Anatom3DPostpartum psychosis
Psychosis puerperalis · Poporodní psychóza
female only
What it is
Sudden mania, psychosis or confusion in the days to weeks after birth; 1–2 per 1,000 births, a psychiatric emergency. Women with bipolar disorder or a previous episode carry the highest risk.
Symptoms & signs
- Onset within two weeks of birth
- no sleep, racing thoughts, high or rapidly changing mood
- confusion
- delusions and hallucinations, often about the baby
- thoughts of harming herself or the baby
🚩 Get help if…
- call 112 / 911 now Thoughts of harming yourself or the baby
- call 112 / 911 now Hearing voices, strange beliefs, or confusion after birth
- call 112 / 911 now Not sleeping at all, racing thoughts or wild mood swings
- see a doctor soon Sudden mood change in the first 2 weeks after birth
Where it strikes
Medical treatment
- Same-day psychiatric assessment; admission, ideally to a mother-and-baby unit
- antipsychotics; lithium as mood stabiliser — valproate avoided in women who may conceive
- short-term sedatives for sleep
- ECT for severe or resistant illness — often works fast
- Lithium started straight after birth in women with bipolar disorder — fewer relapses in observational studies mixed evidence
- plan in pregnancy for every woman at risk
Natural & lifestyle
- Protected sleep — another adult takes the night feeds
- peer support after recovery
Emerging & experimental
- Transdermal oestradiol — small studies early / small studies
- genetic and sleep research to predict who is at risk
Alternative, off-label & anecdotal
Approaches used outside the guidelines, with what their supporters report and what testing has found so far.
- Placenta capsules for mood — trials: no benefit not confirmed in trials
- Treating at home with herbs or rest alone — dangerous; risk of suicide and harm to the baby anecdotal / traditional
ICD codes
- ICD-10 F53.1
- ICD-11 6E21 Mental or behavioural disorders associated with pregnancy, childbirth or the puerperium, with psychotic symptoms