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Urgent need for improved postnatal care

The lack of support for women suffering from postnatal depression - and the reduction in the health visiting service supporting those mothers - have been highlighted with the publication of a hard-hitting report into maternity services.

Unite/CPHVA raised its continuing concerns in this area as the Healthcare Commission issued its report saying that some NHS trusts could do more to make maternity services safer.

Unite/CPHVA said that there were 690,000 "live" births in 2007 and 15% of those mothers will suffer from postnatal depression.

Dr Cheryll Adams, Unite Lead Professional Officer, Strategy & Practice Development said: "We are very concerned that mothers don't receive the level of emotional and practical support they require in the postnatal period.

"Difficulties with maternal child attachment and other mental health problems can only have negative consequences for children and families. Emotional health issues are often unseen and have been subject to underinvestment in the past.

"This report makes clear the current status of such services, having found that 42% trusts had no access to a specialist perinatal mental health service for women with mental health needs.

"The report also highlights the need for additional support for teenage mothers and those with learning difficulties in the weeks after birth and suggests that specialists midwife roles can be developed to meet these needs.

"These roles already exist in the form of health visitors, but cutbacks in health visiting have seen a major reduction in the number and quality of postnatal visits following the handover from the midwife at between 10 and 14 days."

She said that an improved service to support parents in the postnatal period and beyond, delivered by well-trained health visitors was urgently needed. This was already a recommendation of the new child health promotion programme (CHPP) and the NICE guidance for ante- and postnatal maternal mental health.

Unite/CPHVA welcomed this comprehensive review of maternity services which will provide a benchmark for improving the standard of maternity services.


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Are you concerned about the care offered to women with postnatal depression? Your comments: (Terms and conditions apply)

"As an experienced health visitor with teaching experience, 10 years ago I was involved in training all the health visitors in our area to detect postnatal depression and support women following its identification. Financial constraints meant we were unable to maintain levels of training or recruit new health visitors. Those of us who remain have struggled to give the same standard of care to our clients with drastically reduced
resources. Once again the problem is being highlighted and we're going to have to start from scratch. Does anybody ever take the long view?" - Sue Freeman, Kent

"Yes very much!! I am a part-time practice nurse and ever since my daughter was born five years ago I have been part of a mum and baby group as a helper within a group of leaders. We meet together once a week, serve tea/coffee, chat and have the valuable support of the health visitors and a nursery nurse who come to our group and give talks on weaning, sleep, sibling
rivalry etc. I am aware of the stretched service the HVs provide and they are constantly singing our praises because this is somewhere they can refer the mums to. Sadly some are not seen by the HV soon enough (8-10wks) due to shortage. The possibility of more specialist HVs in postnatal depression would be great!" - Natalie Benson, Brentford, Middlesex

"I am very concerned about postnatal care as it seems to be such a postcode lottery with care in some areas being very good and yet in another area being very poor. I feel that there needs to be standard level of support available to all mothers, wherever they live. I suffered from very bad postnatal depression myself and me and my family had to package together the care I needed ourselves as I needed more intensive care than the local health visitors were able to provide. It cost us a lot of money and I am aware that not all women can afford this. I'm currently involved with a charity supporting mothers through one-to-one listening at home and a support group, which seems to be something really hard to find and which most of the mothers I visit are crying out for. I think as so many women are living away from extended family they are simply not getting enough practical and emotional support and if health visitors are under pressure too, then many mothers are not getting the help they need." - Ruth Jackson, Bristol