Finding perinatal psychiatric care in New Jersey
Published
You may not need a perinatal psychiatrist to start treatment. Many parents get treatment from the OB, midwife, or primary care clinician they already see, and a specialist is one step further when the picture is more complicated. This page covers who can help, when a specialist is worth the search, where to look in New Jersey, and what to have ready when you call.
Who can treat perinatal depression and anxiety?
The first person to treat you is often not a psychiatrist. Obstetrician-gynecologists are often the first, and sometimes the only, point of contact young women have with the health care system. A review written for them notes that counseling may be enough for mild to moderate depression, while severe depression is likely to need an antidepressant (Yonkers et al., Obstet Gynecol 2011, PMID 21422871). ACOG, the national group for obstetricians, has published a guideline that assesses the safety and efficacy of psychiatric medicines during pregnancy and breastfeeding for depression, anxiety, bipolar disorder, and psychosis (Clinical Practice Guideline No. 5, PMID 37486661). Your OB, midwife, or primary care clinician may be able to prescribe for common depression and anxiety, so ask them directly before you start a specialist search. A perinatal psychiatrist is a psychiatrist who focuses on mental health during pregnancy and the year after birth, including choosing medicines with pregnancy and breastfeeding in mind.
When a perinatal psychiatrist makes sense
A specialist is worth seeking out when you have bipolar disorder or a past episode of psychosis, when the first or second medicine has not helped, when you take several psychiatric medicines, or when you are planning a pregnancy and want to sort out medication first. Bipolar disorder is the clearest case: women with bipolar disorder are at high risk of relapse if a mood stabilizer is stopped, they are vulnerable to relapse around delivery, and sharing their care with a psychiatrist increases the chance of avoiding a recurrence (Yonkers et al., Obstet Gynecol 2011, PMID 21422871). Do not stop a mood stabilizer or any psychiatric medicine on your own because you are pregnant. Call the prescriber first.
Why screening for bipolar disorder comes before an antidepressant
Expect questions about past periods of very high energy, little need for sleep, or racing thoughts, and about family members with bipolar disorder. Answer as fully as you can, even if those times felt good. The reason is that depression can be part of bipolar disorder, and telling the two apart helps a clinician choose the right treatment (Yonkers et al., Obstet Gynecol 2011, PMID 21422871). ACOG's screening guideline includes recommendations on screening for bipolar disorder during pregnancy and after birth, alongside depression, anxiety, and postpartum psychosis (Clinical Practice Guideline No. 4, PMID 37486660). A review of 51 papers on perinatal bipolar disorder found the literature mixed on screening, but its authors recommend screening in select situations, including before starting an antidepressant (Wendt et al., Gen Hosp Psychiatry 2021, PMID 33271405).
Where to look in New Jersey
Start with a referral from the clinician you already see, and check your insurer's list of in-network psychiatrists. Postpartum Support International (PSI) runs an online directory of perinatal mental health professionals and groups in the United States and Canada, where you can search for psychiatrists and psychiatric nurse practitioners near you. PSI says listed providers have completed specialized training in perinatal mental health. The PSI HelpLine at 1-800-944-4773 (press 1 for Spanish, 2 for English) is not a crisis line: you leave a message, and a volunteer returns calls and texts every day between 8am and 11pm Eastern with information and names of local resources. The New Jersey Department of Health lists the NJ Family Health Line, 1-800-328-3838, for pregnancy-related mood disorders, Monday to Friday, 8am to 6pm (NJ Department of Health).
If your OB or primary care clinician wants backup
A clinician who is unsure about a medicine does not have to send you away to get an answer. Many states run Perinatal Psychiatry Access Programs, which help medical professionals manage perinatal mental health and substance use conditions themselves (Lifeline for Moms). We did not find a New Jersey program on PSI's list of state access programs, and the state health department's page for professionals points clinicians to PSI and to New Jersey's three regional Maternal and Child Health Consortia (NJ Department of Health). PSI's Perinatal Psychiatric Consultation Program lets prescribers anywhere in the U.S. book a consultation with a perinatal psychiatrist, by appointment and at no cost to the prescriber. It is for clinicians only, not for patients, so the useful move is to mention it if your clinician hesitates to prescribe.
Telehealth across state lines
Video visits can widen the search, especially if the nearest specialist is far away or the wait is long. Before you book with a clinician based in another state, ask whether they are licensed to treat patients located in New Jersey. Licensing rules decide who can see you by video and prescribe for you, they differ from state to state, and they change, so get the answer from the practice in writing rather than assuming. Also ask whether your insurance covers the visit and whether prescriptions can be sent to a pharmacy near you.
What to say, what to bring, what to ask
When you call: say you are pregnant or how many weeks or months postpartum you are, that you want a perinatal mental health evaluation, whether you are breastfeeding, and your main symptoms in a sentence. Ask how soon they can see you and whether there is a cancellation list. What to bring: a list of every medicine and supplement you take, with doses; past psychiatric medicines and how they worked; any screening results, such as an Edinburgh (EPDS) score from your OB or pediatrician; your due date or birth date; and any history of bipolar disorder, psychosis, or postpartum illness in you or your family. What to ask: How much experience do you have treating pregnant and postpartum patients? How do you weigh medicine during pregnancy and breastfeeding? Will you coordinate with my OB or midwife? How do I reach you between visits if things get worse? Do you take my insurance?
When it cannot wait
Finding a specialist can take weeks. Some symptoms cannot wait that long. Hallucinations, sudden confusion, beliefs that do not match reality, or being unable to sleep at all can be signs of psychosis, during pregnancy or after birth: call 911 or go to the nearest emergency room. If you or your baby are in immediate danger, or you have an urge or plan to harm yourself or the baby, call 911 or go to the nearest emergency room. If you are having thoughts of harming yourself, call or text 988 now.
For lines that can help today, including the National Maternal Mental Health Hotline at 1-833-852-6262 (free, 24/7, English and Spanish), see Get Help Now. For what treatment usually involves once you find a clinician, see our article on postpartum depression treatment.