A Cavendish Square Group publication 19 Addressing the mental health needs of pregnant women and women in the first year following the birth of their babies By Dr Ben Nereli, Consultant Perinatal Psychiatrist and Jane Street, Associate Director, Psychology and Psychotherapies at South West London and St George’s (SWLSTG) Mental Health NHS Trust The National Institute for Health and Clinical Excellence (NICE) and a number of recent publications1 describe perinatal mental wellbeing as one of the most current and pressing issues in women’s health today. Maternal mental health disorders have a negative impact upon a couple’s relationship as well as on infant and child development. Perinatal mental illness is a leading cause of maternal morbidity and mortality in high-income countries. The search for an effective treatment has become a priority. The Community Perinatal Mental Health Service, based at Clare House at St George’s Hospital, and the Wandsworth Improving Access to Psychological Therapies service (IAPT) have developed a number of initiatives to support perinatal women and their mental wellbeing in South West London. The Community Perinatal Mental Health Service is a small, highly specialised service providing assessment and treatment to pregnant women or women who have given birth in the past 12 months and who live in the London boroughs of Wandsworth, Merton, Sutton, Kingston and Richmond. Women are referred to the service in a number of ways including by their GPs, midwives and health visitors or by social services and the other adult mental health services within the South West London and St George’s Mental Health NHS Trust area. The Service provides support and care for pregnant women and new mothers experiencing mental health problems, as well as offering counselling and advice pre-pregnancy to those who are considering having children. One patient describes her experience with the St George’s Perinatal Service: “I was referred to St George’s following a psychotic episode immediately after the birth of my first child. I was supported for the following year by my consultant regarding the support I and my husband might need to avoid another episode if I were to have a second child. The consultant listened to what I thought I might need in terms of a C-section, medication, support from family and my husband, described a support process and drafted a care plan. This was incredibly reassuring and gave my husband and I the security we needed. “During my second pregnancy I regularly met with my Specialist Mental Health Midwives. I immediately felt comfortable with both of them. I felt, very quickly, that they knew me and understood how to help me feel safe and supported. My Consultant Perinatal Psychiatrist and Specialist Midwives organised meetings with my Consultant Obstetrician and Anaesthetist to minimise any stress I might experience as the birth approached. My care plan was thorough yet simple and I was fully included in the process. It was also made available for any professional that needed to be aware of my needs. I had developed a complete faith in all the professionals I met during my pregnancy and after my previous experiences in another hospital where I had my first baby, this was not a given. “During and after the birth of my second child, my Specialist Midwife and Consultant Perinatal Psychiatrist continued to support me. The way in which the perinatal team, with their professional experience and confidence and sense of humanity, would always respond to my individual situation and personal needs meant that I did not suffer a second postnatal psychotic episode and my baby and I remained safe and well. 1(Prevention in Mind June 2013; The Cost of Perinatal Mental Health Dec 2014; Falling through the gaps: perinatal mental health and general practice March 2015)
London Mental Health Fact Bbook
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