Mental health issues during pregnancy and the first year postnatally are common, yet often go unrecognised.

Professionals can play an important role by supporting women and families to access support.

Introduction

Mental health issues affect up to 20% of women during the perinatal period, which includes pregnancy and the first year following childbirth. There are a number of ways in which professionals can support good mental health for women in this time, and in turn this can contribute to the wellbeing and healthy development of babies and infants. This is particularly important because the children of mothers who experience mental illness are at an increased risk of being born prematurely and having low birth weight, as well as having behavioural and emotional difficulties later in life. Even relatively mild mental health difficulties can inhibit a mother’s ability to provide her baby with sensitive, responsive caregiving.  Perinatal mental illness is a leading cause of maternal death within a year of birth. Many perinatal mental health issues go unrecognised and are underreported, professionals working with women and families during the perinatal period therefore have an important role to play in helping them to access the support they need.

Often, difficulties arising in the perinatal period are similar to mental health issues arising at other times of life and may include:

  • anxiety
  • depression
  • generalised anxiety disorder (worry)
  • obsessive-compulsive disorder
  • post-traumatic stress disorder

There can also be some important differences in terms of the nature, course and potential for relapse of a mental health problem. 

Professionals should be aware that some women may show ‘red flag’ presentations, which should be considered psychiatric emergencies and prompt an urgent senior psychiatric assessment. 

The Yorkshire and Humber Mother and Baby Unit may be contacted, call 0113 855 5509 if any of the following symptoms are present:

  • Recent significant change in mental state or emergence of new symptoms
  • New thoughts or acts of violent self-harm
  • New and persistent expressions of incompetency as a mother or estrangement from the infant

Having a pre-existing history of psychosis or bipolar disorder, or significant family history (e.g. a relative who experienced postpartum psychosis themselves) may be considered amber flags in terms of being at elevated risk, and should be referred to Leeds Perinatal Mental Health Service

To contact the duty clinician call 0113 855 5505 for advice or a referral form may be sent to perinataldutydesk.lypft@nhs.net.  

Pregnancy and childbirth can be a trigger for women experiencing wider psychological difficulties which might start for the first time during pregnancy. The pages in this section set out some of the key issues to take into account and offers resources for professionals working with new and expectant mothers.