Tokophobia

 

Offer a woman/birthing parent with tokophobia an opportunity to discuss their fears with a healthcare professional with expertise in providing perinatal mental health support. Support may be provided by a specialist midwife in perinatal mental health or maternity and neonatal psychological intervention service where available.

Anxiety disorders

 

Offer women/birthing parents with persistent subthreshold symptoms of anxiety in pregnancy or the postnatal period facilitated self help such as CBT-based self-help materials with facilitated support.

 

 

Offer women/birthing parents with anxiety a low-intensity psychological intervention, in line with treatment recommended for the specific type of anxiety disorder they have. Progress should be monitored closely and if there is no improvement within 2 weeks offer referral for a high-intensity psychological intervention.

 

Offer women/birthing parents with social anxiety disorder high-intensity treatment.

Low-intensity interventions are delivered by a trained coach or facilitator (rather than a therapist) to enable use of self-help materials. High-intensity therapies are delivered by specialists.

Advise women/birthing parent with depression or anxiety disorder in the postnatal period of the possible benefits of directive counselling. 

 

Depending upon the woman’s post-traumatic stress symptoms, consider the use of adjunctive pharmacological treatments.

Depression

 

Offer facilitated self help to women/birthing parents with persistent subthreshold depressive symptoms or mild-to-moderate depression in pregnancy or the postnatal period.

 

Provide structured psychoeducation to women/birthing parents with symptoms of depression in the perinatal period. 

 

 

Advise women/birthing parents with symptoms of depression in the postnatal period of the potential benefits of a social support group. 

 

Recommend individual structured psychological interventions (cognitive behavioural therapy or interpersonal psychotherapy) to women/birthing parents with mild-to-moderate depression in the perinatal period. 

 

 

Consider online approaches for delivery of cognitive behavioural therapy. This needs to be appropriate and acceptable to the service user.

 

Advise women/birthing parent with depression in the postnatal period of the possible benefits of directive counselling. 

 

 

For women who have or are recovering from postnatal depression and are experiencing mother/birthing parent-infant relationship difficulties, consider provision of, or referral for, individual mother/birthing parent-infant relationship interventions.