Andrew Selous and Dr Paul Williams: The ‘hidden half’ of women with postnatal ill health must get the support they need
We must improve perinatal mental health for the “hidden half” of women with postnatal ill health, write Andrew Selous and Dr Paul Williams
The first few months after childbirth are happy ones for many parents, but they are also some of the most challenging. Lack of sleep, changing roles within the family and social pressures can all add up to a very tough period. These months are crucial to the development of a mother-baby relationship, which has a life-long impact on a child.
In a recent survey by the National Childbirth Trust (NCT), of 1,000 women who had recently given birth, almost half described mental health or emotional problems postnatally or during pregnancy.
If left untreated, postnatal mental illness can lead to significant harm not only for a mother but also for her developing child. Studies have shown that it can have an impact on cognitive development, including language development and intelligence, and it has been linked to behavioural problems, mental ill health, substance abuse and alcohol dependence in later life.
Those who have never encountered postnatal depression sometimes find it to imagine just how it must feel. As one mother poignantly explained to us recently, “I knew there was something very wrong almost as soon as my son was born. Nothing I was ‘supposed’ to be feeling was happening. All I wanted to do was cry. I was feeding him, taking good care of him but I felt empty inside and so sad. I can’t remember anyone asking me how I was.”
At around six weeks after they have given birth, most new mothers see their GP for a check on their baby and many get a check themselves. Whilst a pregnant woman has many healthcare appointments before the birth of her baby, the six-week check may be the last opportunity to uncover any problems that she has.
Some women get an excellent six-week check, demonstrating the potential that it offers. If a GP makes the time to talk to her about how she is feeling, problems can be identified, and treatment, support or monitoring can be offered. But research shows that this is often not the case. A disappointing fifth of women questioned in NCT’s survey said they were not asked about their emotional or mental wellbeing at their appointment.
Encouraging a mother to talk about how she feels and is coping is not something that can be done in a couple of minutes. Open, supportive questioning and taking the time to listen and read between the lines is vital to spotting the signs of a developing mental health problem. This can’t be done if the focus of the appointment is on the baby, rather than the mother.
In September, negotiations for the new GP contract begin. We feel it is vital that consideration is given to the inclusion of a separate six-week check on maternal health and wellbeing in the new contract. At the moment GPs are only contracted (and funded) to perform the check on babies.
Our Westminster Hall debate opens up the opportunity to debate the evidence and recommendations for improving perinatal mental health for the “hidden half” of women with postnatal ill health, who don’t get the support they need. These include funding a separate six-week postnatal check so that GPs have the time to give every new mother a full appointment for a maternal health check and improving guidance to GPs on best practice around maternal mental health, including how best to facilitate disclosure of problems.
We need to bring the ‘hidden half’ out of hiding. Postnatal mental illness isn’t just a problem for new mums. If we fail to tackle it, we risk failing the next generation of children too.
Andrew Selous is Conservative MP for South West Bedfordshire and Dr Paul Williams is Labour MP for Stockton South. There Westminster Hall debate is on Thursday 19 July