Vital perinatal mental health is ‘on the precipice,’ the Royal College of Midwives (RCM) has warned as the college launches a roadmap for improving services.
The RCM found that one in five women will experience mental health issues during pregnancy and up to a year after, with suicide remaining one of the leading causes of death in new mothers up to first year after birth.
While mental health is on an equal footing with physical factor as a cause of maternal ill-health and death in the UK, the RCM wrote in the roadmap that ‘mental heath needs remain secondary to physical health needs’.
The RCM claims that, on top of the existing midwife shortfall, only 347 additional midwives across the entire UK would be required to deliver an integrated model of care at scale across the UK.
Executive director of the RCM, Birte Harlev-Lam, said that the new roadmap was ‘not asking for the moon’.
‘Quite simply midwives need time to care and there needs to be more midwives to share the workload.
‘Mental ill-health ranks with physical factors as one of the leading causes of maternal deaths in the UK, and yet this is not reflected in the resources allocated to it, whether in terms of staffing or other support.’
The roadmap highlighted how few of the women who died as a result of poor perinatal support had received a formal mental health diagnosis after having symptoms reported.
One in three women disclosed domestic abuse, which has an established association with mental health conditions, and one in two women had multiple adversity present, with a history of childhood and/or adult trauma present.
The RCM also claimed that there is a ‘irrefutable economic and social care’ for more resources to be allocated towards perinatal mental health services.
The organisation estimates that mental ill-health that is undiagnosed and untreated incurs a financial burden for the state of approximately £8.1 billion a year.
Meanwhile, investing in perinatal mental health and the training of more midwives would cost ‘a fraction’ of that total according to the RCM.
The proposals come as the Care Quality Commission (CQC) announced that it has rated the maternity care at St Georges Hospital as inadequate, following an inspection in March.
As well as being rated inadequate overall, the services were also rated as inadequate for being safe and well-lead.
Following the inspection, the CQC has issued a warning notice calling for the hospital to immediately make improvements to maternity care.
Carolyn Jenkinson, CQC’s deputy director of secondary and specialist healthcare, said that staff ‘often felt unsafe because there weren’t enough of them, and we saw they’d reported numerous incidents in which people’s safety was at risk.
‘Staff said managers told them nothing could be done, but we found opportunities to reduce risks had been missed or ignored.
Among the key changes called for the RCM is for every maternity service to have, as a minimum, a whole-time equivalent band 7 perinatal specialist midwife.
Additionally, the RCM has called for all maternity professionals to have the necessary knowledge and understanding of perinatal mental health and for professionals to be equally concerned with mental as well as physical health.