About 10% to 20% of British women develop anxiety, depression or severe mental health problems in pregnancy or within a year of giving birth, but at least half of these cases are not being diagnosed, midwives have warned in a new report.
Between 2018 and 2020, suicide was the leading cause of maternal death in the first year after birth, the Royal College of Midwives (RCM) says, calling for a boost in staff numbers to increase detection.
The report says too many instances of perinatal cases of anxiety or depression are being missed, despite contact with professionals, that in the NHS, mental health needs remain “secondary” to physical health needs of women during pregnancy.
Birte Harlev-Lam, executive director of the RCM, told the Evening Standard: “Despite midwives being the health professional women see the most during pregnancy, they often have very short appointment slots – 15 minutes or 20 minutes – during which time they have to do a host of observations and checking on the mother and the baby, and so on.
“So the time to sit and have a really honest conversation is limited. Time is a pressure and that goes back to the shortage of staff.”
Another factor was that “midwives don’t always have the right education, or enough of the right education, to have in-depth conversations”.
“About 85% of maternity units have a perinatal mental health midwife who can support and advise all other midwives, but they don’t all have a full time perinatal mental health midwife.
“And 15% don’t have a perinatal mental health midwife at all.”
The new report on mental health on mothers, spanning pregnancy and the first year of their baby’s life, highlights various shortcomings in mental health care, including that even where maternity units do have specialist perinatal mental health midwives, they are sometimes forced to cover staff shortages elsewhere.
Additionally, about 70% of women either hide or underplay the severity of their mental health problems, the authors said, urgently calling for at least 350 additional midwives to help these women.
It said all health workers in contact with pregnant women and new mothers should have annual mental health training and every NHS trust or health board should have at least one specialist midwife.
An NHS England spokesperson said: “Women across England are benefiting from specialist perinatal mental health support with an estimated 51 000 new mums treated over the last year – up nearly 60% compared with two years ago.”
A Department of Health & Social Care spokesperson said: “We are expanding and transforming mental health services …so by 2024 at least 66 000 women with moderate to severe perinatal mental health difficulties will have access to specialist community care, up to 24 months after their babies’ birth.”
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