The mental health needs of pregnant and postnatal women are not being met, according to research carried out at the University of Edinburgh.
The study highlighted significant gaps in the mental health services provided throughout the perinatal period, with many women needing to be seen earlier in their pregnancy rather than being referred postnatally.
In addition, the researchers say healthcare workers need to be better informed about mental wellbeing during and after pregnancy and suggest women would benefit from access to a broader range of treatments, including psychological therapies or peer support during this time.
The findings are published in Psychology and Psychotherapy: Theory, Research and Practice. Despite recent improvements in clinical practice, they highlight the need to better understand a woman’s psychological needs in the perinatal period.
Mental Health Difficulties during Pregnancy (MHDP) are common, with between 7 and 20 per cent of pregnant women experiencing depression and around 15 per cent experiencing anxiety. Co-morbidity of these conditions can often occur, as well as the worsening of pre-existing conditions such as OCD and eating disorders. Untreated MHDP is associated with birth complications and low birth weight, attachment difficulties and childhood behavioural issues, as well as perinatal suicide.
Researchers at the University of Edinburgh worked with NHS Grampian and interviewed 11 women with moderate mental health problems from urban and rural areas in Scotland for the study.
The women interviewed felt there needed to be a more realistic awareness of the difficulties of pregnancy and the associated mental health issues that can occur. They described the stigma and shame attached to experiencing mental difficulties during the perinatal period, particularly when their experiences did not match their expectations of pregnancy. The researchers found that guilt and shame prevented women from seeking help and sharing their emotions with others.
Angus MacBeth, senior lecturer in clinical psychology at the University of Edinburgh, stated that work needed to be done to fill the gaps in the services.
He said: ‘We need to ensure that services have an optimal fit to the needs of the individual, especially during pregnancy, as well as once the baby is born. The voices of the women interviewed in our research offer a powerful reminder that although perinatal mental health care provision across the nations of the UK continues to improve, there is still work to ensure that services have an optimal fit to the needs of the individual, especially during pregnancy, as well as once the baby is born.’
Despite participants describing positive experiences of perinatal mental health services, the women felt there was a need for earlier referrals. Most women were referred postnatally and received no input during pregnancy.
Dr MacBeth added: ‘It is vital that health and social care providers, including the third sector, are well informed about perinatal mental health so that they can effectively engage with individuals during pregnancy.’
