Pregnant woman with depression

Women’s health

How much do you know about mental health problems during and after pregnancy?

Up to one in five women experience mental health problems during pregnancy or within a year of giving birth, many with no previous history of mental illness.

Twelve percent of women experience depression during pregnancy and 13 percent experience anxiety. Between 15 and 20 percent experience one or both in the first year after childbirth.

The Saving Lives, Improving Mothers’ Care report by MBBRACE-UK identified that one-quarter of all maternal deaths between six weeks and one year after childbirth were related to mental health problems, and one in seven of those women died from suicide making it the leading cause of death in pregnancy and up to a year after delivery.

Whilst many are aware of postnatal depression, a range of other mental health conditions may also present during and after pregnancy.

A recently published report by the Royal College of Obstetricians and Gynaecologists, Maternal Mental Health – Women’s Voices, based on a UK survey of over 2000 women who had given birth in the previous five years, highlighted a wide spectrum of mental health illness that may present: low mood, anxiety disorders, depression, obsessive-compulsive disorder, post-traumatic stress disorder, psychosis, as well as more general emotions and symptoms of anger, absent-mindedness, exhaustion and tiredness.

Good communication between health professionals across the sectors and agreement on management plans will assist in women being better supported.

The impact of this is wide ranging, affecting both the woman and her family, particularly if left untreated. Overall, 74 percent of the respondents had no previous history of mental health problems, whilst of those who did have a previous history, 95 percent of them went on to experience them during or after pregnancy.

The report highlighted variances in care and inconsistencies in the management of perinatal mental health across the UK. It was apparent from the survey that in women with pre-existing mental health problems, there was no clear consensus from healthcare professionals as to how medication should be managed, and women received varying responses from different professionals. A number of women were taken off their medication with no alternative treatment or support, with potentially dangerous implications for their mental health and rebound implications for the newborn baby with respect to their care and safety.

Breastfeeding whilst on psychotropic medication also raised significant concerns with many women feeling they were not well supported and received conflicting advice from healthcare professionals.

Good communication between health professionals across the sectors and agreement on management plans will assist in women being better supported. Improving care for these women is a priority.

References

MBBRACE-UK.Saving Lives, Improving Mothers’ Care: Surveillance of Maternal Deaths in the UK 2011-2013 and Lessons Learned to Inform Maternity Care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2009-13. Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2015. www.npeu.ox.ac.uk/mbrrace-uk/reports

Royal College of Obstetricians and Gynaecologists. Maternal Mental Health – Women’s Voices. Feb 2017. www.rcog.org.uk/maternalmentalhealth

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