If you work with women during the perinatal period, here are 10 things you may find it helpful to know.
Women and families receive care and support from many different professionals and services during pregnancy and in the postnatal period.
If your role involves working with women in the perinatal period, it’s vitally important that you have an understanding of perinatal mental health problems, as these are very common and affect more than 1 in 10 women.
If you can recognise that a woman has a mental illness, or is at risk of developing one, and you know which services can help her get the care and treatment she needs, you can make a huge difference to the woman and her family.
If your role involves work with women, their infants and families in the perinatal period, here are 10 things you should be aware of:
1. It’s not all Postnatal Depression
Women can be affected by a wide range of mental health problems in pregnancy and the postnatal period. These can include depression, anxiety, obsessive compulsive disorder, post traumatic stress disorder, bipolar disorder, postpartum psychosis and many more. Understanding some of the symptoms of these illnesses, and why women may be at risk of developing them, means that you are more likely to identify these women and help them to get the care they need.
2. Many women don’t get the care and treatment they need
A woman may not disclose current or previous mental health problems for many reasons, including stigma, fear that her baby will be removed from her care, or assumptions that what she is experiencing is normal in pregnancy or after birth. It is important that you routinely talk to women about their mental health. You can have an important role in identifying women at risk of perinatal mental illness and helping them to get referred to the services they need.
3. It’s never too early to start talking to women who have existing mental health problems about pregnancy
Unplanned pregnancies are common. It is important to discuss contraception and pregnancy plans with all women of childbearing age who have current or previous mental health problems. Women can be referred to perinatal mental health services for preconception advice when they want to plan a pregnancy.
4. Women who have perinatal mental health problems experience high rates of domestic abuse
Domestic abuse often starts or escalates in pregnancy. Women who have mental health problems are particularly vulnerable to domestic abuse. Experiencing domestic abuse can also lead to depression, post traumatic stress disorder and other mental health problems. Rates of domestic abuse have increased during the pandemic. All women should be asked about domestic abuse and the effect this has had on their mental health.
5. Suicide risk
Suicide remains one of the leading causes of maternal death in the UK. Women who die by suicide in the perinatal period use violent methods, such as jumping from a height or under a train. Recognising women who are at high risk of suicide is essential. Helping these women to access specialist care can potentially prevent women dying.
6. It’s always important to consider child safeguarding concerns
Many women who have perinatal mental health problems can still care for their baby and other children well despite their illness. However, it is important to consider risks to children, especially when parental mental illness is combined with other risks such as domestic abuse or substance misuse. Ensuring families get help and support early can prevent negative consequences for children that can sometimes be associated with parental mental illness.
7. Women can take medication for mental health problems during pregnancy and breastfeeding
Psychiatric medication should not be stopped when a woman finds out she is pregnant without considering the risks and benefits of treatment in her individual case. Women who stop medication for mental health problems can have high rates of relapse, even if they have been well for many years. It’s important that each woman talks to her GP or a psychiatrist to help her decide whether to continue, stop or change her medication. It’s just as important to have treatment for mental health problems as it is for physical illnesses in the perinatal period.
8. Talking therapies are effective
There are many different psychological interventions (talking therapies) that are effective for women who have perinatal mental health problems. These include individual and group therapies for women, parent-infant therapies, and couple and family therapies.
9. Partners need care and support too
Partners can face many challenges when a woman has a perinatal mental illness. Partners may find the transition to parenthood difficult. They may find it hard to manage competing demands, for example caring for a woman who is unwell, looking after a baby and other children and working. Partners can also experience mental health problems in the perinatal period and may need treatment.
10. Joint working and good communication are essential
There are many different professionals and services involved in the care of women and families in the perinatal period. These include maternity services, health visitors, GPs, general adult mental health services, primary care talking therapies services, children’s services, third sector services and also specialist perinatal mental health services and Mother and Baby Units. Understanding your local care pathways will allow you to help women access the services they need. All the professionals involved need to work closely with each other and with the woman and her family. Good communication is essential. Professionals need good supervision and space to reflect on their work. Whatever your role, you have an important part to play in ensuring women and families have the care and support they need. You can help to ensure women are as well as possible in the perinatal period and that families can enjoy this important time in their lives.
Would you like to learn more?
If you would like to develop your understanding and confidence in relation to the care of women during the perinatal period, our introductory Digital Academy courses may be for you.
Developed by Consultant Perinatal Psychiatrist Dr Lucinda Green, ‘A Brief Introduction to Perinatal Mental Health‘ and ‘Introduction to Perinatal Mental Illness, Risk, Care and Treatment‘ will support you in understanding the prevalence and impact of perinatal mental illness – building the core theoretical knowledge and practical skills that are central to providing effective care throughout this period.
With a strong clinical focus, both courses benefit from a range of engaging interactive and multimedia elements and a flexible, self-directed format – allowing them to easily be incorporated into a busy schedule.