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Keywords:

  • postpartum psychosis;
  • puerperal psychosis;
  • mood disorders;
  • bipolar disorder

Key content

  • Postpartum psychosis is a severe mental illness with a dramatic onset shortly after childbirth.
  • All women should be screened antenatally for the known risk factors.
  • Women with bipolar disorder have at least a 1 in 4 risk and need close contact and review during the perinatal period even if they are well.
  • Prompt recognition of the illness and rapid institution of treatment are of vital importance.

Learning objectives

  • To recognise women at high risk for severe postpartum mental illness.
  • To recognise and appreciate the severity of postpartum psychosis and the need for prompt assessment and treatment.

Ethical issues

  • Who should ultimately make decisions about taking medications in pregnancy – the clinician or the woman and her family?
  • What advice should a woman at high risk of postpartum psychosis be given if she is considering pregnancy?