Postnatal affective disorders. Part 2: prevention and management

•  Women with a history of mental illness should be screened during early pregnancy, as the risk of recurrence following delivery is substantial. •  The risk of suicide in seriously mentally ill women is elevated following childbirth. •  Postpartum psychiatric illnesses respond to the same treatments as at other times; breastfeeding, however, limits medication choice. •  Mothers requiring admission to a psychiatric hospital following delivery should be admitted to a mother and baby unit unless contraindicated.Learning objectives:•  To recognise the risk factors and preventative measures for postnatal affective disorders. •  To discuss the psychological, pharmacological and social management. •  To understand the potential adverse effects of pharmacological treatment on the developing infant via breast milk.Ethical issues:•  Do the risks to both mother and infant of not treating postpartum psychiatric illness outweigh the risk to the infant of psychotropic medication?Please cite this article as: Oates M. Postnatal affective disorders. Part 2: prevention and management. The Obstetrician & Gynaecologist 2008;10:231–235.