UK Maternal Mental Health Awareness Week
1st – 7th May 2017
Today I am starting off Talking Mums Complicated Pregnancies: Pregnancy comes in all shapes and sizes, with discussion on maternal mental health
Finally it has been recognised what has been on the tip of many women’s tongues for years. More recognition and help is needed regarding the mental health of pregnant women and new mothers.
Following The RCOG’s International Women’s Day event in 2016 a survey was launched in which 2300 women responded. The findings aren’t surprising but at least now there are documented statistics which have prompted action
Up to 1:5 women suffer mental illness during pregnancy or within a year post birth. That is a lot of women and families! Up to a quarter of maternal deaths between 6 weeks and one year postnatal are related to maternal mental illness.
Perinatal mental illness encompasses a large range of disorders including but not limited to low mood, anxiety, depression and psychosis.
Of the 2300 respondents to the survey, 81% had experienced mental health problems. Sadly and appallingly only 7% of these women had been referred to specialist mental health services. From experience I suspect this is multifactorial. The top two reasons being experience and knowledge of the health professional making the assessment and secondly the resources of the maternity unit.
The trust where I work is a large unit, it is a referral centre and a maternity unit that has a research facility too. Irrespective of this the Specialist Mental Health team for pregnancy can only cater for those women in the the top ‘tier’ of mental health problems. Mainly including those with diagnosed mental health disorders such as Biploar, OCD and Schizophrenia. They will take onto their caseload women who have previous serious postnatal depression and psychosis but the larger percentage of women with mild to moderate depression / anxiety / postnatal depression are too large in numbers for them to deal with. These women are advised and referred back to their GP.
It was clear that over the last few years we have made progress in recognising that maternal mental health matters, but so much more is needed to be done and the road ahead is winding with many hills to get over.
Key themes from the survey were
- Women received inconsistent advice regarding the safety of mental health medication during pregnancy and breastfeeding.
- Overwhelming pressure to breastfeed combined with lack of support led to immense feelings of failure.
- That the impact on the whole family can be overwhelming and care of the family often gets forgotten.
- Women felt that when they discussed their concerns with healthcare professionals, they weren’t asked open questions and appointments were rushed. Women recognised that this was often due to lack of time and pressure on services rather than the lack of interest from the health professional.
- Women felt that there was a lack of knowledge when it comes to the range of mental health problems, symptoms and medication.
- Anxiety appears to be the poor relation with mental health conditions. Many questions and conversations focus on postnatal depression and anxiety symptoms were ignored.
- Women expressed the lack of understanding and support on mental well being when a physical condition was a problem.
- Lack of knowledge and understanding that pregnancy loss and stillbirth can have on mental health in subsequent pregnancies.
Key priorities on moving forward were stated as
- Women should feel able to talk openly and honestly to healthcare professionals.
- Women should have timely and local access to mental health services with continuity of care, regardless of where they live in the UK (access to mental health services at present is very inconsistent across the UK)
- Mental health conditions are wide ranging and healthcare professionals should receive adequate training to recognise the symptoms and provide accurate advice.
- Not forgetting partners – support should be available for partners.
See what The Maternal Mental Health Alliance are doing in an effort to achieve the above #Everyonesbusiness
One recommendation was that every maternity unit should have a specialist labour ward team that can see and assess every woman that has had a traumatic birth prior to discharge. Whilst I wholeheartedly welcome this, a ‘traumatic birth’ is a very subjective phrase.
In my experience a ‘traumatic’ birth can encompass so many situations. I have seen ‘textbook’ labours and births and mothers have described it as horrendous and traumatic but then I have seen labours that I would deem traumatic but the mother can’t thank us enough for helping her through it and seems to have a positive view about the whole experience. Of course once home these feelings may change and the effects of trauma manifest. Also training staff takes time and resources are scarce. However a dedicated team would be a fantastic start.
GIVING TIME THE TIME OF DAY
I have been in many situations in my career where during an appointment a woman has opened up about her feelings and state of mind. I want to sit and listen to her. I want to find help and appropriate advice for her but then I also know there are another 15 women out in the reception area waiting to be seen in the next hour and a half. One mother has another appointment to go to, another has a taxi coming in 15 minutes, another hasn’t yet had breakfast and is feeling faint, another had to wait an hour for her last appointment and is getting angry at the wait again and another has a crying young child with her. The pressure is immense to fulfil your professional and moral responsibility. These women are crying out for help and yet the health services (whilst it’s getting better) still aren’t well equipped to help them.
THE PHYSICAL AND THE MENTAL
Another point I find interesting is the fact that it is only fairly recently that the mental health of mothers suffering from a physical illness is being recognised and addressed. The physical and mental self are absolutely linked after all.
MATERNAL MENTAL HEALTH AWARENESS
As part of my blog I wanted to share some pregnancy experiences that have been complicated by mental health problems. Over this week, which is UK Maternal Mental Health Awareness Week and also sees World Maternal Mental Health Day on the 3rd May I will be sharing a few stories of how mental health has affected the lives of some women and their families.
I hope it helps to raise awareness of why research and effort into this subject is so very important for women, their children and their partners.
You can follow The Maternal Mental Health Alliance on twitter @MMHAlliance
Use the hashtag #MaternalMHMatters