms, functioning, obstetric care, sleep, safety, substance use, domestic abuse and the person's preferences. Treatment may include psychological care, medication or specialist input.
After birth
Low mood, anxiety and intrusive thoughts are common reasons to seek help. Severe confusion, marked agitation, rapidly reduced sleep, unusual beliefs or hallucinations after childbirth require urgent assessment.
What assessment covers
The person, the pattern and the context
A page can explain the framework. It cannot decide whether a diagnosis applies or which treatment fits an individual.
- Current symptoms, safety and the impact on eating, sleep, self-care and caring for the baby.
- Previous mental-health episodes, treatment response and family history of severe perinatal illness.
- Medication exposure, breastfeeding plans, physical health and other medicines.
- Support at home, relationship stress, trauma, domestic abuse and practical pressures.
Medication education
Medication decisions in pregnancy and breastfeeding
This page deliberately does not turn pregnancy into a list of supposedly safe or unsafe drugs. The same medicine can carry a different balance for two people because diagnosis, previous relapse, pregnancy stage, dose, other medicines, obstetric history and feeding plans all matter.
Do not stop automatically
Abruptly stopping an effective medicine can cause withdrawal or relapse. A positive pregnancy test should prompt an individual review, not an unsupervised stop.
Compare both sets of risk
The discussion includes what is known and uncertain about exposure, and the risks of untreated depression, anxiety, bipolar disorder, psychosis or severe insomnia.
Plan after birth as well
Delivery, sleep loss, breastfeeding, previous postpartum episodes and early-warning signs belong in the same written plan rather than being left until a crisis.
For condition-specific questions, monitoring and the risk-benefit framework, read the dedicated psychiatric medication in pregnancy and breastfeeding guide. It remains education, not an instruction to continue or stop a particular medicine.
What this page does not imply
It is not safe to assume that every medicine must be stopped in pregnancy, or that every medicine is safe. Do not stop an effective psychiatric medicine abruptly after a positive pregnancy test. Ask for an individual risk-benefit discussion.
When routine care is not enough
After childbirth, severe confusion, hallucinations, unusual beliefs, extreme agitation, rapidly worsening mood, an inability to sleep despite opportunity, thoughts of harming yourself or the baby, or an inability to keep either of you safe need same-day emergency assessment.
Medication in pregnancy and breastfeedingContinue →Read the postpartum depression guideContinue →Book a structured consultationContinue →