Follow Up Support

Depression is easily detected by screening during antenatal and postpartum visits. A study by Katon et al found that a program of collaborative depression care adapted to obstetrics and gynecology setting had a greater impact on depression outcomes than usual care. For screening to be effective, systems must be in place to ensure accurate diagnosis and effective treatment and follow-up for women with positive screening results. If collaborative care is not an option, clinicians should have appropriate mental health referrals available.

The New York State Office of Mental Health’s Postpartum Depression Screening Report emphasizes that screenings must be paired with timely follow-up evaluation, diagnosis, and referral. Providers are encouraged to use validated tools and ensure that systems are in place to support ongoing care after a positive screen, including treatment or connection to community and behavioral health services.

Treatment Options

Currently, there are no national guidelines specific to the treatment of postpartum depression, and treatment should be tailored to the individual patient based on symptom severity, treatment history and breastfeeding status. Treatment may be provided by a primary care provider and/or a mental health professional. A number of resources including guidelines, toolkits and trainings are available to help clinicians incorporate screening and management of maternal depression within their practices.

  • ACOG issued a Clinical Practice Guideline in 2023 which, includes recommendations on treatment and management of perinatal mental health conditions including depression, anxiety, bipolar disorders, and acute postpartum psychosis, with a focus on psychopharmacotherapy.

Various psychotherapy methods have been found to be effective in treating mild to moderate depression. Interpersonal Psychotherapy (IPT), Cognitive Behavioral Therapy (CBT) and psychodynamic therapies have all demonstrated efficacy for postpartum depression. If possible, a combination of medication and psychotherapy is most beneficial. Pharmacotherapy is the treatment of choice in women with moderate to severe depression, particularly in women with a history of depression. Clinical trials have found that SSRIs are effective with fewer side effects and less sedation for nightly infant feedings than other treatment options. The clinician must be guided by patient preferences, patient treatment history and breastfeeding status. Some antidepressants are found in small amounts in breast milk. A guide to using specific medications during breastfeeding may be found at the National Institutes of Health, Health and Human Services, Drugs and Lactation Database -https://www.ncbi.nlm.nih.gov/books/NBK547437/for women who are pregnant or breastfeeding, consultation with a perinatal psychiatrist or clinician knowledgeable about the latest research on the use of psychotropic medications during pregnancy and breastfeeding is warranted. One important caveat to treatment is that 15% of mothers with PPD are misdiagnosed, and later diagnosed with bipolar disorder. Antidepressants must be added cautiously and the patient should be monitored for symptoms of hypomania.

Non-clinical interventions such as rest, exercise, and social support strategies (such as support groups) may also be helpful. Psychoeducation is an important aspect of treatment. Social support for the mother should include communication with the other parent and other family members, as appropriate and consistent with patient confidentiality. Asking the partner to attend one or two therapy sessions can provide psychoeducation and help address problems between the couple, including those resulting from maternal depression. Community organizations such the Postpartum Resource Center of New York provide important education and support for mothers and their partners.

A number of resources – including guidelines, toolkits and trainings – are available to help clinicians incorporate screening and management of maternal depression within their practices.

Emergency Resources

If a woman is thinking about harming herself or her infant, help is needed immediately. If there is imminent danger to someone's life, call 911.

For women in crisis who need immediate help, state and local hotlines are available as resources for both health care providers and families:

The Office of Mental Health (OMH) operates psychiatric centers across the state, and regulates, certifies and oversees more than 4,500 programs operated by local governments and nonprofit agencies. These programs include various inpatient and outpatient programs, emergency services, community support, and residential and family care programs.

A directory of OMH-licensed providers by county is available through the OMH Website

The directory is a searchable list of programs licensed or funded by OMH. Users can:

  • Search for mental health programs by county or program category
  • View program details such as program name, address and phone number
  • Click on any county on the map to view all programs in that county

To schedule an appointment for a program in your county, please contact the program directly. For further information or assistance, you may also contact your County Department of Mental Hygiene.

In addition, Non-governmental organizations in New York State provide information, referrals and other resources specific to maternal depression, and may be a useful resource for health care providers and families. The Postpartum Resource Center of New York, Inc. isa nonprofit organization that promotes maternal depression awareness in New York State, and provides resources for parents, families, healthcare providers, and communities to help address mental health and parenting with psychiatric disabilities. The Center also provides services, training and support for women and families dealing with or are at risk for prenatal or postpartum depression.