Shining a spotlight on perinatal mental health

I would one day like to become a mum. Part of me is filled with excitement about bringing a child into this world, the pitter patter of tiny feet early in the mornings and waving them off on their first day at school. However, another part of me is somewhat anxious about this potential new life. People tell me that ‘children are the best gift ever given to you’ and ‘having a baby is a life-changer and gives you a whole new perspective on why you wake up every day,’ but what happens if I don’t want to wake up? Perhaps if I can’t have children, or if I do and I feel suffocated, isolated and inadequate in providing love, care and financial stability to my child. What if either me or my partner experiences a perinatal mental health illness?

We all need to be more proactive in acknowledging that 20% of women develop a mental health issue during pregnancy or within a year of giving birth (Public Health England 2019). Within your friendship group, your workplace, or your family, you will know someone who is struggling with their mental health because of pregnancy and parenthood.

Mental health illness during the perinatal period comes in various forms, including anxiety and depression; 50% of pregnant women experiencing this go undetected and do not access treatment and suicide is the leading cause of maternal death in the UK (Healthy London Partnership, 2020).

But it is not only new mums that experience perinatal mental illness, partners do too. In fact, one in ten new fathers experience postnatal depression, with up to 45% affected by postnatal stress and anxiety (Fathers Network, 2020). Research has also shown a higher incidence of perinatal depression in lesbian women compared to heterosexual women (Royal College of Psychiatrists, 2020). Gender and sexuality are not the only characteristics that can contribute to perinatal mental illness in new parents, research shows that there are various factors that can increase the likelihood:

Ethnicity: individuals and partners from ethnic minorities are more likely to experience mental health illness during or after pregnancy. The reasons for this are unclear, however contributing factors could include poverty, lack of social support, services that do not meet the needs of this population, language barriers and stigma around accessing services (NIHR, 2019).

Gender reassignment: Greenfield and Darwin suggest individuals of the trans population who do not feel ‘man enough, trans enough, pregnant enough or safe enough during pregnancy, birth and postpartum’ are at greater risk of experiencing perinatal mental illness (2020).

Coronavirus and vaccinations: evidence suggests that women are experiencing enhanced mental health challenges during the perinatal period because of the pandemic and government or hospital-imposed restrictions. Elements that contribute include changes to labour and birth, the shift from face-to-face consultations to remote, and informed decision making on receiving a vaccination (Maternal Mental Health Alliance, 2021).

Existing physical health illness: physical health problems significantly increase the risk of poor mental health and vice versa (The Kings Fund, 2021). Brown et al. (2019) found that women with a physical health condition were more likely to experience perinatal mental health illness.

So what can you and I do?

We know that if a mental health illness is left untreated during the perinatal period, it can have significant long-lasting impacts on women, partners, their children and other family members. The perinatal period offers a window of opportunity. The prevention, recognition and treatment of mental health problems during this time is vital.

Recognising the need to do more in this area of mental health, the Health Innovation Network (South London AHSN) hosted a national Innovation Exchange webinar: ‘Maximising Digital Opportunities in Perinatal Mental Health and Wellbeing’. Digital solutions were presented alongside an NHS Provider that had already successfully introduced one of the solutions into their service.

The digital interventions presented at this event all provide innovative approaches to help prevent mental health issues and promote physical and mental wellbeing. They were selected following their work with the NHS Innovation Accelerator, DigitalHealth.London Accelerator Programme, the TechForce19 programme and NHS Providers with special consideration given as to how inclusive they are to all new parents, how they work with parents to co-develop their intervention, and how they tackle digital exclusion. The solutions selected are detailed below:

1. MUTU System: clinically proven support for pre and postnatal fitness
2. Baby Buddy: a guide through pregnancy – designed to help you look after your baby’s mental and physical health, as well as your own, and give your baby the best start in life
3. MUSH: bringing local mums and mums-to-be together through pregnancy via peer group pods of five to learn, share, forge friendships and navigate each week together
4. Peppy: providing ready to access highly trained practitioners at the touch of a button on a smartphone
5. SilverCloud: providing evidence-based wellbeing and behavioural health solutions, delivered digitally and at scale with programmes to support depression, anxiety, phobia, OCD and more
6. Ieso Health: chat to a therapist in private from your own home.

I would encourage everyone to proactively ask how your friends, colleagues and families are coping. It’s ok not to feel ok at this time. Talk, listen and guide people to find support.

If you are an innovator or healthcare professional who would like to hear more about work in this area, listen to our Innovation Exchange podcast episode on perinatal mental health.