Maternal mental health including perinatal

Local picture

Unfortunately there is no local data on specific perinatal mental illnesses, although we can estimate the numbers based on national prevalence data. Indicators have now been included in both the maternity and health visitor’s service specification which means future analysis will give a more detailed local picture.

Table 4 shows the numbers of live births from 2006 to 2014 with 3246 live births for Central Bedfordshire.

  2006 2007 2008 2009 2010 2011 2012 2013 2014
Table 4: numbers of live births in Central Bedfordshire. Source: ChiMat and Office for National Statistics
Central Bedfordshire 3,014 3,180 3,246 3,092 3,176 3,298 3,295 3,214 3,246

Table 5 is another example of showing the live births trend in Central Bedfordshire against the number of live births in Bedfordshire.

Table 5: Trend of live births in Central Bedfordshire

Table 5: Trend of live births in Central Bedfordshire

We can use the annual number of births for Central Bedfordshire, and the national prevalence rates for different conditions to estimate the numbers of women presenting with mental health problems in Central Bedfordshire, see Table 6.

Rates of perinatal psychiatric disorder per thousand maternities Estimated number of women affected in Central Bedfordshire each year
Table 6: Annual rates of perinatal psychiatric disorder per thousand maternities. Source: Guidance for commissioners of perinatal mental health services. JCPMH. *Based on 2013/2014 birth rate
Puerperal psychosis 2 in1,000 10

Puerperal psychosis:

Women who have suffered from puerperal psychosis before

50% chance of reoccurrence

5 additional to the number above

Chronic serious mental illness 2 in 1,000 10
Severe depressive illness 30 in 1,000 90
Mild-moderate depressive illness and anxiety states 150 in 1,000 445
Post traumatic stress disorder 30 in 1,000 90
Adjustment disorders and distress

150 to 300 in 1000

445 to 885

In addition to the psychiatric disorders shown above, we can also calculate the number of women in Central Bedfordshire who are affected by mental health conditions shown in table 1. Based on 3246 Central Bedfordshire live births, Table 7 illustrates the local rates of mental health conditions.

Condition Estimated prevalence Estimated number of women affected in Central Bedfordshire each year
Table 7: Local estimates of the prevalence of mental health conditions. Source: Royal College of Psychiatrists
Baby blues 80% 2,597
Postnatal depression 10% - 15% 326 - 487

Although baby blues due to hormonal fluctuations after birth is a relatively frequent finding, establishing cases that could potentially lead to postnatal mental illnesses, including postnatal depression is vital. As such postnatal depression falls someway between baby blues and puerperal psychosis in terms of severity, duration and prevalence.

Poor social support

Women who lack social support have been found to be at increased risk of antenatal and postnatal depression (1). Having a poor or no relationship with a partner is also a risk factor for postnatal depression.

The Office for National Statistics show that infant mortality rates are higher among babies that are registered in one name (that is, by just the mother) than for other registration types (2).

The table below shows the number of births that were registered by just the mother. This provides an indication of the number of women that are likely to lack support of the father during pregnancy and as a new mother. Although the rate of sole registrations is lower in Central Bedfordshire than nationally, this still equated to 127 births in 2014.

Table 8: Sole registrations of births in 2014. Source: Office for National Statistics
Central Bedfordshire 3.9% (127)
East of England 4.3%
England 5.4%

Mother-baby relationship

There are no specialised inpatient mother and baby units in Central Bedfordshire, the nearest being near Hatfield (Hertfordshire). Acute serious perinatal illness typically presents as an emergency and often requires inpatient care. Separation of mother and infant prevents the early development of mother baby attachment and relationship. This could be difficult to reverse and have longstanding effects on both child and mother. Separation causes distress and interferes with treatment of the mother and could prevent breastfeeding. The NHS England Clinical Reference Group for perinatal mental health is working to improve quality of care and equity of access to specialist care (3).

 

References

(1) NICE (Internet). NICE clinical knowledge summaries. Depression - antenatal and postnatal. London: National Institute for Health and Clinical Excellence; 2013 (updated 2013 Jan; cited 2015).

(2) Office for National Statistics. Gestation-specific infant mortality, 2013 (Internet). Newport: ONS, 2015 (cited 2015 Nov 19).

(3) Department of Health (February 2014) Closing the Gap: Priorities for essential change in mental health


Last updated Thursday, 11th May 2017