Two linked studies assess different approaches for preventing and treating postnatal depression.1 2 This condition is a common form of maternal morbidity that affects about one in eight women from diverse cultures.3 It is also a leading cause of maternal mortality. The UK Confidential Enquiry into maternal deaths found that psychiatric disorders contributed to 12% of all maternal deaths, with suicide being identified as the leading cause of maternal mortality in the United Kingdom.4 Postnatal depression can also have serious consequences for the health and wellbeing of the family. Infants and children are particularly vulnerable—impaired maternal-infant interactions can affect their cognitive, emotional, social, and behavioural development. Clearly, postnatal depression is a substantial public health problem that requires attention.

Given the diversity in causes and severity of symptoms, researchers have evaluated various treatments. Although antidepressants are effective many women are reluctant to take medication, especially when breast feeding. A recent systematic review indicates that psychosocial and psychological interventions may provide an alternative to pharmacological treatment.5 In the linked randomised controlled trial (doi:10.1136/bmj.a3045), Morrell and …