The psychiatrist in the obstetric unit. Establishing a liaison service.
L Appleby, H Fox, M Shaw, R Kumar


The establishment and first 18 months of a psychiatric liaison service to a general hospital obstetric unit are described. The service was initially intended to predict antenatally those at risk of post-natal depression and to offer follow-up throughout pregnancy and in the post-natal period. However, a large proportion of referrals were of women currently unwell. Furthermore, post-natal follow-up in the community proved difficult. Referrals, diagnoses and disposal are analysed, leading to conclusions about the effectiveness and problem of such a service. The components of a comprehensive obstetric liaison provision are proposed, emphasising the need for strong community links built around a CPN service, allowing adequate postnatal psychiatric care.