This page is a clinical resource, not a substitute for individual assessment, consultation, emergency evaluation, or a midwife’s applicable scope-of-practice requirements.
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Community midwives are often among the first providers to recognize changes in a client’s emotional well-being during pregnancy and postpartum. Our continuity of care, extended visits, home-based care, and ongoing attention to the parent–baby dyad place us in a unique position to identify concerns, begin conversations, coordinate support, and help clients access appropriate care.

This resource guide brings together Massachusetts-specific and national tools to support community midwives with screening, assessment, clinical consultation, medication questions, referrals, client education, and urgent response. It includes resources for depression, anxiety, obsessive-compulsive symptoms, trauma-related disorders, bipolar disorder, substance use, suicidality, and postpartum psychosis.​
This resource contains the following:
  • Screening & Assessment Tools
  • ​​Massachusetts-Based Clinical Services
  • ​​Massachusetts Provider Consultation and Referral Support
  • ​Education and Client Support
  • Perinatal Mental Health and Substance
Available for Download:
Screening and Assessment Tools:

MCPAP for Moms Obstetric Provider Toolkit.
The MCPAP for Moms Obstetric Provider Toolkit was developed for front-line perinatal care providers.
​It includes:
  • Edinburgh Postnatal Depression Scale (EPDS)
  • Generalized Anxiety Disorder-7 (GAD-7)
  • Bipolar disorder screening
  • Guidance for assessing suicide risk
  • Clinical assessment and treatment algorithms
  • Medication guidance
  • Patient education materials in multiple languages
​Screening is a starting point, not a diagnosis. Results should be considered alongside the client’s symptoms, functioning, history, supports, sleep, substance use, and clinical presentation.

American College of Obstetricians and Gynecologists
ACOG provides clinical guidance for screening, diagnosing, and treating depression, anxiety, bipolar disorder, suicidality, and postpartum psychosis during pregnancy and postpartum.

​Massachusetts-Based Clinical Services
Availability, insurance participation, referral requirements, and geographic eligibility may change. Contact the program directly before promising access to a client.

South Shore Health Perinatal Behavioral Health 
Program:
The South Shore Health Perinatal Behavioral Health Program, part of the Grayken Center for Treatment, provides specialized behavioral health care during pregnancy and for up to two years postpartum.
Services include:
  • Psychiatric evaluation and medication management
  • Short-term therapy
  • Treatment for anxiety, depression, bipolar disorder, trauma, and other mood concerns
  • Guidance about psychiatric medication during pregnancy and lactation
  • Coordination with maternity care and community providers
  • Referrals for longer-term community-based care
Location: 797 Main Street, Weymouth
Appointments: 781-624-5065

Massachusetts General Hospital Center for Women’s Mental Health
The MGH Center for Women’s Mental Health provides specialized psychiatric evaluation and treatment related to reproductive health.
Clinical services include:
  • Preconception consultation
  • Psychiatric care during pregnancy
  • Evaluation and treatment of postpartum depression and anxiety
  • Consultation about psychiatric medication during pregnancy and lactation
  • Treatment for premenstrual dysphoric disorder and other reproductive mental health concerns
The Center also maintains an extensive Postpartum Anxiety Resource Hub with research summaries and clinical information.

Beth Israel Deaconess Reproductive Psychiatry and Women’s Mental Health
Beth Israel Deaconess Medical Center provides multidisciplinary assessment and treatment for mental health and substance use concerns before, during, and after pregnancy. The program supports clients with depression, anxiety, bipolar disorder, trauma, eating disorders, substance use disorders, and complex medication or preconception planning needs.
Division of Maternal-Fetal Medicine: 617-667-2636
Confirm current referral requirements when referring clients who receive maternity care outside the BIDMC system.

Postpartum Support International—Massachusetts
The Massachusetts Chapter of Postpartum Support International promotes perinatal mental health education, awareness, support, and access to treatment throughout the state.
The PSI Massachusetts Provider Directory can help midwives and families search for Massachusetts clinicians with specialized perinatal mental health training. Confirm insurance participation and availability directly with the clinician.
Massachusetts Department of Public HealthThe Massachusetts DPH Perinatal Mood and Anxiety Disorder Initiative offers information and resources for professionals, pregnant and postpartum people, and families.
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When You Have a Concern
Start Here:
  1. Ask directly and assess. Explore the client’s symptoms, functioning, sleep, supports, mental health history, substance use, safety, and ability to care for themselves and their baby.
  2. Use a validated screening tool. A screening score can identify the need for further assessment, but it does not establish a diagnosis or determine safety on its own.
  3. Determine urgency. Do not wait for a referral or routine consultation when the presentation suggests an immediate safety concern, mania, psychosis, or rapidly worsening symptoms.
  4. Consult MCPAP for Moms. Massachusetts midwives can obtain real-time psychiatric consultation and help locating appropriate services.
  5. Make a supported referral. Whenever possible, confirm that the program is accepting patients, accepts the client’s insurance, and can meet their clinical and language needs. Close the loop at a subsequent visit.
  6. Document the plan. Include screening results, clinical assessment, safety questions, consultation, referrals, client response, follow-up plan, and any communication with other providers.
When a concern is identified, document:
  • The client’s reported symptoms and relevant observations
  • Screening tool, score, date, and responses requiring follow-up
  • Direct assessment of safety, suicidality, thoughts of harm, psychosis, and mania when indicated
  • Protective factors, available supports, and the client’s ability to care for themselves and the baby
  • Clinical consultation obtained
  • Referrals offered and whether the client accepted them
  • Communication with collaborating or receiving providers
  • The safety and follow-up plan, including timeframe
  • Reassessment at subsequent visits
When Immediate Evaluation Is Needed
Arrange immediate evaluation when there is concern about:
  • Suicidal thoughts with intent, a plan, or inability to remain safe
  • Thoughts of harming the baby or another person with intent, a plan, or fear of acting
  • Hallucinations, delusions, paranoia, severe confusion, or other possible symptoms of postpartum psychosis
  • Possible mania or a mixed mood episode
  • Severe agitation, disorganization, or a sustained inability to sleep
  • Inability to safely care for oneself or the baby
  • Any rapidly worsening presentation or immediate safety concern
— Do not rely on a screening score alone when the clinical presentation suggests risk.
— Do not leave a client alone when there is an immediate safety concern.
​— Activate emergency services or arrange evaluation in the nearest emergency department.
For suicidal crisis or emotional distress in the United States, call or text 988 or use the 988 online chat.

