Consider electroconvulsive therapies when a postnatal woman/birthing parent with severe depression has not responded to one or more trials of antidepressants of adequate dose and duration.

 

 

Consider electroconvulsive therapies as first-line treatment for postnatal women/birthing parents with severe depression especially where there is a high risk of suicide or high level of distress, when food or fluid intake is poor, and in the presence of psychotic or melancholic symptoms.

 

In pregnant women/birthing parents, electroconvulsive therapies should only be undertaken in conjunction with close fetal monitoring (using cardiotocography to monitor fetal heart rate), specialist pregnancy anaesthetic care and access to specialist maternal-fetal medical support.