Maternal mental health - the Hidden Half

By Elizabeth Duff, Senior Policy Advisor, National Childbirth Trust on 23 April 2021 Maternal Mental health

Yesterday marked the release of our latest Hidden Half survey results. Last year, in April 2020, National Childbirth Trust (NCT)’s campaigning work led to secured funding for a dedicated postnatal maternal check in primary care so that new mothers have their own appointment and are offered adequate time for disclosure and discussion of their concerns.

NCT commissioned research, carried out in March, on nearly 1000 women in England who'd had a baby in that year. We found a quarter of women are not being asked about their emotional or mental health at their six-week GP check-up, around 150,000 in the last year. Many – even if the doctor asked – didn't feel comfortable to talk openly about a physical or mental health problem.

We've talked to GPs who do this check well and who find it really helpful to catch up with patients after a pregnancy. Even when the woman feels OK, there is so much to cover in the postnatal weeks for mums' wellbeing, including follow-up of pregnancy and birth complications, such as hypertension or gestational diabetes, as well as the scars and stitches that may result from a difficult birth. Women need to know how to care for themselves and if the problems may affect their later life or future pregnancies.

It's great for mums, and dads where possible, to talk through all their concerns of mental and physical health. For GPs who feel they need a refresh on how best to deal with sensitive postnatal issues, there is guidance and encouragement from the RCGP.

Midwives, maternity support workers (MSWs), health visitors (HVs) and GPs do their utmost for new mothers, knowing that this is a vulnerable time for the woman and her baby. But there's no doubt that resources in this area are over-stretched and some mothers fall through the gaps. The postnatal period is a time of fast-paced change. Both mother and baby can be thriving one week and have troubles the next, with a downhill spiral if problems are not spotted. First-time mums especially don't always know what is 'normal' and what isn't. In usual times, a chat with other mums – for example, in an NCT group – will clear up some worries, but that sort of support hasn’t been available for much of the year, so it’s been a very tough time.

The NCT website has lots of information that will help like but we haven't always been able to prevent new mums feeling isolated during the lockdown, in spite of all efforts including our permitted 'Walk & Talk' support groups.

Parents need their health and wellbeing to be the parents they want to be. At NCT, we want to work alongside midwives, MSWs, health visitors and GPs to make sure mums, their babies and their partners get all the help they need. Midwives in a trusted relationship with the women in their care can assure mothers that this postnatal check is there for them. If there are specific issues that the woman needs help with, the midwife should contact both HV and GP so that they’re aware of any extra needs.

At NCT, we know there is fantastic work going on to help parents: we just want to join it all up and make sure no family suffers unnecessary worries or delays in getting help because they don’t get the best practice that’s going.