Perinatal mental health
During pregnancy, and up to one year after birth, one in five women will experience mental health issues, ranging from anxiety and depression to more severe illness.
Midwives and MSWs play a vital role in identifying the signs of poor mental health and supporting women who experience it during pregnancy.
Strengthening perinatal mental health
The midwife is at the heart of promoting great maternal mental health, not least because they spend more face-to-face time with women during their birth journey than any other healthcare professional. It means that they are best placed to spot problems early on and put strategies in place for dealing with them. This may be by providing low intensity treatments or helping them to access the wider integrated maternal mental health network and systems so they can see other relevant healthcare professionals.
The RCM has developed a roadmap for significant improvements in perinatal mental health in the UK. Aimed at midwifery and healthcare leaders and all those working in healthcare planning, the roadmap outlines a series of steps governments across the four nations need to take.
These are:
- Funding for and training 350 additional specialist perinatal mental health midwives. This could save the NHS around £8.1 billion each year.
- All professionals working with women in the perinatal period have the necessary knowledge and understanding of perinatal mental health.
- Every maternity service has a minimum whole-time equivalent Band 7 perinatal specialist midwife.
- All maternity professionals should be equally concerned with mental as well as physical health in pregnancy, childbirth, and postnatal period.
- All professionals working with women in the perinatal period have the knowledge and understanding of perinatal mental health including trauma informed care, and at a minimum, updated annually.
- Every maternity Trust/ Health Board has a minimum whole-time equivalent band 7 Perinatal Specialist Midwife supported by a team, which may include maternity support workers, and necessary administrative support.
- Access to local maternal mental health system and community based mental health teams
- Education and training in perinatal and infant mental health appropriate to the role working at specialist, advanced or consultant level practice.
Why perinatal mental health support matters
For most women, pregnancy and childbirth can be a symbolic passage to parenthood, with an expectation of joy and excitement. However, the societal expectation can be very different to the reality, with 70% of women either hiding or underplaying the severity of their mental health problems. For those women experiencing mental ill-health, barriers often exist preventing them from accessing care, including variation in availability of service, care, and treatment. These are often worsened by cultural stigma, previous trauma, deprivation, and discrimination.
Despite perinatal mental illness being the most common health complication during or after pregnancy, gaps remain in the equity of access to treatment including access to a specialist midwife, or a perinatal mental health service in a location near to the woman’s home.
The RCM’s priorities for perinatal mental health
All professionals working with women in the perinatal period have the knowledge and understanding of perinatal mental health including trauma informed care, and at a minimum, updated annually.
Every Trust or Health Board with a maternity service has a minimum whole-time equivalent Band 7 Perinatal Specialist Midwife supported by a team, which may include maternity support workers, and necessary administrative support.
Access to local maternal mental health system and community based mental health teams.
Education and training in perinatal and infant mental health appropriate to the role working at specialist, advanced or consultant level practice.
All maternity professionals should be equally concerned with mental as well as physical health in pregnancy, childbirth, and postnatal periods.
Our roadmap to success
While it is the role of the national governments to deliver services, our roadmap is intended to provide guiding principles for that delivery, for further strengthening the midwifery contribution to the perinatal mental wellbeing of women. Including case studies from midwives making a positive impact to the women and families in their care, the roadmap sets how the provision of good perinatal mental health support could and should become a reality across the UK.
i-Learn
This i-learn module provides an understanding of the problem and its scale within pregnancy and the postpartum period in the UK. It provides information on understanding and identifying how disorders may present, the way to ask about mental wellbeing during an appointment and which services can help with information and support.
The module will also consider the responsibilities of midwives and support workers in identifying women who need support, practical steps to ask about mental wellbeing, women at higher risk of mental illness in pregnancy and why it is important for mental illness to be identified and treated early for both the woman and her unborn child.
MIDIRS perinatal mental health pack
Prepared by our information specialists at MIDIRS, this search pack encompasses the treatment and experiences of women and partners experiencing mental health problems during the perinatal period. Includes service provision and interventons, rates of mental illness and levels of provision, and the impact on the infant. The pack does not include postnatal depression (PN16, PN115, PN116), antenatal depression (P132) or women with specifc diagnosed mental disorders (MS54).
This content is for RCM members only
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