Knowledge of morbidity risks and optimal treatment of women with
major psychiatric illnesses during pregnancy, at childbirth, and
during the postpartum period is strikingly limited, particularly
with major affective disorders (1–8). Such knowledge is
clinically important given the considerable complexities of
clinical management of affectively ill women during perinatal
periods (9, 10). These complexities include the need to balance
potential teratogenic and other adverse effects of medication on
the offspring against the consequences of acute and potentially
life-threatening untreated maternal illness, the impact of the
illness on families, and the potential adverse effects of acute
maternal illness on fetal and neonatal development (9–12).
Despite their potential clinical impact, many cases of perinatal
mood disorder go undiagnosed and untreated (5, 13). A link
between childbirth and psychiatric illnesses has been recognized
clinically for centuries, including many observations of a
strong association of ma