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, PHQ0, GAD-7)¹.
Screening should be complemented with a clearly defined and locally tailored referral process¹.

Edinburgh Postnatal Depression Scale (EPDS)

Patient Health Questionnaire (PHQ-9)

Generalized Anxiety Disorder (GAD-7)

Additional Resources

General Considerations for PMAD Treatment

Recommendations for treatment are outlined in the Care Pathway Document.

General considerations for PMAD treatment include:

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

Patient Handouts and Resources

Canadian Network for Mood and Anxiety Treatment (CANMAT)
- Patient and family guide: Seeds of Hope – Nurturing Mental Health and Managing Perinatal Mood, Anxiety, and Related Disorders.
- Aims to equip and empower individuals with accessible and practical information about perinatal mental health.
North Bay Parry Sound District Health Unit
- Information on Postpartum Mood Disorders. Includes information on baby blues, perinatal mental health disorders, fathers' mental health, and what individuals/support persons can do.
- A list of mental health services for individuals who are Pregnant, Postpartum and Families with a Baby.
Best Start
- Printable handout to help individuals recognize if they have symptoms of anxiety or depression during pregnancy or postpartum. Includes information on where to get help. Also available in French.
- 12 page brochure providing pregnant individuals and new parents with information on the baby blues and postpartum mood disorders. Also available in French.

Clinical References

Society of Obstetricians and Gynaecologists of Canada (SOGC)
- 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/