LGBT mental health 180Every NHS trust or health board with maternity services should have a specialist maternal mental health midwife, according to a new report from the Royal College of Midwives (RCM).

The new publication, supported by the Maternal Mental Health Alliance, outlines standards for specialist maternal mental health midwives and was launched at the Royal College of Midwives Annual Conference on November 11.

The document lays out key recommendations to improve midwifery services including the need for a whole system approach to perinatal mental health within each trust/health board and all health professionals working with women in the perinatal period to have a basic awareness, knowledge and understanding of perinatal mental health.

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Cathy Warwick, chief executive of the RCM, said: “The standards and recommendations are not simply a wish list. They are essential in enabling midwives to acquire the skills and expertise to identify women with mental health problems, and to provide appropriate support, care and referral so that they receive the best possible care.

“Perinatal mental illness exerts a significant toll on families and the impact on the women themselves, their baby, and the wider society cannot be underestimated. We know that suicide is a leading cause of death in new mothers in the UK. Despite this, provision of perinatal mental health services in the UK is at best patchy, and in some areas, non-existent.

“The cost of providing better services for the women and their families will be far less than the cost of failing to treat them. These are things that must, and should be done. The system is failing many women and their families and that is simply not acceptable.”
The document outlines the standards needed for specialist mental health midwives, along with their training requirements. It also stresses that all health professionals should give equal importance to women’s mental and physical health, throughout pregnancy and after the birth.

Up to 20% of women are affected by mental health problems at some point in pregnancy or the postnatal period – within the first year after birth. Depression and anxiety are common in pregnancy, with 11% of pregnant women experiencing depressive symptoms in the early postnatal period, with 5% having a major depressive disorder. About half of the women affected with depression or anxiety are identified.

The cost to the NHS each year of perinatal mental illness is estimated to be around £1.2 billion yet the report suggests that it would cost just under £300 million to provide a level of service and care that is consistent with national guidance.

Dr Alain Gregoire, chair of the Maternal Mental Health Alliance, added: “Mental health problems are the most common major health complications of having a baby in the UK and a major cause of death. Good care of all women with mental health problems in pregnancy depends on the compassionate, knowledgeable and skilful involvement of midwives working in a well-organised pathway of care.

"Every maternity service must have a specialist mental health midwife who ensures this happens. The valuable new resources from the RCM will help them, and all midwives to deliver better outcomes for women and their infants."

The RCM is also launching a new e-network for midwives, health visitors and health professionals working in perinatal mental health. The network will enable health professionals to access a range of resources and information on maternal mental health. It will also provide a forum for discussion to help them provide better support and care to women.

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