The arrival of a new baby is a major life event for any family. It can be joyful, exciting, overwhelming and challenging all at once. In addition to the expected ups and downs connected with becoming a parent, many people experience mental health problems, too.
- One in four women have a mental health problem in pregnancy and during the 24 months after giving birth
- The most common mental health problems experienced during pregnancy and after birth are anxiety, depression and post-traumatic stress disorder
- In the UK, maternal suicide is the leading cause of direct deaths occurring within a year after the end of pregnancy
Parents’ mental health is important, both to their wellbeing and their child’s. It’s vital that all parents get the support they need so that they can form strong bonds with their babies and lay the foundations for a healthy, happy life for all involved.
With the NHS investing £365 million in more mental health support for new mothers we spoke to women who had a child in the last three years to find out what services could learn from their experiences.
In our new report ‘Mental health and the journey to parenthood’, we share what we heard about what’s working and what needs to improve.
What did women tell us?
Our report focuses on 1,738 women who either had a mental health condition diagnosed before, during or after having a baby or experienced a mental health problem that was not diagnosed.
Many women reported a good experience of care. Reasons included healthcare staff - such as GP’s, midwives and health visitors - proactively asking them about their mental health, responding quickly when women ask for help and having access to specialist perinatal mental health services.
Variable mental health support
However, the survey findings also indicate that many women are not experiencing support that meets national NICE guidelines which set out what mothers should expect when it comes to the recognition, assessment and treatment of mental health problems during and after pregnancy.
When asked about the support they had received:
- A third of women (33%) who had a diagnosed mental health condition said they were not given any advice about maternity and mental health at any point.
- Nearly half (47%) of all women described getting support for their mental health as ‘difficult’ or ‘very difficult’.
- More than half of all women (58%) said they did not get a care plan that considered their maternity and mental health needs, while 36% reported not feeling involved in decisions about their care.
- A third of all women (36%) rated the quality of mental health support given by health professionals (e.g. GPs, midwives and health visitors) as poor or very poor.
The report calls for more to be done to ensure that services understand and adopt these guidelines and provide parents with more consistent care.
Tackling fear, promoting awareness
What we heard highlighted how unique each person’s experience of becoming a parent can be, and how important it is that the support made available is tailored to their circumstances. While each experience was different, three key issues linked them together.
1. The range of issues that can help contribute to mental health problems
Severe pregnancy sickness, the physical health of babies, a history of mental health problems, feelings of isolation and a lack of empathy from professionals can all play their part.
2. People don’t know where to turn for help
Despite the increased focus on NHS support for mental health, women told us about not being given enough information about the mental health support available and what to do if they need help.
3. Women feel scared about speaking up
Even though women know they are struggling with their mental health, factors such as fear that they will be judged as bad parents or healthcare staff attitudes can act as a barrier to seeking support.
Kristy and Rachel share their stories
Kristy was unwell throughout her pregnancy, which put her desire to have a home birth at risk. After the birth of her son, she also felt pressure to breastfeed and to create ‘the perfect family’ while continuing to be physically ill. All of which had an impact on her mental health.
Rachel had anxiety and depression throughout her pregnancy and after her baby was born. Because she felt supported to talk about her mental health by her midwife, health visitor and GP, Rachel got the care she needed.
What would help?
People interact with a variety of professionals on their journey to becoming a parent, and people told us that they would like more chances to discuss their mental well-being.
We heard several examples of where this is working well. People told us about professionals who helped them tackle problems by proactively asking them about their mental health and helping them get support quickly.
The report recommends creating more opportunities for this to happen, for example by making sure that more mothers get a postnatal six-week health check from their GP.
In our research we asked people, considering how their mental health has been supported during their journey to parenthood, what could have done differently.
Factors that made an experience more positive
- Good care from professionals at every stage
- Staff bearing their mental health in mind and proactively asking how they were
- Support being provided in what people felt was a timely fashion
- Successful referral to perinatal support
Factors that would have helped make an experience better
- If everyone involved had a greater understanding of the impact of becoming parents on people’s mental health
- Being listened to and having personal circumstances taken into account
- Greater availability of support and clearer signposting
- Being able to keep seeing the same staff members
The report also recommends considering how access to support for partners can be further improved.
Commenting on the findings, our National Director Imelda Redmond said:
“It’s good to see that the NHS is investing in better mental health support for new mothers. While our research does highlight the positive impact that the right support can have, it also shows how much more needs to be done to make sure that all women get the right help, at the right time.
“People meet with a whole host of professionals before and after having a baby, and space must be made for them to talk about how they’re feeling. Parents must feel empowered to speak up and understand where to go for support so that they can manage any mental health problems they face, form strong bonds with baby and help lay the foundations for a healthy, happy life for all involved.”
Responding to the report Maria Bavetta, Champion Network Manager for Maternal Mental Health Alliance said:
“Capturing the voice of people impacted by perinatal mental health is an essential component to influencing service improvements. Healthcare professionals across the pathway must know who and when to make a referral and women must be supported to confide safely and be able to access the right care.
“This report adds further evidence to the vital need for perinatal mental health services to be available for all women and their families wherever they live; policymakers and perinatal mental health providers must take action to ensure there is no postcode lottery.”