Australian mental health reform for perinatal care

Marie-Paule V Austin, Philippa F Middleton and Nicole J Highet
Med J Aust 2011; 195 (3): . || doi: 10.5694/j.1326-5377.2011.tb03236.x
Published online: 1 August 2011

Improving health outcomes for mothers, children and families

Mental health morbidity associated with the perinatal period — from conception to the end of the first postnatal year — is now recognised as a major public health issue, with depression affecting up to 15% of women during this period.1 It has been reported that 45% of postnatal depression begins in pregnancy,2 and about 38% of women with postnatal depression have a comorbid anxiety disorder.3 About 3% of women experience moderate to severe depression during the perinatal period and 0.2% experience a puerperal psychosis,4 and maternal suicide continues to be identified as one of the leading causes of indirect maternal mortality.5 There is growing evidence of the negative impact of poor mental health outcomes not only for the mother, but also for her child and family.6

  • 1 St John of God Health Care, Sydney, NSW.
  • 2 School of Psychiatry, University of New South Wales, Sydney, NSW.
  • 3 beyondblue: the national depression initiative, Melbourne, VIC.
  • 4 Discipline of Obstetrics and Gynaecology, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, SA.



We acknowledge beyondblue: the national depression initiative for funding and supporting the National Postnatal Depression Research Program, the National Action Plan for Perinatal Mental Health, and the clinical practice guidelines for depression and related disorders in the perinatal period.9

  • 1. Gaynes BN, Gavin N, Meltzer-Brody S, et al. Perinatal depression: prevalence, screening accuracy, and screening outcomes. Evidence Report/Technology Assessment No. 119. Rockville, Md: Agency for Healthcare Research and Quality, 2005. (AHRQ Publication No. 05-E006-2.)
  • 2. Green JM. Postnatal depression or perinatal dysphoria? Findings from a longitudinal community-based study using the Edinburgh Postnatal Depression Scale. J Reprod Infant Psychol 1998; 16: 143-155.
  • 3. Austin M-P, Hadzi-Pavlovic D, Priest S, et al. Depressive and anxiety disorders in the postpartum period: how prevalent are they and can we improve their detection? Arch Womens Ment Health 2010; 13: 395-401.
  • 4. Oates MR. Perinatal psychiatric syndromes: clinical features. Psychiatry 2009; 8: 1-6.
  • 5. Cantwell R, Clutton-Brock T, Cooper G, et al. Saving mothers’ lives: reviewing maternal deaths to make motherhood safer: 2006–08. The eighth report on confidential enquiries into maternal deaths in the United Kingdom. BJOG 2011; 118 Suppl 1: 1-203.
  • 6. Halligan SL, Murray L, Martins C, et al. Maternal depression and psychiatric outcomes in adolescent offspring: A 13-year longitudinal study. J Affect Disord 2007; 97: 145-154.
  • 7. Buist A, Bilszta J. The beyondblue National Postnatal Depression Program, prevention and early intervention 2001–2005, final report. Volume 1: National Screening Program. Melbourne: beyondblue: the national depression initiative, 2006.
  • 8. beyondblue: the national depression initiative. Perinatal Mental Health National Action Plan, 2008–2010, full report. (accessed Jun 2011).
  • 9. Austin M-P, Highet N; Guidelines Expert Advisory Committee. Depression and related disorders — anxiety, bipolar disorder and puerperal psychosis — in the perinatal period. A guideline for primary care health professionals. Melbourne: beyondblue: the national depression initiative, 2011.
  • 10. Cox J, Holden J, Sagovsky R. Detection of postnatal depression: development of the 10 item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987; 150: 782-786.
  • 11. Austin MP, Colton J, Priest S, et al. The Antenatal Risk Questionnaire (ANRQ): acceptability and use for psychosocial risk assessment in the maternity setting. Women Birth 2011. In press.
  • 12. Leung SSL, Leung C, Lam TH, et al. Outcome of a postnatal depression screening programme using the Edinburgh Postnatal Depression Scale: a randomized controlled trial. J Public Health (Oxf) 2011; 33: 292-301.
  • 13. Pignone MP, Gaynes BN, Rushton JL, et al. Screening for depression in adults: a summary of the evidence for the US Preventive Services Task Force. Ann Intern Med 2002; 136: 765-776.


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