PMAD Red Flags & Risk Factors
Guide for Community Partners
Perinatal Mood & Anxiety Disorders (PMAD) are the most common complication of childbirth, affecting 15-20% of pregnant women and women with young children and up to 10% of men with young children.
PMAD Red Flags
Patient is …
- Having trouble bonding with baby
- Confused, unable to care for self
- Suspicious of staff, visitors and family
- Especially difficult to interact with
- Experiencing mood instability like excessive anxiety or worry, sadness, irritability
- Experiencing scary thoughts
- Responding to internal stimuli
- Very withdrawn, or shows loss of interest in normal activities
PMAD Risk Factors
- Personal of family history of PMAD, anxiety, depression, bipolar or any other psychiatric illness
- Perfectionist personality
- High expectations of motherhood
- Recent stressors: illness, divorce, move, job change, death, financial setback
- Lack of social support
- Complications with pregnancy or breastfeeding
- Traumatic labor and delivery
- Fussy, colicky, ill or high-need baby
- Reproductive losses: miscarriage, abortion, infertility
- Unplanned pregnancy
- Stressful relationship with significant other
- Mother of multiples
- Mother of infant(s) in NICU
- Thyroid imbalance
- Vitamin D deficiency
Checklist: What To Ask…
- Are you feeling like yourself?
- How is your sleeping/eating?
- Do you have the support you need?
- Are you taking any medications?
- Have you had times when you feel more worried or sad?
- Have you ever taken medications for depression/anxiety?
- Are you taking any vitamins, supplements or herbs?
- Have you had severe mood changes during your periods?
- How are you feeling about being a mom?
- Is there anything more you think I should know about?
- Do you have any particular concerns?
- Can you rest when your baby is resting?
- Can you rest when you want to rest?
- How is your appetite?
- Are you feeling like yourself emotionally?
- Do you have the energy to do the things you need to do?
- Are you feeling more irritable than usual?
- Are you having any scary or unusual thoughts?
- Do you have any thoughts like, “Life isn’t worth living”?
- Do you ever wish to “fall asleep and not wake up”?
- Pine Rest PMAD Resources
- Pine Rest Mother & Baby
- Postpartum Support International
- Postpartum Progress Blog
- Beyond The Blues: Understanding & Treating Prenatal and Postpartum Anxiety, Shoshana Bennett and Pec Indman
- Dropping the Baby & Other Scary Thoughts, Karen Kleiman
- Medications and Mother’s Milk 2017, Thomas Hale and Hillary Rowe
- The Postpartum Husband, Karen Kleiman
- Therapy & the Postpartum Woman, Karen Kleiman
Referring a Patient
For information on how to refer a patient and more, please visit our Resources for Community Partners page.