In February 2011, the month after my son was born, I became ill with severe postnatal depression. I remained ill for the majority of his first year. The NHS care I received kept me safe - I was a risk to myself, and therefore was admitted to a Mother and Baby Unit. But it didn't do much else to help me: it was only after I gained admission to a private hospital that I really started to get better. I was lucky to have the means.
Although now recovered, the severity of my illness, the mental scars it left, and my grief over the time missed with my son can still catch me unawares.
As a survivor of postnatal illness, I know that perinatal mental health provision is patchy at best. But even so, I was completely horrified by the figures recently released by the National Childbirth Trust (NCT) based on data they gathered through FOI requests.
When they contacted Clinical Commission Groups (CCGs) across England, they found that only 3% said they have a perinatal mental health strategy. Worse still, of the remaining 97% with no strategy, 60% have no plans to put one in place.
It's hard not to be shocked - especially when we consider that suicide is one of the leading causes of death for women during pregnancy and one year after birth.
I came so close to ending my life during the months I suffered - I wanted the mental anguish to stop and I genuinely thought I may never recover. I was not alone in feeling like this, and now my heart aches for those who have died - and the families left behind.
Perinatal mental illnesses can be mild, moderate or severe. The mental illness can have existed before pregnancy, or it can develop for the first time or be greatly exacerbated in the perinatal period - and each illness requires different kinds of care and treatment.
Yet often we see ‘postnatal depression’ used inappropriately to cover all perinatal mental illnesses. Antenatal depression, maternal obsessive compulsive disorder, postpartum psychosis, post-traumatic stress disorder – general knowledge about such conditions is poor. Is it any wonder, when we consider the huge gaps in provision for mothers?
There is a fundamental lack of understanding about the impact that infertility, conception, pregnancy, birth, becoming a parent and bereavement (both ante- and postnatal) can have on mental health. As a society, we mythologise reproduction and everything that comes with it. It is glowing and magical – all soft-lighting and pastels - and therefore impervious to anything untoward. It helps no one in the long run, because it implies that variation from the “norm” is unacceptable.
Even as I write this I can feel the effects of the stigma – how much do I disclose? What will the response be? I'm not proud to have been suicidal, but I refuse to feel guilty about my illness. I find that when people are judgemental, it tends to say more about them than me - and I want to talk about what happened to me to prevent further deaths.
It’s not that the medical profession don’t acknowledge the seriousness of this issue. Clinical guidance issued by the National Institute of Health and Care Excellence (NICE) in 2007 on antenatal and postnatal mental health states that: “Mental disorders during pregnancy and the postnatal period can have serious consequences for the health and wellbeing of a mother and her baby, as well as for her partner and other family members.”
And yet, in response to the NCT's request for information, some CCGs directed them to local NHS trusts or NHS England. This suggests a lack of clarity about who is responsible for commissioning and providing services. Amazing charities are attempting to fill the voids, but we shouldn't need to rely on the third sector to do this - there are massive gaps in services, and the NHS needs to step up.
For me, it’s personal - I am incredibly thankful to have survived, and I still wonder how I managed it sometimes. But it should also be personal for anyone who may give birth, or who has a partner, sister, daughter or friend who may. This is why the Maternal Mental Health Alliance has launched its #everyonesbusiness campaign. It highlights that pregnant women and new mothers in almost half of the UK do not have access to specialist mental health services, potentially leaving them and their babies at risk. They have even put together maps to show the gaps in provision.
This is an issue that needs urgent attention - something very fundamental is broken, and it involves all of us.
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Guest post: Mental health care for new mothers - 'my bad experience was one of many'
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MumsnetGuestPosts · 08/07/2014 17:37
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