At the end of another Maternal Mental Health Awareness week it is easy to move our attention away from perinatal mental health for another year. In this article the Maternal Mental Health Alliance (MMHA) remind us of the importance of maintaining a focus on this vital topic for Mothers, babies and families. They call for action in a year when the political arena is all up for grabs. What will you do?
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Last week was Maternal Mental Health Awareness week, an opportunity to improve understanding of the 1 in 5 women who experience a mental health problem during pregnancy and after birth. It was a fantastic coming together of women sharing their stories and celebrating the services who provide compassionate care, as well as a showcase of everyone who is committed to improving the mental health support available to women, babies and families across the UK.
Whilst the awareness week may be over, we must continue to make the case for better resourcing of maternal mental health care.
As well as being very common, maternal mental health problems can be incredibly serious and suicide remains the leading cause of maternal death six weeks to a year after giving birth (MBRRACE 2023).
Despite this, a 2023 report by Royal College of Midwives (RCM) Strengthening Perinatal Mental Health acknowledged that ‘mental health needs remain secondary to physical health needs of women during pregnancy’ even though the two are on equal footing as a cause of maternal deaths in the UK.
At the Maternal Mental Health Alliance (MMHA), a UK charity and network of over 130 organisations we want to ensure that all women and families affected by perinatal mental health problems can access high-quality, compassionate care
The current landscape
In the last 10 years, thanks to national investment and commitment, there has been welcome progress in the availability of specialist perinatal mental health services for women with the most severe and complex issues across the UK and Maternal Mental Health Services (MMHS) for some women experiencing trauma or loss as a result of their pregnancy in England. However, for women with common ‘mild to moderate’ problems such as depression or anxiety, there is still no routinely funded provision. A gap that urgently needs filling.
Why maternity services are vital to creating positive change for women, babies and families?
Maternity services play a crucial role in perinatal mental health. The Care Quality Commission (CQC)’s 2023 Maternity Survey, notes there has been an increase in the number of women being asked about their mental health by their midwife, showing the deep commitment of midwives to support women. Yet the MMHA often hears anecdotally that healthcare professionals feel unable to do everything they need to support women’s mental health due to lack of time and resources.
The annual MBRRACE reports into maternal deaths tell us that women facing multiple adversities, including mental ill-health, are still more likely to die in the perinatal period and the Maternity Survey also noted that women ‘who reported having a long-term mental health condition were more likely to report poorer experiences’ in seven of the major areas of maternity care discussed (such as their concerns being taken seriously during antenatal care and their personal circumstances being taken into consideration during postnatal care).
It is clear we need to do more to ensure maternity services can deliver the maternal mental health care that midwives want to provide, and which women and families need.
How you can help
With a general election due in the UK, we have a prime opportunity to make sure improving perinatal mental health support for women, babies and families is on the political agenda.
As ever, if we want to raise awareness of maternal mental health and make the case for addressing the gaps which exist within care, the best way to achieve that is by doing it together – by speaking with one voice, we maximise our chance to be heard.
We hope that as many of you as possible can get behind the MMHA’s ask and show your support. As maternity professionals, your experiences and voice are powerful in helping us to make a strong case for the urgent mental health needs of women, babies and families.
What the MMHA is calling for from the next government:
1.Equip universal services, such as maternity and health visiting, to provide high-quality and compassionate mental health care.
This would include:
- Providing training and education for all midwives and health visitors so they can ask about mental health in a skilled way at every routine contact with women.
- A well-resourced workforce, including Specialist perinatal mental health Midwives and Health Visitors in all areas.
- Better integration of mental health care into maternity and health visiting services. Having healthcare professionals who deliver psychological interventions within maternity and health visiting services would ensure women receive support in a joined-up way. Just as ultrasonography is provided within multidisciplinary maternity services to meet the specific needs of this population, this could be done with psychological therapies. A newly published scientific paper demonstrates that this way of delivering care, with psychological therapists, equivalent to those employed in Talking Therapies recruited and integrated into maternity teams, would be economically as well as clinically viable. Significant cost benefits could be released by implementing such changes across the population, saving £18.8m in England alone.
2. Specialist mental health services across the UK.
- Ensure specialist teams across the UK receive sustained funding to enable the delivery of specialist services that meet national quality standards and achieve national ambitions, including NHS England’s Long-Term Plan.
- Sufficient resources for Maternal Mental Health Services providing essential support for women experiencing trauma or loss related to childbirth (e.g. PTSD following childbirth, miscarriage, stillbirth, and separation through social care proceedings.)
3. Joined up care for women and families across statutory services and the voluntary sector:
- Perinatal mental health care works best when services delivering care work in a coordinated system, with planning done in partnership across statutory services and voluntary and community sector organisations, and clear referral pathways so that parents receive the support they need. To help ensure this happens we need:
- Clear mechanisms of accountability to ensure local areas commission and fund voluntary community sector organisations providing perinatal mental health support.
4. Work to reverse health inequalities in maternal mental health:
- Introducing government targets to improve pregnancy and birth outcomes for the most disadvantaged groups.
- A commitment to a trauma-informed approach in health services and equipping staff with the skills to address mental health and social needs.
- Actioning the recommendations from The Birth Companions Birth Charter for women with involvement from children’s social care.
- Implementing a life course approach to women’s health by delivering on the commitments in the Women’s Health Strategy and implementing the National Suicide Prevention Strategy.
5. Greater data transparency to demonstrate where progress is being made and what gaps remain.
How can you help?
- Use MMHA’s template letter to communicate with your political representative.
- Spread the word on social media tagging @MMHAlliance and #MMHAmanifesto
If you have any questions, please contact us at info@maternalmentalhealthalliance.org
Thank you for your support.
Maternal Mental Health Alliance
May 2024