Around 350 new Londoners will be born today. Their health throughout their lives will depend on many things – the air they breathe, the food they eat, the house they live in. And before all that, it will depend on the health of their mother.“Maternal mental health problems are preventable, detectable and treatable”
As a GP, I know we pay a lot of attention to the physical aspects of maternity services – the need for personalised care and for women to feel safe and to make their own choices about the care they receive.
But mental health is a different matter. Instead of being part of every care plan, every policy and every discussion around maternity services, it remains an afterthought, a ‘nice to have’, or is simply overlooked entirely.
Between 10 and 20 per cent of women will experience a diagnosable mental health issue during or shortly after pregnancy. The stakes could not be higher: suicide is the second biggest cause of maternal deaths. And for children, the impacts of maternal mental ill health can be life-long, with a higher risk of poor physical, social, emotional and intellectual development.
There is clear guidance on the need for specialist perinatal mental health services. But less than a third of London Clinical Commissioning Groups have the right level of services available, and a third provide no services at all.
Recruiting and retaining staff within maternity services is a problem – with shortages of both midwives and obstetricians. Many of the remaining staff are also approaching retirement and the flow of new staff into maternity-related disciplines is drying up.
Dwindling resources are diverted towards acute hospital care, while community-based services face further shortfalls. This is simply bad economics, for the cost of a single admission into an in-patient mother and baby unit, you could pay the annual salary for a full-time community mental health nurse.
Dr Alan Gregoire, Chair of the Maternal Mental Health Alliance, recently told the London Assembly Health Committee that the current situation for maternal mental health in London is equivalent to over 50 per cent of women having no access to a midwife, an obstetrician or a maternity hospital.
The situation for women from seldom-heard groups, such as homeless women, trafficked women, refugees and asylum seekers, women in prison, and women with disabilities, is likely to be worse still.
Maternal mental health problems are preventable, detectable and treatable.
The next Mayor of London must work across London’s health landscape to make sure that this issue is addressed, so that today’s new Londoners do not inherit a lifetime of avoidable health problems and inequalities.
To watch the recent Health Committee meeting on maternity services in London, please click here.
Dr Onkar Sahota AM is Chair of the London Assembly Health Committee.
