Poor mental health during pregnancy is killing mothers and threatening the physical and mental development of babies

Statistics are showing that one in seven mothers who die between six weeks and a year of giving birth are killing themselves.

The leading body investigating maternal deaths in the UK says that suicide is the leading direct cause of maternal deaths in the year following childbirth, more than haemorrhage, pre-eclampsia or blood clots.

This means that undiagnosed and untreated psychiatric health conditions are quite simply killing women in the UK - and across the world.

It gets worse - mental stress during pregnancy could result in low birth weight of the baby, growth restriction, premature birth, pre-eclampsia, physical and mental health problems of the child later in life. However, it is important to remember that not all mothers/ babies are affected.

Raja Gangopadhyay is a Consultant Obstetrician and Gynaecologist with a special area of clinical interest in Perinatal Mental Health. He works tirelessly to highlight this plight and wants to reshape maternity services and educate us all.

He said: “Mental health conditions during pregnancy are more common than diabetes, high blood pressure (pre-eclampsia) or heart disease. Yet, it’s not treated with the same readiness or seriousness by the medical profession. I am not sure why we still classify health conditions into ‘physical’ and ‘mental’ when there is often an overlap.

“Suffering and deaths from perinatal mental health illnesses are often preventable if appropriate measures are taken during pregnancy and in the immediate postpartum period. The perinatal period could offer a very efficient opportunity to detect and address mental health conditions as mothers have so many interactions with health care professionals during this period.
“However, this has remained neglected in many parts of the UK’s Maternity Services, there is a lack of uniformity on the perinatal mental health pathways within the Maternity Units across the country. So many mothers do not get adequate information and support during pregnancy.”

Doctor Gangopadhyay believes that urgent work is needed in this area and over the last few years he has raised his concerns regarding the need of better care within the Maternity Services with senior team members of all relevant Royal Colleges, the Maternal Mental Health Alliance, NHS England, the Maternity Review (2015-16), MPs and the Policy makers. He sincerely hopes that his concerns are acted upon soon.

In a bid to raise awareness he attended the All Party Parliamentary Group ‘1001 Critical Days’ meetings at the House of Commons to discuss the role of the Maternity Services and also spoke at a debate last year at the House of Lords.

This month, on November 20 he held his second debate at the House of Commons and gathering professionals and lay people from across the globe to discuss the ‘Importance of addressing Mental Health during pregnancy.’ This event had a great impact on the social media and reached 22.2 million Twitter impression alone.

He says that education and information should start early in the pregnancy and if possible, even before the pregnancy to minimise the risk.

He added: “Sadly the perinatal mental health has remained a ‘Cinderella’ in Obstetrics but the care is NOT always about funding.

“We as health care professionals must never forget priceless human values such as kindness, listening and use of sensible appropriate words during interaction with the mothers and their families. We must remember to put the mothers and their families first and foremost of everything we do. They are over and above any ‘clinical criteria’/ ‘guidelines’/ ‘pathway.’”

A perinatal mental health condition can affect ANYONE, irrespective of their ethnicity, cultural, financial, educational and professional background during pregnancy and one year of childbirth.
Raja says nobody is immune and every single pregnancy can result in postpartum psychosis or post-natal depression (PND) without any warning. It can happen to ANY mother even without a history of mental health problems before pregnancy.

Seven out of ten mothers who discontinue their medication during pregnancy, could have a relapse of their mental health symptoms, therefore, medications should not be suddenly stopped without medical advice. Depression during pregnancy is almost equally common as PND, therefore the symptoms should not be ignored.

He added: “At least ten percent of women develop mental illness during pregnancy and within one year of childbirth. Many mothers suffer in silence due to stigma, shame and fear of the baby being removed by social services. These sad deaths and suffering are often preventable.

“Finally, we must believe that ‘it is possible to make a difference’ through collaboration, working together with and (most importantly) listening to the mothers, their families and the wider community.

“If the pregnant mother is worried or depressed they may feel lacking in self-esteem. There is so much stigma attached to feeling low during pregnancy and that is one of the reasons it gets worse. They don’t talk about it and get the help they desperately need.

“One of the very big fears is that the child may be removed by social services but this is a complete myth. The very existence of mother and baby units show us that the health professionals acknowledge that the best place for the child is with their mother.

“Mental health conditions are killing more new mums within the first year of childbirth than any other pregnancy related illness. We all have a role to play to save the valuable lives of the mothers.

“This is an illness. It needs care, it needs support and it needs treatment, like any other health condition. With appropriate care, all women can recover.
“From the ‘Parliament to Pub’, we all need to be talking about this and listening to and taking extra care of the pregnant women in all of our lives."

Features : Sarah Newall Media

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