Perinatal mental health focuses on the period during pregnancy and up to a year after birth (postpartum). Generally it is recognised that there is a higher vulnerability to mental illness during what is described as a ‘transitional life stage’.
In September 2022, the World Health Organization (WHO) launched a global ‘Guide for integration of perinatal mental health in maternal and child health services’, highlighting that almost one in five women will experience a mental health condition during the perinatal period. Echoing this statistic, perinatal mental illness in England can affect up to 27% of pregnant and new mothers, encompassing an extensive range of potential conditions (NHS England » Perinatal mental health). Additionally concerning is the knowledge that according to the WHO, amongst women who suffer with perinatal mental health conditions, 20% of them will experience suicidal thoughts or engage in self-harm.
This is highlighted in Shout data, which shows that nearly a third of people who texted Shout about pregnancy or baby-related topics had suicide as an issue.
There are mental health disorders that are specific to this perinatal period, including depression, anxiety, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and postpartum psychosis. According to the Royal College of Psychiatrists, one in five women will experience a mental health problem during their pregnancy and in the first year after birth, with depression and anxiety disorders being the most common. Professional support in these instances is key.
Women who have previously struggled with mental health issues can be more at risk during pregnancy and post-birth, however, given the life-changing nature of pregnancy, childbirth and motherhood, any woman can find their mental health and wellbeing challenged as they adjust to the changes in their life. Additionally, this can impact on their attachment with their child and on the mental health and wellbeing of a partner and other family members.
Why the need for perinatal mental health support is more urgent than ever
A recent report by MBRRACE-UK found that maternal suicide is the leading cause of direct (pregnancy-related) death in the year post-pregnancy for women in the UK and Ireland, while approximately a quarter of deaths of women during pregnancy and in the year after the end of pregnancy were due to mental health related causes. Tellingly in terms of support and services, the assessors in this enquiry felt that ‘improvements in care might have made a difference in outcome for 67% of women who died by suicide’.
Other data insights from Shout show that in 2022:
➡ We took more than 12,000 conversations where the terms ‘pregnant’, ‘pregnancy’ or ‘baby’ were mentioned
➡ Topics that were mentioned in conversations include pregnancy, abortion and miscarriage, with the most common issues being around relationships (40%), stress (38%), sadness (36%) and suicide (32%)
➡ Approximately 60% of the people who texted us were aged 25 - 34, 30% were aged 35 and over and 10% were aged 18-24
Understandably, this is a critical period in which to ensure that support is available given the likely impact of unsupported mental health challenges on women’s overall health and wellbeing, the potential impact on their unborn/newborn child’s physical, behavioural, and emotional development, and broader consequences on the wider family. In addition, factors such as poverty, housing, ethnicity, abuse, community challenges, unemployment, etc., are all risk factors which could potentially impact a mother’s mental health and wellbeing.
How is Mental Health Innovations working to support perinatal mental health?
We recently convened a roundtable of experts in perinatal mental health including representatives from the The Royal College of Psychiatrists, the Maternal Mental Health Alliance (MMHA) and the NHS, to discuss how digital services such as Shout can play a key role in delivering positive outcomes alongside traditional pathways across the UK.
In addition to other perinatal mental health services provided in the UK, there are currently 19 Mother and Baby Units (MBU) in England, two in Scotland and one in Wales. These units provide specialist inpatient treatment for mothers who are experiencing mental illness. Importantly, they admit the mothers with their babies so that they can be supported to care for their babies while receiving treatment.
We are also partnered with new parent support organisation Best Beginnings, which offers the and its Babybuddy App and have previously worked with Pandas (PANDAS Foundation) to support their communities which are aimed at parents, parents-to-be and those experiencing loss. Through this work, we’ve been able to ensure that partner audiences can connect with 24/7 support, particularly when their own services are unavailable, giving women access to crucial ‘in the moment’ help and resources.
Due to the complex nature of perinatal mental health, for many women, having someone to talk to anonymously and in confidence can also help during a time in their lives when they might find it hard to let friends and family know they are struggling.
“Thank you for talking to me this morning. I was worried about feeling judged and bad for how I feel at the moment but you made me feel heard and normal. Thank you for your kind words.” - Texter feedback from PANDA keyword
Behind each text conversation is someone reaching out for support during what can be one of the most challenging times in their life. Volunteers act as a listening and empathetic ear who will connect with them in a non-judgemental, compassionate and supportive manner, helping them think about their next steps and connecting them with information and specialised services where necessary.