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Perinatal mental health services – supporting pregnant women and new mothers

First published on 17th March 2023


The original blog can be read here.


 

Every year on Mother’s Day we tell mums that they are the best, our modern times superheroes. We celebrate the incredible job they do every day to care and provide for their family. And we say things like ‘I don’t know how you do it all!’.

This year we want to reflect on the pressure that comes with such expectations – a pressure that can be felt by women even before they become mothers. Pregnancy and becoming a mother can be extremely challenging and one in four women will experience mental health issues during this transition. We need to take the pressure off and support mothers, especially those who face depression, anxiety, psychosis and/or trauma.

Perinatal mental health problems that are not treated effectively cost society £8.1 billion every year, with the annual cost to the NHS estimated at £1.2 billion. A significant proportion of this relates to the impact on their child, as new mothers suffering with their mental health might struggle to form attuned relationships with their new babies and build strong foundations based on secure attachment. By supporting mums, we support the next generation.

In less than ten years, we have come a long way in increasing access to mental health care for pregnant women and new mothers. In 2014, fewer than 15% of localities provided specialist services for women with complex or severe perinatal mental health conditions. Today, these services are available in every locality across England, with over 49,000 women accessing support in the 12 months leading up to December 2022.

Maternity and mental health services are working hand in hand to ensure this world-leading programme delivers real change for new mothers who are struggling. From a midwife asking a pregnant woman about her mood, to a doctor referring a new mother at risk of post-partum psychosis to her local specialist service, everyone plays a role in improving care. The NHS has also set up new Maternal Mental Health Services, which combine maternity, reproductive health, and psychological therapy for women. They provide critical care for women whose mental health suffers after experiencing birth trauma or baby loss.

We need to do more. Suicide is still one of the leading causes of death in pregnancy and up to six-weeks postpartum, with a worrying increase in cases in recent years, especially in teenage mothers. Numbers might be small (1.5 women per 100,000 died by suicide in 2020) but every suicide is a tragedy that impacts the lives of countless family members, friends, and colleagues. Two further ways we are improving perinatal mental health are by extending the period in which we offer postnatal support to two years and introducing a whole family approach to the care we provide. We are also working to ensure partners of pregnant women and new mothers with mental health issues also have access to support. Having a new baby can also be a challenging time for new fathers and research shows that up to 50% of those whose partners are suffering from depression were also affected by depression themselves.

There are great examples across the country of how this approach is making positive changes for families. For example, Leeds Perinatal Mental Health Service has set up a Partners Peer Support Service which supports fathers who are scared and overwhelmed or unsure how to support their partners. Through face-to-face sessions, dads and kids pram walks, baby sensory sessions, Zoom games nights, and many other activities, new dads can gain confidence as parents and talk about their mental health – and this makes a real difference to how they can then support mothers.

Mothers are often seen as the pillars of family life. This comes with a lot of pressure and can negatively impact women. It’s our responsibility to ensure mothers’ mental health is prioritised right from the beginning, throughout pregnancy and in the early years of a child’s life.


 

Dr Giles Berrisford Dr Giles Berrisford is Associate National Clinical Director for Perinatal Mental Health for NHS England. Dr Giles Berrisford is the Clinical Lead at the Birmingham Perinatal Mental Health Service at BSMHFT – leading one of the largest inpatient Mother and Baby Units in the country. He is the Chair of the national charity Action on Postpartum Psychosis (APP) – working closely with women and families directly affected by postpartum psychosis – the most severe form of perinatal mental illness. He is committed to bringing about improved access to maternal mental health services and reducing the unwarranted variation in care currently seen across the country.

Professor Jacqueline Dunkley-Bent Professor Jacqueline Dunkley-Bent has vast experience in healthcare provision and is the first Chief Midwifery Officer in England. She has worked as a midwife and a nurse and held senior positions in clinical practice, education, leadership and management including: Director of Midwifery and Nursing positions for Women’s and Children’s services at Imperial College Healthcare Trust & Guy’s & St Thomas’ NHS Foundation Trust. Academic roles have included: Senior Lecturer, Curriculum Leader, LME and Professor of Midwifery. Jacqueline was appointed Chief Midwifery Officer in Spring 2019 at NHS England and NHS Improvement and is National Maternity Safety Champion for the Department of Health. She is also visiting Professor of Midwifery at Kings College London and London South Bank University. Her experience has seen her leading and influencing national maternity standards and guidance. She also influences healthcare, nationally and internationally through research, education and publications and is frequently invited to speak at national and international conferences. She is a member of the British Journal of Midwifery editorial board and until recently was an active member of the Maternity and Newborn Forum at the Royal Society of Medicine. She has joined the Tommy’s Charity National Advisory Board as Midwifery advisor, and the Women of the Year management committee. Her voluntary work currently includes Midwifery Advisor for the Wellbeing Foundation Africa and until recently a trustee. In 2014 she received the HSJ, BME Pioneers award and in 2015 she was selected from over 100 nominations for inclusion on Nursing Times’ Leaders 2015 list that celebrates nurses and midwives who are pioneers, entrepreneurs and inspirational role models in their profession.

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