Perinatal mental health

Our perinatal mental health service is available to support women and their families during pregnancy, birth and the first year after birth (also called the perinatal period). We aim to detect, prevent and treat perinatal mental illness and allow women time to consider the treatment and support options available to them.

We work collaboratively with women, their families and other healthcare professionals to plan care for pregnancy and the early postnatal period. The healthcare professionals we work in partnership with can include other maternity services, psychology, children and families’ social services and GPs. 

Pregnancy and childbirth are significant life events that involve complex physiological and hormonal changes on a backdrop of emotional adjustment. The perinatal period presents a risk of the development of mental illness or the relapse of pre-existing mental illness.  Depression and anxiety are the most common mental health problems.
 
Anxiety disorders include:
  • Panic disorder
  • Generalised anxiety disorder
  • Obsessive compulsive disorder
  • Post-traumatic stress disorder 
Post-partum psychosis
Post-partum psychosis (psychosis after childbirth) affects approximately one in every 1000 women who give birth.  Women with a diagnosis of bipolar affective disorder or who have a family history of bipolar illness/postpartum psychosis are at high risk, but it can occur in women with no previous psychiatric history. 
 
It usually occurs shortly after birth and symptoms can come on suddenly.  These include perplexity, confusion, rapidly changing mood, with accompanying fleeting delusions and hallucinations.  Post-partum psychosis is a psychiatric emergency requiring urgent treatment, often with admission to a mother and baby unit.  

Maternal mental illness can have serious consequences on the mother-infant relationship and the emotional state of the infant. There are longer term effects on childhood social attachments and cognitive development. There can be wider disruption to relationships and families.

Treatment with psychotropic medication in pregnancy is effective, but requires an individualised risk benefit analysis, weighing up the risks to the unborn baby against potential benefits to the mother.  Consideration must also be given to whether the mother intends to breastfeed. There is therefore a lower threshold for referral to psychological services including counselling, cognitive behaviour therapy, psychotherapy and parent-infant psychotherapy.

Referrals

Referrals are accepted from all healthcare professionals.

Clinics

Our team operates Monday to Friday, 9am-5pm. The perinatal nurse specialist can be contacted on the team mobile phone. 

Outside of usual working hours cover is provided by emergency services including the mental health liaison team.  

Perinatal mental health clinics
Monday and Tuesday afternoons, 2-5pm

Perinatal mental health team

Dr Lucinda Donaldson, consultant perinatal psychiatrist
Ms Ola Ajala, clinical nurse specialist
Dr Abi Smith, specialty trainee
Dr Navanthi Ratnayake, special interest higher trainee

Location

Antenatal Clinic, Level 5, Kenwood Wing, The Whittington Hospital, Magdala Avenue, London N19 5NF

Contact

020 7561 4142 or 07774 629071 (Monday to Friday, 9am-5pm)

Working on it!