Sadly, every year, one in twenty new or expectant mothers take their own lives in the UK. The leading cause of death for new mothers occurring within the first year following pregnancy is suicide.
Whilst the “baby blues“, which are very short-lived, lasting only a few days, are nothing to worry about, some new mothers develop more serious mental health conditions. In the UK, one in ten women will develop a mental illness whilst pregnant or during the first year after having a baby. Post-natal depression (PND) affects between 10-15 women in every 100 who have had a baby. Other mental health conditions related to pregnancy include perinatal anxiety, perinatal OCD, post- partum psychosis and birth related Post-Traumatic Stress Disorder (PTSD).
The National Childbirth Trust (NCT) has recently surveyed over one thousand new mothers in the UK about their emotional health and wellbeing. The results are concerning.
The Hidden Half
The report, aptly named the “Hidden Half”, found that nearly half of new mothers’ mental health problems don’t get picked up on by health professionals. Many women are too scared to talk about their problems for fear that they will be perceived as failing at motherhood. Others worry that if they are seen as having difficulty coping, their baby will be taken away. Unfortunately, as with all mental health problems, there is still a large amount of stigma surrounding perinatal mental health. Worryingly, many mothers said they simply did not have the opportunity to discuss their concerns. Some of those that did manage to open up, felt their problems were dismissed as the normal baby blues and did not recieve any further support.
Post-natal Check Ups
Most new mothers visit their GP for a check up 6-8 weeks after birth. (Some practices, however, do not routinely offer this). NICE guidance encourages the GPs conducting this check to ask about the mother’s emotional well-being. This is an ideal time to try to spot any mental health difficulties as it is the last routine check for mums after they have given birth.
Unfortunately, the quality of these checks varies widely. Personally, I very lucky with mine. I was given two separate twenty-minute appointments with the GP. One was for me and one for my baby’s health check. This gave ample opportunity for the GP to find out how I was coping. She had time to ask more than a simple “are you ok?”
However, this is not the case for everyone. 79% of mums had to share their appointment with their baby’s routine health check. One-third estimated this left them about three minutes of the appointment time to talk about themselves. Even more worryingly 22% of the new mums were not asked about their mental health at all.
The Wider Problem
It is not only the mother, baby and their families which suffer if mental health problems go untreated. In terms of the economic burden, perinatal mental health problems cost an estimated £8billion per yearly cohort of births. These costs are related to not only health and social services for the mother but also the later impacts on child health. PND has been found to contribute to multiple child developmental problems.
What can be done?
On paper, the answer to this is easy. More funding and more time. Then GPs can give a full appointment dedicated to the mother’s check up. This would tackle a whole host of problems. If appointments were longer, it would give chance for a proper dialogue between the GP and the mother. GPs are so pressurised for time currently, that it may appear they are rushed or uninterested, as a quarter of new mums reported in this survey. To make these changes in England the estimated cost is £20million. This is not too bad really, considering each case of perinatal depression costs society about £74,000.
But as usual, the same questions remain… In a climate of austerity, where does this money come from? In a time of GP burnout, staff shortages and an increasing exodus of qualified doctors how do we create the extra space for these much-needed appointments?
If you have concerns about your mental health during or following pregnancy, please speak to your midwife, GP or Health Visitor.
For more information and support, visit PANDAS
Any opinions above are the author’s alone and may not represent those of his/her affiliations. Any comment is based on the best available evidence at the time of writing. All data is based on externally validated studies unless expressed otherwise. Novel data is representative of the sample surveyed. An online recommendation is no substitute for seeing your own doctor and should not be taken as medical advice. Article edited for publication by Dr Hannah Arnstein
Images courtesy of pexels
Sources and Further Reading
- Knight M, Nair M, Tufnell D, Kenyon S, Shakespeare J, Brocklehurst P, Kurinczuk JJ (Eds.) on behalf of MBRRACE-UK. Saving Lives, Improving Mothers’ Care -Surveillance of maternal deaths in the UK 2012-14 and lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-14. Oxford: National Perinatal Epidemiology Unit, University of Oxford 2016 available online at: https://www.npeu.ox.ac.uk/downloads/files/mbrrace-uk/reports/MBRRACE-UK%20Maternal%20Report%202016%20-%20website.pdf