There is increasing awareness of perinatal mental health as a public health issue. The Government is keen for midwives to further develop their role in public health. Midwives need to be adequately prepared to take on a more developed role in perinatal mental health if practice improvements are to be made. I am aware that death from psychiatric causes has been the leading cause of maternal death for the last few years. Although the most recent Confidential Enquiry into Maternal and Child Health indicated that this is no longer a leading cause, mental health problems before and after childbirth have a significant impact on the health of women, family relationships and children’s subsequent development. I believe that midwives need to be able to detect women with current mental health problems and those at high risk of a serious mental illness following delivery, in order to improve the care and support offered to them throughout their contact with maternity services. One of the most serious areas where we see ongoing harm is in adult mental health. Recent research shows that a large proportion of adult mental health problems can be laid at the door of early childhood. We need to consider the likely future effects of not breaking the cycle while these people are young. The ACE Study estimates that 54 per cent of current depression and 58 percent of suicide attempts in women can be attributed to adverse childhood experiences, which also correlate with later high levels of alcohol and drug consumption. In order to screen systematically and sensitively, and to enable them to refer on appropriately, I feel that midwives need to understand why they are asking questions about mental health; how to encourage women to disclose past and current problems; what the risks of recurrence and relapse are; and what services are available in their area of practice. 1|Page
I feel very strongly that having post graduate qualifications and experience like my own in counselling and different approaches to psychotherapy are essential attributes for this post. The facts about childbirth and mental illness are startling (reference, Oates M 2001): About one in ten women will develop postnatal depression after delivery. < After psychosis (puerperal) postnatal develop will women 500 in one> Suicide is one of the leading causes of maternal death in the UK. A woman is 20 times more likely to be admitted to a psychiatric hospital in the two weeks after delivery than at any time in the two years before or after. Despite this, talking about and confronting the issue of mental illness during pregnancy or the postnatal period still poses challenges for healthcare professionals. Motherhood is loaded with emotive expectation. This contributes to a large number of cases of perinatal mental illness going undiagnosed. This can have serious consequences including poor bonding between mother and baby; reduced quality of life for the mother, baby and father; prolonged disability caused by living with an untreated serious mental illness; and potential risk to the health and safety of the mother, baby or other family member, either through neglect or harm due to illness. As a midwife with 20 yrs of clinical practice and with some experience as a service user, I was pivotal in setting up the current bereavement service and have been Counselling women and their families at West Middlesex Hospital since June 2009. I also have experience of providing supportive psychotherapy to a diverse range of clients with differing pathologies in a primary care and private setting since 1999. In my Role as Midwifery Matters facilitator (2007-2009) South East Strategic Health Authority, I regularly travelled across the patch, giving presentations to multi professional audiences. I am confident in designing, producing and presenting a
range of presentations, including role play, power point, interpersonal workshops and...