Doctors ‘Failing To Spot’ Depression In New Mothers

Doctors are missing vital signs that mothers are depressed and at risk of harming themselves or their babies, experts have warned. An estimated one in seven women experience mental health problems either before giving birth or in the year after.

And new guidelines issued said the Health Service had to do much more to tackle the problem. Family doctors and other health staff will be expected to put a series of questions to young mothers to gauge whether they need support.

Mothers will be asked if they have been bothered by feeling down, depressed or hopeless, have taken little interest or pleasure in doing things and whether they feel they need help.

The guidance from the National Institute of Health and Clinical Excellence said that mothers needing psychological treatment should be seen within a month, and again within a further three months.

Steve Pilling, consultant clinical psychologist at University College London, said depression in mothers had a long-term detrimental effect on their children. “Children who had mothers who had signs of anxiety tended not to do as well in terms of educational performance,” he added. “This impact is very significant if looked at overall across the country.”

Dr Pilling said performance differed between regions and doctors needed to offer better care to mothers. He added: “There is very significant under-recognition by doctorsof this. GPs need to recognise severe cases.”

Fiona Shaw, a patient representative on the NICE guidelines team, suffered severe depression after the birth of her second child. She said: “Mental health disorders in the antenatal and postnatal period are as serious as at any other time in a woman’s life, but with the added pressures and exhaustion that come with having a baby and a young family, and all the personal, familial and cultural expectations as well.

“So often, women feel guilty if they are struggling, or feeling low – as if it’s their fault. But many women I speak to are concerned they will not be listened to if they come forward, or that they will be judged, or that their condition is not serious enough to warrant help from a healthcare professional.

“These guidelines are about spotting what is not normal for each individual woman. This may be feeling highly anxious for a prolonged period, not eating, not enjoying anything, or maybe just staying in nightclothes, day after day, or find it increasingly difficult to go outside.”

The guidance says women should be asked regularly about their mental health and that GPs should be more happy to accept questions from mothers about their treatment. If the woman is pregnant or breastfeeding, her doctor should discuss with her the risks of taking or not taking medication to treat her illness at every stage.

Dr Gillian Leng, who drew up the guidance, said: “For the first time clear advice is provided to the NHS and women, no matter where they live in England and Wales.”

The guidance covers a range of illnesses including depression, eating problems, anxiety, schizophrenia and obsessive compulsive disorder.