This integrative review synthesised clinician perspectives on specialist perinatal mental health (PMH) service care pathways, drawing from 35 studies identified across six international databases (no date, language, or geographic limits) using PRISMA guidelines and Whittemore & Knafl's framework.
Three themes emerged: (1) pathways are highly criteria-driven with complex referral processes and service gaps that risk women being 'lost between services'; (2) structural and relational factors consistently shape accessibility, engagement, and inclusion; and (3) perspectives on service integration highlight the need for open communication and clear, coordinated pathways — especially for women with complex needs and minority groups.
Only clinician perspectives were synthesised, excluding patient/family voices. The full text was not accessible, limiting appraisal of individual study quality. Narrative synthesis (vs. meta-analysis) limits precision of findings.
Clinicians should advocate for flexible, culturally sensitive, and trauma-informed PMH pathways that reduce rigid criteria barriers and ensure seamless handoffs between services. Particular attention is needed for women with complex needs and those from minority groups, who are most at risk of falling through gaps in care.
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