Aim A review of the management and outcomes of patients with perinatal mental health problems at Watford General Hospital.

Background Watford general hospital is part of an acute trust providing maternity services to the population of West Hertfordshire across 3 Hospital sites with 5800 deliveries per annum. The trust have appointed an Obstetrician to develop a perinatal psychiatry service.

Methods A retrospective review of all deliveries at Watford General Hospital in September 2009. Our audit also looked at existing patient health records (PHR), electronic patient records, referral pathways, care pathways and support services

Results 469 women were delivered of 473 babies with 24 identified as having perinatal mental health issues. 80% of perinatal cases were of Caucasian background, 67% were multiparous and only 8% of patients had received preconception counselling.

38% had postnatal depression in a previous pregnancy, 8% anorexia, 42% depression, 8% Bipolar disorder and 4% with Schizophrenia.

There was a wide range of psychotropic drugs used for treatment without any preferences noted. None of the patients with symptoms of depression were offered psychotherapy.

This group of patients had a 79% vaginal delivery rate.

Summary The development of a specialist perinatal mental health service in our unit will help to improve our outcomes. A perinatal psychiatry service isn't reserved for tertiary units and can be set up in a DGH with a mixture of enthusiasm and commitment from clinicians and managers.