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Midwives demand better mental health support for women

Study finds postnatal depression more common after birth of male baby, and birth complications

Louise Prime

Thursday, 08 November 2018

We need greater investment in specialist mental health midwives and maternal mental health services, and maternity services must be able to offer women the support they need throughout and after their pregnancy, including continuity of carer, the Royal College of Midwives (RCM) has demanded. It said it is “simply not good enough” that currently only about half of NHS trusts in England provide a specialist maternal mental health service to women.

Research* published online yesterday revealed that birth of a male infant and birth complications are each separately associated with a significantly increased incidence of postnatal depression (PND): the odds of PND increased by 71–79% when male infants were born compared to female infants; and the occurrence of birth complications increased the odds of PND by 174% compared with having no complications.

The study authors pointed out that both factors “can be easily assessed by health professionals” and concluded: “We hope these findings will encourage further investigation of whether women experiencing complications, particularly if their consequences are prolonged, should be monitored for depressive symptoms.”

The College reported** in July last year that mental health problems in pregnancy and postnatally are the most common serious health problems suffered by women, and one of the main causes of death at this time, and called for urgent action against the ‘shocking situation’ in which unacknowledged and neglected suffering and despair are common experiences for women in the UK.

RCM global advisor Joy Kemp said: “What is important is that our maternity services are able to offer women the support they need throughout and after their pregnancy. Improving continuity of carer will support this. This is when women see the same midwife or group of midwives throughout and after their pregnancy. With this way of caring for women midwives will know the woman better and be better able to spot problems such as PND developing, and then take action to support the woman and organise the care they need.”

She added: “There is also a need to invest in specialist mental health midwives and maternal mental health services. Every trust and board with maternity services should have a specialist midwife in post to enable women who are unwell to get the very best care and support they need. Currently only around half of NHS trusts in England provide a specialist maternal mental health service to women and this is simply not good enough.”


* Myers S, Johns SE. Male infants and birth complications are associated with increased incidence of postnatal depression. Social Science and Medicine 2019; 220: 56-64. Available online 19 October 2018. DOI: 10.1016/j.socscimed.2018.10.008

** Every mother must get the help they need. Royal College of Midwives, July 2017.

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