PERINATAL MENTAL HEALTH CONDITIONS
For the purpose of this bundle, perinatal mental health conditions refer to mood, anxiety, and anxiety-related disorders that occur during pregnancy or within one year of delivery and are inclusive of mental health conditions with onset that predates pregnancy. The bundle provides actionable steps that can be adapted to a variety of facilities and resource levels to improve quality of care and outcomes for patients with perinatal mental health conditions.
Patient Safety Bundle Documents
Patient Safety Bundle
Element Implementation Details
Implementation Resources
Patient Safety Bundle
Element Implementation Details
Implementation Resources
Data Collection Plan
Change Package
Learning Modules
Data Collection Plan
Change Package
Learning Modules
QUICK LINKS
READINESS
Every Unit
- Develop workflows for integrating mental health care into preconception and obstetric care before pregnancy through the postpartum period including provision of pharmacotherapy when indicated, including: *
- Identify mental health screening tools to be integrated universally in every clinical setting where patients may present. *
- Establish a response protocol based on what is feasible for each area of practice and local mental health resources.
- Educate clinicians, office staff, patients, and patients’ designated support networks on optimal care across the preconception and perinatal mental health pathway including prevention, detection, assessment, treatment, monitoring, and follow-up best practices. *
- Facilitate trauma-informed trainings related to perinatal mental health conditions.
- Develop and maintain a set of referral resources and communication pathways between obstetric providers, community-based organizations, and state and public health agencies to address patient needs, including social factors of mental and physical health. *
*See Perinatal Mental Health Conditions Element Implementation Details (PDF)
RECOGNITION & PREVENTION
Every Patient
- Screen for perinatal mental health conditions consistently throughout the perinatal period, including but not limited to:
- Obtain individual and family mental health history at intake, with review and update as needed. *
- Screen for depression and anxiety at the initial prenatal visit, later in pregnancy, and at postpartum visits, ideally including pediatric well-child visits. *
- Screen for bipolar disorder before initiating pharmacotherapy for anxiety and depression. *
- Screen for structural and social factors of health that may impact clinical recommendations or treatment plans and provide linkage to resources.
*See Perinatal Mental Health Conditions Element Implementation Details (PDF)
RESPONSE
Every Event
- Initiate an evidence-based, patient-centered response protocol that is tailored to condition severity and responsive to the patient’s values and needs: *
- Activate an immediate suicide risk assessment and response protocol as indicated for patients with identified suicidal ideation, significant risk of harm to self/others or psychosis.
- Establish care pathways that facilitate coordination and follow-up among multiple providers throughout the perinatal period for pregnant and postpartum patients referred to mental health treatment. *
*See Perinatal Mental Health Conditions Element Implementation Details (PDF)
REPORTING & SYSTEMS LEARNING
Every Unit
- Incorporate mental health into multidisciplinary rounding to establish a non-judgmental culture of safety.
- Convene inpatient and outpatient providers in an ongoing way to share successful strategies and identify opportunities for prevention and evaluation of undesired outcomes related to perinatal mental health. *
- Identify and monitor data related to perinatal mental health care with disaggregated data to support analysis.
*See Perinatal Mental Health Conditions Element Implementation Details (PDF)
RESPECTFUL, SUPPORTIVE & PATIENT-CENTERED CARE
Every Unit/Provider/Team Member
- Include each pregnant and postpartum patient and their identified support network as respected members of and contributors to the multidisciplinary care team. *
- Engage in open, transparent, empathetic, and trauma-informed communication with pregnant and postpartum patients and their identified support network to understand diagnoses, options, and treatment plans.
*See Perinatal Mental Health Conditions Element Implementation Details (PDF)
Additional Resources
Implementation Webinar (Video)
National Maternal Health Hotline
Bundle Element Context and Reference List (xlsx)
Perinatal Mental Health Conditions REDCap Template
Implementation Webinar (Video)
National Maternal Health Hotline
Bundle Element Context and Reference List (xlsx)
Perinatal Mental Health Conditions REDCap Template
Additional Resources
Patient Safety Bundle – Spanish (PDF)
Element Implementation Details – Spanish (PDF)
Implementation Resources – Spanish (PDF)
Data Collection Plan – Spanish (PDF)
Data Collection Plan – French (PDF)
Implementation Resources – French (PDF)
Patient Safety Bundle – French (PDF)
Patient Safety Bundle – Spanish (PDF)
Element Implementation Details – Spanish (PDF)
Implementation Resources – Spanish (PDF)
Data Collection Plan – Spanish (PDF)
Data Collection Plan – French (PDF)
Implementation Resources – French (PDF)
Patient Safety Bundle – French (PDF)
Patient Safety Bundle Acknowledgements
- This Patient Safety Bundle was originally developed by the Alliance for Innovation on Maternal Health in collaboration with Ariela Frieder, MD; Barbara Hackley, PhD, RN, CNM; Camille Hoffman, MD, MSCS; Pec Indman; Lisa Kay; John Keats*, MD, CPE, FACOG; Sue Kendig, JD, MSN, WHNP*; Emily Miller, MD, MPH; Tiffany Moore Simas, MD, MPH, Med; Kisha Semenuk, MSN, RN; Katherine Wisner, MD, MS; Chris Raines, MSN, RN, WHCNP.
- This patient safety bundle was revised by Nancy Byatt, DO, MS, MBA, FACLP; Camille Hoffman, MD, MSCS; John Keats, MD, CPE, FACOG; Sue Kendig, JD, MSN, WHNP; David Laflamme, PhD, MPH; Emily Miller, MD, MPH; Tiffany Moore Simas, MD, MPH, Med.
- The California Maternal Quality Care Collaborative, Amritha Bhat, MD, MPH, Connecticut Hospital Association, Illinois Perinatal Quality Collaborative, and Policy Center for Maternal Mental Health reviewed and provided feedback on this document.
©️ 2025 American College of Obstetricians and Gynecologists. Permission is hereby granted for duplication and distribution of this document, in its entirety and without modification, for solely non-commercial activities that are for educational, quality improvement, and patient safety purposes. All other uses require written permission from ACOG.
