Perinatal mental health services
What is perinatal mental health?
The perinatal period is usually defined as the time between conceiving a baby until the end of the first postnatal year. 20% of women (or 1 in every 5 women) experience mental health problems during this time, making this a relatively common experience. Women may experience mental health problems prior to pregnancy and/or develop mental health problems during pregnancy or in the postnatal period.
A wide range of mental health conditions can occur during this time, most commonly depression and anxiety. Research shows that 50% of women with depression go undetected and do not access treatment and support. There are some conditions specific to this time in a woman’s life such as tokophobia – a severe fear of child birth, and post-partum psychosis – a severe but treatable illness that occurs after having a baby.
It is not always possible to predict whether or not a woman is likely to experience mental health problems during this time, however, we do know that some groups of women are at much higher risk, for example, 25% (or 1 in 4) women with bipolar affective disorder experience post-partum psychosis.
Why is perinatal mental health so important?
It is vital that women receive treatment and support as early as possible. We know that if left untreated, mental illness can have a significant and long lasting impact on women and their families.
The perinatal period is often a window of opportunity: treating mental health problems at this time prevents avoidable suffering and isolation, strengthens families, ensures children have a healthy start, has economic benefits and helps to prevent suicide – a leading cause of maternal death in the UK.
What support is available?
Women with mild to moderate mental health problems can be supported by a range of services in primary care, such as through GPs, mid-wives, health visitors, primary care psychology services – IAPT (Increasing Access to Psychological Treatment), and in places like children’s centres. There are many third sector organisations that also provide a range of support services.
Women with more severe or complex illnesses, for example, schizophrenia and bipolar affective disorder should be seen by a specialist perinatal mental health team.
What are specialist perinatal mental health services?
Community perinatal mental health teams
Community perinatal mental health teams support mothers who are experiencing moderate to severe mental health problems in the perinatal period to recover in the community.
They also offer pre-conception advice to women with existing mental health problems who are planning a pregnancy.
They are staffed by a range of professionals and offer family focussed interventions, and work closely with maternity services, health visitors, IAPT, GPs, other community services and third sector organisations.
Maternal Mental Health Services
The NHS Long Term Plan included a commitment to develop and implement maternal mental health services (referred to in the Long Term Plan as maternity outreach clinics) in every area of the country by 2023/24.
Maternal mental health services will combine maternity, reproductive health and psychological therapy for women experiencing moderate to severe or complex mental health difficulties directly arising from, or related to, their maternity experience. This may include those who experience post-traumatic stress disorder following birth trauma, perinatal loss or severe fear of childbirth (tokophobia). You can find more information on maternal mental health services in London here.
Mother and baby units
Mother and baby units provide specialist care and treatment when a mother is suffering from a mental illness and needs an admission to hospital.
These services allow for the mother and her baby to remain together, supporting their attachment and bonding, while the mother receives the care and treatment she needs to recover from mental illness.
A range of family focussed interventions are on offer, with staff including psychiatrists, nurses, psychologists, nursery nurses and occupational therapists. Women can be admitted from 30 weeks of pregnancy until the end of the first postnatal year.
Perinatal mental health resources
Building better perinatal mental health services
In this video, hear directly from parents about their experiences, find out more from clinicians about what they do within specialist mental health teams, and see what a good specialist service looks like.
Finding your local community perinatal mental health service
Download our community perinatal mental health services information sheet that lists local services in London.
Resources produced by the London Perinatal Network
- The Perinatal mental health services for London: guide for commissioners outlines components according to how they are accessed and commissioned, highlights key priorities for commissioning perinatal mental health services based on existing national standards, and considers London’s unique challenges and demographics
- Help and emotional support during pregnancy and the first year after having a baby is an information sheet for pregnant women and their families about support that psychological therapy services (IAPT) can offer. It was developed in collaboration with the London IAPT leads and is supported by London Clinical Networks
- The perinatal mental health care pathway, endorsed by the co-clinical directors of the Maternity and Mental Health Strategic Clinical Networks, outlines the different strands that sit across the perinatal mental health life span. Five major strands are included:
- Maternity and neonatology
- Maternal mental health psychiatry
- Maternal mental health psychological therapies
- Parent-infant mental health
- Social care
- Pan-London Perinatal Mental Health: Guidance for Newborn Assessment aims to provide guidance for health care professionals involved in the care of babies born to women who have taken medication for mental disorders during pregnancy.
Resources produced by our partners
- Parent Infant Partnership UK: Rare Jewels
- NHS England: Mental Health Taskforce’s The Five Year Forward View for Mental Health.
- NHS England: National Maternity Review Report
- Department of Health and Social Care: Future in Mind report
- Department of Health and Social Care: Annual Report of the Chief Medical Officer 2014: The Health of the 51%: Women
Other resources
- National Perinatal Epidemiology Unit: Perinatal mortality Surveillance Report – UK Perinatal Deaths for Births from January to December 2014
- Cheshire and Mersey Specialist Perinatal Service has developed a brand-new training hub for professionals, focused on supporting perinatal mental health during a pandemic.
