Talking with women in the pre-conception or perinatal periods about psychotropic medication is an essential, sometimes difficult, part of the work of the perinatal psychiatrist. Understanding the current evidence base; knowing how and when to acknowledge the uncertainty inherent in current knowledge and how that translates to the individual woman; balancing risks of medication with risks of not treating and benefits of treating; sharing decision-making while not putting all of the responsibility on the woman; communicating with the woman, her partner, other professionals, services and agencies; and knowing when and how to seek further help or advice, are all essential components of good practice when prescribing in pregnancy and breastfeeding.

Eating disorders can have a profound impact on women during the pre-conception, antenatal and postnatal periods, and this has implications for their care and treatment. This chapter describes the rate, course and risk factors for eating disorders within the context of the perinatal period. It covers what is known from current research and clinical evidence about the effect of the most common eating disorders on pre-conception health, pregnancy and birth outcomes. Drawing on existing clinical guidance and research evidence, it provides an overview of the guidance and recommendations for the assessment, management and treatment of eating disorders from pre-conception through to the postnatal period.