This information is sourced from the Royal College of Psychiatrists (RCPsych):

• Episodes of mental illness during pregnancy are common and effect up to 1 in 5 pregnant women
• Social isolation and the Covid-19 pandemic is likely to result in an increased rate of episodes of mental illness
• Pregnancy is likely to increase this risk further
• Mental illnesses remain one of the leading causes of maternal death
• It is worth highlighting that remote assessements make it more difficult to identify women experiencing domestic violence, women with safeguarding concerns and women who are misusing substances

Acknowledging difficulties and specific anxieties can help. These are likely to include:

• Covid-19 itself and risks to pregnant women
• the impact of social isolation resulting in reduced support from wider family and friends
•  the potential of reduced household finances
• major changes in ante-natal and other NHS care

It is also important to:

• Maintain access to midwifery services
• Access sources of self-help for anxiety and stress
• When necessary refer to local IAPT (Improving Access to Psychological Therapies) Services
• Utilise strategies to support mental health and well-being during this period
• Continue to inform midwifery services of any concerns so that advice and additional support can be offered

This group of women must be identified as at risk of postpartum psychosis so that robust plans can be put in place for labour and the immediate postpartum period:

• Women with a diagnosis of bipolar affective disorder
• Women who have had previous episodes of postpartum psychosis
• women who have previous diagnoses of psychotic illness
• Women with severe early postnatal depressive disorder
• Women with severe enduring mental illness.

These red flag symptoms require immediate referral to specialised perinatal mental health services:

• Recent significant changes in mental state or emergence of new symptoms
• New thoughts or acts of violent self-harm
• New and persistent expressions of incompetency as a mother or estrangement from the infant

The Royal College of Psychiatrists also has a web page of resources for women in the perinatal period with links to multiple support services