​Massachusetts Provider Consultation and Referral Support
​MCPAP for MomsMCPAP for Moms should be the first-line resource for Massachusetts community midwives caring for clients with perinatal mental health concerns.
MCPAP for Moms provides:
  • Real-time consultation with a perinatal psychiatrist
  • Guidance on assessment, diagnosis, medication, and ongoing management
  • Help locating therapists, prescribers, support groups, and other services based on insurance and location
  • Screening tools, clinical algorithms, and patient education materials
  • Support for concerns arising during pregnancy and through one year postpartum

​Massachusetts obstetric providers—including midwives—may use the program at no cost. A client does not need an established psychiatric diagnosis.
Provider consultation: 855-MOM-MCPAP (855-666-6272)
Hours: Monday–Friday, 9 a.m.–5 p.m.
MCPAP for Moms is not an emergency or crisis service.
Education and Client Support
Postpartum Support International
Postpartum Support International offers peer support, care navigation, online support groups, specialized support communities, and a directory of perinatal mental health professionals. Resources are available for pregnant and postpartum people, partners, families, people experiencing pregnancy or infant loss, and those affected by birth trauma.

MGH Center for Women’s Mental Health
The MGH Center for Women’s Mental Health publishes accessible reviews of research related to psychiatric illness, pregnancy, postpartum care, lactation, infertility, pregnancy loss, premenstrual disorders, and menopause.

Additional Specialized Resources
  • International Association for Premenstrual Disorders: Information about premenstrual dysphoric disorder and premenstrual exacerbation of underlying mental health conditions.
  • Massachusetts Association for Infant Mental Health: Professional education and resources supporting infant and early relational health.
  • The Menopause Society: Clinical and patient resources related to menopause, midlife mental health, and healthy aging.
  • Marcé Society for Perinatal Mental Health: International research and professional education in perinatal mental health.
  • ​MotherToBaby provides evidence-based information about medications, substances, infections, vaccines, and other exposures during pregnancy and lactation. Clients and clinicians may contact its specialists directly.
  • LactMed is a peer-reviewed National Library of Medicine database containing information about medications and other substances during lactation, including breastmilk levels, possible infant effects, and potential alternatives.
  • The PSI Perinatal Psychiatric Consultation Program offers free, appointment-based consultation with perinatal psychiatry specialists for medical prescribers in the United States. For Massachusetts providers, MCPAP for Moms will usually be the more immediate and locally connected resource.​

​Information for Partners
& Families 
Perinatal Mental Health and Substance

SHORE Program at South Shore Health
The Perinatal SHORE Program provides integrated mental health and substance use treatment for pregnant and postpartum clients through two years after birth.
The program offers in-person and virtual care for clients experiencing:
  • Opioid or other substance use disorders
  • Alcohol use disorder
  • Co-occurring mental health concerns
  • Questions about medications used during pregnancy or lactation
Clients must be at least 18 years old.
Appointments: 781-624-5065

Boston Medical Center Project RESPECT
Project RESPECT provides comprehensive maternity care, behavioral health support, medication treatment, and recovery services for pregnant and postpartum people with substance use disorders. Its multidisciplinary model addresses medical, psychiatric, substance use, and social needs.

Medication, Pregnancy, and LactationThese resources can support informed clinical conversations. Questions about prescribing, continuing, stopping, or changing psychiatric medication should be discussed with the client’s prescriber or a perinatal psychiatric consultant. Clients should not be advised to abruptly stop psychiatric medication without an individualized clinical plan.
Resource development note: Portions of this resource were informed by publicly available educational materials from the Massachusetts General Hospital Center for Women's Mental Health and other evidence-based perinatal mental health resources. The content has been adapted and expanded by the Massachusetts Chapter of the National Association of Certified Professional Midwives for educational use.
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