Practice overview
Care across a changing reproductive timeline
Treatment decisions should reflect the individual's psychiatric history, current symptoms, reproductive stage, preferences, support system, medical context, and the risks of both treatment exposure and untreated illness.
- Care model
- Longitudinal psychiatric care coordinated closely with obstetrics, pediatrics, and lactation support
- Typical pace
- Visit frequency increases across pregnancy and the early postpartum period, with rapid escalation pathways for acute presentations
- Population
- Individuals who are preconception planning, pregnant, or postpartum, and their infants
Common presentations
- Preconception psychiatric planning and counseling
- Psychiatric illness onset or exacerbation during pregnancy
- Perinatal depression, anxiety, and OCD
- Bipolar disorder in the perinatal period
- Postpartum psychosis
- Medication safety questions across pregnancy and lactation
PMHNP priorities
- Weigh risks of untreated illness against medication and fetal or neonatal exposure risks
- Use current, specific evidence when addressing medication safety in pregnancy and lactation
- Recognize postpartum psychosis and initiate immediate emergency action
- Include sleep protection and parent-infant bonding in the treatment plan
- Coordinate closely with obstetric and pediatric care
Care team
Reproductive psychiatrists, PMHNPs, obstetricians, maternal-fetal medicine clinicians, pediatricians, lactation consultants, doulas, and postpartum support services.