Care Shortage Leaves New Mothers’ Lives At Risk

A shortage of specialist care for post-natal depression could drive more and more women to commit suicide, nurses warned yesterday. Suicide is the leading cause of maternal death and every year a small number even kill their own children.

But a shortage of specialist perinatal mental health nurses is making it much more difficult for the Health Service to save the lives of mothers with severe depression. Women are being separated from their babies and admitted to general psychiatric wards – making their condition more difficult to treat.

Delegates at the Royal College of Nursing’s annual congress in Harrogate demanded more funding to assess, support and treat women suffering from mental illness while pregnant or after the birth.

Nurse Karen Easton said: ‘Having a baby should be a time of great joy and pleasure. However, for many women it is blighted by mental illness. This is true both for women with a pre-existing illness and those whose illness begins in the early post-partum period. We are not discussing baby blues but serious mental illness, which for some women requires admission to hospital to maintain their safety and aid recovery. Many of them are admitted without their babies.’

Between 10 and 15 per cent of mothers experience mild to moderate depression and three to five per cent will develop moderate to severe problems. Two in every 1,000 women to give birth will experience psychosis which can lead them to have delusions and hear voices that may tell them to kill their baby. Women are 35 times more likely to develop a psychotic illness in the 30 days after giving birth than at any other time and every year a handful of women take their own lives.

The Confidential Inquiry into Maternal Deaths in 2001 recommended that every woman with post-natal depression should have access to a specialist mental health team and where admission to hospital is required they should have their child with them. But this is not happening in many areas. And the National Institute for health and Clinical Excellence recommended in February that all women with perinatal depression should have access to a mother and baby unit and women must not be separated from their babies.

But a survey for the charity Mind last year found that less than half of mental health trusts have a specialist perinatal service, three quarters have no mother and baby unit and more than one in ten still admit mothers and babies to general psychiatric wards.

In 2000, the Royal College of Psychiatrists recommended that every health authority should identify a specialist with an interest in perinatal psychiatry.

But Ms Easton told delegates: ‘Seven years on, this is nowhere to be seen or is very limited. ‘Suicide is the leading indirect cause of maternal death. Some women have taken their infant with them and even other siblings as well. These are devastating, tragic and preventable deaths.’

Nurse Lisa Lester told delegates: ‘We need expert nurses in perinatal mental health services so no more women die this way.’

Geraldine Lear, a great grandmother and nurse, said she herself had suffered depression after the births of her first two children. She said: ‘I could not sleep as I was convinced that my house would be burnt down if I did not keep watch.’ She said the problem passed after a few weeks but other mothers suffered for much longer.

Last month a survey by Oxford University exposed the poor state of postnatal care offered by the Health Service.