Perinatal mental health

The term perinatal mental health is commonly used to describe the emotional and psychological wellbeing of a mother/birthing person and father/partner from conception, through pregnancy and up to the child’s first birthday.

Perinatal mental ill health encompasses mental health conditions that can affect parents during pregnancy or within the first postnatal year. These conditions include Antenatal and Postnatal Depression and Anxiety, Postpartum Psychosis, Obsessive Compulsive Disorder (OCD), Tokophobia, Birth Trauma or Post Traumatic Stress Disorder (PTSD).

Early recognition, support and treatment can be a huge benefit to the health and wellbeing of the whole family unit, so it is important to seek professional help/guidance from a GP or midwife as soon as you think you or someone you know might be affected by any of these conditions. You can read more about the conditions here. 

Common Risk Factors

 Certain factors can increase the impact of pregnancy and birth on your mental health. These risk factors do not guarantee you will suffer from perinatal ill health, but they can hugely impact your ability to transition into parenthood without added stress and worry.

• Previous history of mental illness
• Low social support (especially poor support from current partner)
• History of childhood trauma and poor parenting
• Pregnancy-related major life events/stresses
• Domestic abuse
• Substance misuse
• Relationship problems
• Major life events
• Loss of own mother
• Previous ectopic pregnancy, miscarriage still birth or neonatal/child death
• Birth trauma
• Financial worries – employment/debt
• Housing problems
• Baby with special needs/on neonatal units
• Teenage mothers/fathers
• Insecure environment – housing 

Common Treatments

Self-help:

Self-care/making time for yourself; healthy eating; increasing exercise; becoming more socially active; attending mother & baby groups/activities; practising mindfulness; developing self-help coping strategies; journaling; arts/crafting; peer-to-peer support and talking to friends and family to build your own support network around you.

More information on self-help tips and support can be found here: Self-help – NHS (www.nhs.uk)

Talking therapies:

Different types of talking therapies can be effective in treating perinatal mental ill health.

The most commonly offered are:

Cognitive Behavioural Therapy (CBT); Guided Self-Help; Eye Movement Desensitisation & Reprocessing (EMDR); Counselling; Psychotherapy (Anyone with a child under 1 will be prioritised. Parents should be triaged within 4 weeks & seen within 16 weeks as per NICE Guidance CG192)

 Further information on talking therapies and how to self-refer to your local service can be found here: NHS talking therapies for anxiety and depression – NHS (www.nhs.uk)

Medication:

There are a variety of medications that can support your recovery. Please do speak to your GP or midwife and they can help you to find the best one for you.

Bumps is a safe and useful website to research medications during and after pregnancy: bumps – best use of medicine in pregnancy (medicinesinpregnancy.org)

Specialist perinatal mental health services:

Specialist perinatal mental health services are available for any woman/birthing person who has a diagnosis of a mental health condition, during pregnancy or up to a year after the birth of their baby.

 More information on perinatal mental health services and referral processes can be found here: Perinatal mental health services: what are they? | Royal College of Psychiatrists (rcpsych.ac.uk)

For psychosis and severe mental ill health:

If you are concerned for your or your partner’s safety, contact emergency care immediately, where rapid support and treatment will be offered.

More information on how to get urgent help can be found here: Get urgent help for mental health – NHS (www.nhs.uk)

 Help offered could be support from the local mental health crisis intervention team, a place in a mother & baby unit and/or antipsychotic medication. Further information on mother and baby units can be found here: Mother and baby units (MBUs) | Royal College of Psychiatrists (rcpsych.ac.uk)