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Perinatal Mood and Anxiety Disorders (PMAD)


Perinatal Mood and Anxiety Disorders (PMAD) refer to mood and anxiety symptoms that can occur during pregnancy or up to one year postpartum. 

Many women experience some mild mood changes during or after the birth of a child, including postpartum “blues,” which occur in 50 - 80% of women.  However, 15 - 20% of women experience more significant symptoms of depression or anxiety. 

Women of every culture, age, income level and race can develop perinatal mood and anxiety disorders. Symptoms can appear at any time during pregnancy and the first 12 months after childbirth. Risk is higher with parents facing financial hardship, poor social support, teen pregnancy, and mothers of NICU infants.  While many PMAD disorders are underdiagnosed, there are effective and well-researched treatment options (including counseling, support groups, and medications) to help women recover. 

Although the term “postpartum depression” is often used, there are several forms of illness that women may experience, including: 

  • Depression During Pregnancy & Postpartum 
  • Anxiety During Pregnancy & Postpartum 
  • Obsessive-Compulsive Disorder (OCD) During Pregnancy or Postpartum 
  • Postpartum Post-Traumatic Stress Disorder 
  • Postpartum Panic Disorder 
  • Bipolar Mood Disorders 
  • Postpartum Psychosis 

Untreated maternal mental illness can have lasting effects on mothers, infants, and families; and can impact child development and well-being. 

Periodic psychosocial screening is recommended by the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, and the American Academy of Pediatrics.  While no national guidelines exist regarding recommended screening intervals, many experts recommend that screening should occur at: 

  • Preconception 
  • Every trimester during pregnancy 
  • Well baby visits in the 1st year 

Two widely used, validated, screening tools are available online at no charge:

The Perinatal Mood and Anxiety Disorders:  Maternal Screening and Care Pathway was developed to assist Health Care Providers in Orange County with incorporating routine PMAD screening into clinical practice. The Orange County Perinatal Council anticipates that improved PMAD screening accompanied by early referral to community mental health services will result in better maternal and infant outcomes.

The Orange County Perinatal Mental Health Toolkit was developed by the Orange County Perinatal Mood and Anxiety Disorders (OC PMAD) Collaborative to build the foundation for a perinatal mental health system of support. The toolkit contains local resources, evidence-based tools, and recommendations to assist healthcare and service providers in offering education, preventive interventions, screening, referral, and treatment for new and expecting parents. Updates to this toolkit will be made yearly. For specific inquiries regarding mental health services and treatment programs for non-perinatal adults and children, contact 1-855-OC-LINKS (1-855-625-4657).