Perinatal Mental Health Care Pathway

Care Pathway for Health Care Providers

Perinatal mood and anxiety disorders (PMAD) are a common complication during pregnancy and the first year after delivery. Health Care providers play an essential role in identifying PMAD and facilitating timely access to pharmacotherapy and/or psychosocial support and treatment¹.

Care Pathway Document

Various community partners have come together and created this local care pathway for the management of perinatal mental health.

See the Document

Screening Tools

Patients with risk factors for mood and anxiety disorders should be screened at least once during pregnancy and once during the postpartum period using a validated screening tool (i.e. EPDS, PHQ-9, GAD-7)¹.
Screening should be complemented with a clearly defined and locally tailored referral process¹.
Screening tools below are PDF fillable and printable.

Edinburgh Postnatal Depression Scale (EPDS) Fillable/Printable

Patient Health Questionnaire (PHQ-9) Fillable/Printable

Generalized Anxiety Disorder (GAD-7) Fillable/Printable

Additional Resources

Key Messages related to PMAD Treatment

Different treatment approaches/intensities may be required depending on the severity of illness and individual preferences¹
Perinatal care providers should provide information about psychosocial and community-based supports (in person, virtual, or hybrid models) with patients presenting with perinatal mental health concerns¹
Most of the common pharmacological agents used to treat perinatal mood and anxiety disorders are not teratogenic¹
Pregnant and postpartum individuals will benefit from counselling focused on shared decision making¹

General recommendations for treatment are outlined in the PMH Care Pathway Document.

For more information see CANMAT Clinical Practice Guidelines for the Management of Perinatal Mood, Anxiety and Related Disorders.

Patient Handouts

Self-Help Resources:

Clinical Resources

Society of Obstetricians and Gynaecologists of Canada (SOGC)
- Perinatal Mental Health for Health Care Providers
- Guideline No 454: Identification and Treatment of Perinatal Mood and Anxiety Disorders.
- Provides practical, evidence-based recommendations for OBGYNs, midwives, nurses, family doctors, and other health care providers who interact with pregnant and postpartum families.
Canadian Network for Mood and Anxiety Treatment (CANMAT)
- 2024 Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety, and Related Disorders.
- This guideline's evidence-based recommendations provide clinicians with key information to promote the delivery of effective and safe perinatal mental healthcare.
- It is intended to serve as a valuable tool for clinicians in Canada and around the world to help optimize clinical outcomes in the area of perinatal mental health.
Provincial Council for Maternal Child Health
- Perinatal Mental Health Guidance for the identification and management of mental health in pregnant or postpartum individuals is designed to support HCP's identify, direct, and monitor those who are pregnant or postpartum who may be experiencing difficulties with their mental health.
- Additional information and resources are available on their Perinatal Mental Health page.

Citations

[1] Shea, A., Jumah, N. A., Forte, M., Cantin, C., Bayrampour, H., Butler, K., Francoeur, D., Green, C., & Cook, J.(2024). Guideline No. 454: Identification and treatment of perinatal mood and anxiety disorders. Journal of Obstetrics and Gynaecology Canada, 46(10), 102696. https://doi.org/10.1016/j.jogc.2024.102696

[2] Vigod et al, S. N. (2025). Canadian Network for Mood and Anxiety Treatments 2024 Clinical Practice Guideline for the Management of Perinatal Mood, Anxiety, and Related Disorders. The Canadian Journal of Psychiatry. https://www.canmat.org/2025/02/12/available-now-canmat-2024-guidelines-for-perinatal-mood-anxiety-and-related-disorders-and-accompanying-patient-and-family-guide/