Left unchecked - why maternal mental health matters

Healthwatch England undertook a survey about maternal mental health to see whether the introduction of a mental health check in the six week mental health check had made a difference.  They heard from 2,693 people who had had a baby since April 2020.

Care in hospital is having an impact on mental health. Nearly half (42%) of respondents experienced negative impacts on their mental health due to the care and support they received during labour. 

Postnatal consultations are not working well for most women. Only one in five were satisfied with the time their GP spent talking to them about their mental health.

Some GP practices are not complying with the requirement to deliver the six-week postnatal consultation. Sixteen per cent did not have a postnatal appointment at all. This was at a similar level for all three time periods whether during the pandemic or not. 

Many new mothers and birthing parents are struggling to access the support they need for their mental health. Two-thirds  struggled with their mental health during and after pregnancy. Of these, 41% received no support at all. 

There are long waits for maternal mental health referrals. Nearly three in five (58%) of these waited over two weeks for an appointment, and just under one in five (19%) waited over six weeks. Some people  waited between six and 18 months or were never contacted. 

Delays in accessing mental health support can have a devastating impact on new parents. Many people said that their mental health suffered whilst waiting for treatment. Some struggled to leave the house, bond with their child or experienced a breakdown of relationships. 

First-time mothers are more vulnerable to mental health impacts and are less likely to receive the care they need. Over a third (35%) of first-time mothers experienced mental health difficulties for the first time; almost half (44%) of these didn’t receive any guidance or referrals when experiencing mental health difficulties. This creates a double burden of stressors on first-time mothers.

A lack of support erodes trust in NHS maternity services. Several participants stated they would not have another baby due to their traumatic experiences and poor care or would use private healthcare services for future births. It is essential to tackle the issue of care given and support available with mothers’ first engagement with the maternal healthcare system, as it will facilitate trust in the longer term. A lack of trust can increase burdens on the healthcare system and the mother herself later down the line. The consequences of not accessing high-quality perinatal mental health care are estimated to cost the NHS and social care £1.2 billion per year.

 There is a gap around monitoring whether the postnatal consultations are taking place in line with best practice guidance. Integrated Care Boards (ICBs) do not consistently monitor whether the postnatal consultations are taking place. GPs are not always aware of best practice guidance on making these consultations meaningful.