In Reply: Perinatal depression

We thank Dr. Laflamme for her insightful letter regarding our article.

We wholeheartedly agree that earlier contact with obstetric-care providers, such as during “fourth trimester” contact, is ideal. We also encourage all obstetric providers to screen at least at the 6-week in-person postpartum visit.

Her second point, that family medicine physicians are well-positioned to identify and treat perinatal depression, is also excellent. We agree, and we encourage all family medicine physicians to educate themselves on the basics of psychiatric treatment during pregnancy and lactation.

There is a good deal of misinformation on the safety of psychiatric medications during pregnancy and lactation, and we recommend that all frontline providers, including internal medicine, family medicine, and OB-GYN physicians, as well as pediatricians, receive education on this topic.

To that end, the International Marcé Society for Perinatal Mental Health is supporting a curriculum in reproductive psychiatry. This ongoing project developed by leaders in reproductive psychiatry aims to educate all frontline providers on these important issues.

With more-complex psychiatric issues during pregnancy or the postpartum period, or when there is a complicated history of prior mental illness, reproductive psychiatrists are available for consultations to primary care providers.

Thank you for this addition to the discussion.

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