Perinatal Mental Health Experiences of Women and Health Professionals

Perinatal mental illness is relatively common amongst women and occurs in the period from conception to the baby’s first birthday. Research has shown that depression alone can affect one in seven women. This report describes the key findings from two surveys: of around 1,500 women; and of more than 2,000 health professionals. In both surveys, although respondents were self-selected, their number enables trends to be identified with confidence.

Survey of women who suffered with perinatal mental illness
In the survey of women, all had experienced some form of mental health problem during the perinatal period. Almost half said they had suffered with either depression or anxiety while they were pregnant, and two thirds said they had suffered with postnatal depression. Two per cent had suffered with puerperal psychosis.

The most common symptoms were low mood and tearfulness, experienced by eight out of ten women. In all, more than eighteen symptoms were described, with some being notable because it is less likely that they would be picked up by health professionals. For example, half experienced feelings of anger, while more than four out of ten felt it was hard to leave the house. Over half experienced a change in their appetite with over-eating more common than a loss of appetite. Bonding with their baby was difficult for just over a quarter of those surveyed and a fifth reported having suicidal thoughts.

Survey of professionals
The survey of health professionals included the experiences of hospital and community midwives (365), health visitors (1330), Family Nurse Practitioners (106) and others. Almost all the midwives reported that they ask women about their emotional wellbeing when they are booked in for maternity care, but only one in ten of women recalled or recognised that they were being asked. It was suggested by some professionals that there is an over-reliance on the use of the Whooley questions alone, which are currently recommended for use as a first step in case finding by NICE.

Women with a previous history of mental health problems are at increased risk of developing mental health problems during pregnancy and the postnatal period, but only half of professionals said that they were confident that they knew about the previous history of the women in their care. They acknowledged a lack of confidence due to poor or insufficient training, availability of information from other professionals, undocumented history in maternity notes, poor continuity of care, lack of support services and the reluctance of women to discuss their mental health issues.