Normalizing Discussions About Maternal Mental Health

• Trauma-Informed Care Implementation Resource Center - Trauma-Informed Care Implementation Resource Center provides resources from trauma-informed care leaders across the country to help improve patient outcomes, increase patient and staff resilience, and reduce avoidable health care service use and costs.

• 1-833-TLC-MAMA Hotline Partner Toolkit | MCHB: The National Maternal Mental Health Hotline is a free 24/7 resource for patients and their families. This toolkit includes content for health care professionals and providers to promote the MMH Hotline through various platforms such as posters (some in different languages), newsletters, social media, workshops, and even direct client services.

• POEM’s (Perinatal Outreach & Encouragement for Moms) Perinatal Mental Health Screening Protocol and Briefing: A Culturally Responsive Framework for Screening with Black Birthing Persons: This framework for culturally responsive screening was created in collaboration with Black birthing people, Black birth workers, perinatal service providers throughout Ohio, and the POEM Program of Mental Health America of Ohio. A literature review and primary data from focus groups and interviews with Black birthing persons and birth workers/clinicians also informed recommendations to the protocol.  

• Summary of Perinatal Mental Health Conditions (PDF): This document provided by Lifeline for Moms is a detailed summary of various perinatal mental health conditions, including their definitions, onset, risk factors, duration, prevalence, symptoms, and treatment options. 

Recommendations for screening maternal mental health conditions 

• ACOG Clinical Practice Guideline #4: Screening and Diagnosis of Mental Health Conditions During Pregnancy and Postpartum: This Clinical Practice Guideline outlines guidelines for the screening and diagnosis of perinatal mental health conditions including depression, anxiety, bipolar disorder, acute postpartum psychosis, and suicidality.

• The Policy Center for Maternal Mental Health Issue Brief: Universal Screening for Maternal Mental Health Disorders: Universal screening using validated tools is critical for early detection and treatment, yet implementation remains inconsistent. This document highlights the importance of universal MMH screening, recommended tools and protocols, challenges to implementation, and opportunities to improve care and outcomes for mothers and families.

Tools for screening maternal mental health conditions 

• ACOG’s Perinatal Mental Health Tool Kit: Screening: ACOG recommends that screening for perinatal depression and anxiety occur at the initial prenatal visit, later in pregnancy, and at postpartum visits using a standardized, validated instrument. Highlights of the Tool Kit include how to talk to patients about their mental health and screening as well as recommendations for administering and scoring screening tools. An overview of suggested tools is included.   

• Lifeline for Moms: Resources for Integrating Perinatal Mental Health Care into Obstetric Settings: These resources include an Overview Guide and supporting materials to help obstetric settings implement perinatal mental health care into everyday workflow.

• Lifeline for Moms: Assessing Perinatal Mental Health: This clinical guide from Lifeline for Moms outlines evidence-based screening tools and treatment pathways for perinatal depression, anxiety, PTSD, and bipolar disorder, helping providers assess severity and initiate appropriate care.

• Lifeline for Moms: Assessing Risk of Harm to Baby: This Lifeline for Moms resource helps providers evaluate intrusive thoughts and assess risk levels for potential harm to infants, distinguishing between anxiety related symptoms and those associated with psychosis, and guiding appropriate treatment and safety planning.

• Lifeline for Moms: Assessing Risk of Suicide: This Lifeline for Moms guide supports providers in evaluating suicidal thoughts and behaviors in perinatal patients, offering structured questions, risk stratification, and intervention strategies based on severity to ensure safety and appropriate care.

• Assessing for Bipolar Affective Disorder Before Beginning an SSRI: Perinatal Psychiatrist Melissa Wagner, MD PhD, faculty for the OPQC and Ohio Department of Medicaid Maternal Mental Health Quality Improvement Project, highlights the importance of assessing patients for bipolar disorder (BD) if an SSRI medication is being considered for treatment of moderate or severe depression.

Recommendations for treatment of maternal mental health conditions 

• Lifeline for Moms Toolkit was developed by the UMass Chan Medical School to provide healthcare providers actionable information, algorithms, and clinical pearls to support detection, assessment, and treatment of perinatal mood and anxiety disorders.

• Lifeline for Moms: Follow-Up Treatment of Perinatal Mental Health Conditions: This resource from Lifeline for Moms provides guidance on monitoring treatment progress, adjusting medications, and supporting recovery for individuals with perinatal mental health conditions, including recommendations for adjunctive care and care coordination.

• ACOG Perinatal Mental Health Tool Kit: Assessment and Treatment of Perinatal Mental Health Conditions: This section of the Tool Kit contains recommendations on treatment and management of perinatal mental health conditions including depression, anxiety, bipolar disorders, and acute postpartum psychosis, with a focus on psychopharmacotherapy.