Your obstetric or primary-care visit
Ask for screening and assessment by name. California places duties on both the health plan’s maternal mental-health program and practitioners providing prenatal or postpartum care.³
Use the screening request →Pregnancy + the year after birth · California
You can love the baby and still need help.
Sleep breaks apart. Fear becomes a household weather. A thought arrives that you would never choose. The first job is not to decide what kind of parent you are. It is to decide what kind of help this moment asks for.
Evidence checked August 28, 2026. Perinatal-clinician review is pending; no clinical-review badge is claimed.
Do not wait for a routine appointment
Some changes need help now.
Call 911 or go to an emergency department if you may act on thoughts of harming yourself or the baby, cannot care for your immediate safety, or have severe confusion, hallucinations, delusions, or a sudden loss of contact with reality. ACOG calls postpartum psychosis a condition requiring immediate medical attention.¹
Call or text 988 for a suicidal or mental-health crisis. For pregnancy and postpartum support that is not an emergency, call or text the National Maternal Mental Health Hotline at 1-833-TLC-MAMA; it is free and available 24/7.²
If another adult is nearby, ask them to stay, take over driving and infant care, and make the call with you. This is not the hour to prove you can carry it alone.
Six decisions · no required order
Start with the question in front of you.
01Something feels urgent
Separate danger from distress.
Not sleeping at all, feeling watched or unusually powerful, hearing or seeing things, confusion, or thoughts of suicide need same-day help—not another screening form.
→02I want to be screenedAsk at any pregnancy or postpartum visit.
California requires a maternal mental-health screening program. ACOG recommends screening early in pregnancy, later in pregnancy, and postpartum.
→03My screen was positiveAsk what happens after the score.
A screening result is a door, not a diagnosis. Ask who will assess you, when they will call, and what to do if you worsen first.
→04I want therapyUse the same access rules as other care.
Ask for a perinatal clinician. If your plan cannot offer timely care, use California’s appointment-access script and document every offer.
→05I have a medication questionBring the exact medicine and the exact fear.
Do not start, stop, or change a psychiatric medicine from a webpage. Ask for an individual discussion of untreated illness, pregnancy or feeding, and the medicine itself.
→06I need time or incomeTreatment, pay, and job protection are separate systems.
California disability pay and job-protected leave can overlap, but they are not the same application. Map both before choosing dates.
→After a positive screen
The score should produce a person, a plan, and a date.
A questionnaire can find symptoms that deserve attention. It does not by itself distinguish depression, anxiety, bipolar disorder, trauma, sleep deprivation, substance effects, a medical condition, or postpartum psychosis.
- Ask who is responsible for the clinical assessment.
- Ask when that person will contact you.
- Ask what number to use if symptoms worsen before then.
- Before an antidepressant is started, ask whether bipolar disorder has been considered. ACOG specifically recommends bipolar screening before medication for anxiety or depression when it has not already been done.¹
“My screen was positive. What assessment happens next, who owns the follow-up, and what should I do if this gets worse before that appointment?”
California access stack
Use every door you already have.
Your health plan
Ask for a clinician with perinatal experience and the first available appointment. Record each name, date and offer. If the plan cannot arrange timely care, use the formal access route.
Use California’s access script →Medi-Cal
Pregnancy-related Medi-Cal coverage continues through 12 months after the pregnancy ends, regardless of immigration status. Ask the managed-care plan for behavioral health; use the county route for specialty mental-health services.⁴
Find both Medi-Cal doors →Time away from work
Symptoms can be disabling even when they do not look dramatic from outside. Disability pay, pregnancy disability leave, CFRA and employer accommodations answer different questions.
Map pay and job protection →Medication decisions
A search result cannot weigh your untreated illness against a particular medicine.
Bring the medicine name, dose, pregnancy or postpartum timing, feeding plans, what happened without it, and the outcome you fear most. Ask the prescriber to compare the risks of treatment, no treatment, and the available alternatives for your actual history. ACOG’s treatment guideline advises against withholding or discontinuing mental-health medication solely because of pregnancy or lactation.⁵
Do not stop abruptly because a webpage frightened you. Contact the prescriber. If you cannot reach them, ask the pharmacist or your plan’s advice line how to obtain prompt clinical guidance.
No score can tell you what treatment you need. No directory can make an opening real until it is checked.
The future directory will let you filter for perinatal experience, price, insurance, location and confirmed availability. Payment will never purchase a higher position. Until verified listings exist, this page uses public access routes rather than invented recommendations.
See the directory promise →Read the rules and guidance directly.
- American College of Obstetricians and Gynecologists, Patient Screening, summarizing Clinical Practice Guideline No. 4: screening in early pregnancy, later pregnancy and postpartum; bipolar screening before pharmacotherapy; immediate risk assessment after a positive self-harm answer; immediate medical attention for postpartum psychosis. Checked August 28, 2026.
- U.S. Health Resources and Services Administration, National Maternal Mental Health Hotline: call or text 1-833-TLC-MAMA, free, confidential and 24/7. Checked August 28, 2026.
- California Health & Safety Code §1367.625 and §123640: health-plan program and practitioner screening duties. Checked August 28, 2026.
- California Department of Health Care Services, Postpartum Care Coverage: full medically necessary Medi-Cal coverage through pregnancy and the 12-month postpartum period. Checked August 29, 2026.
- American College of Obstetricians and Gynecologists, Clinical Practice Guideline No. 5, treatment and management during pregnancy and postpartum. Checked August 28, 2026.
This is educational information, not diagnosis or individual medical advice. Perinatal-clinician review is pending.