Maternal Mental Health

About 10 Members have indicated that they wish to speak or intervene, which is unusual in a 30-minute debate. To make a speech in this debate, a Back Bencher must have the leave of the Member in charge, Ms Kyrke-Smith, and of the Minister. Obviously, there also needs to be time enough. If you wish to make a speech as opposed to intervening and have secured the necessary permissions, please stand as usual when the Member in charge has finished moving the motion and remain on your feet while I assess demand and the need for a time limit. I am expecting that we will need a two-minute limit. I request that other Members seek to intervene very, very briefly and only during the speeches of the Member in charge and the Minister. I will call the Minister to reply at 11.20 am.

I beg to move,

That this House has considered maternal mental health.

It is a pleasure to serve under your chairship, Ms Furniss. I am so glad to have secured this debate on maternal mental health, which I know really matters to people in my constituency and across the country, yet it is still too easily overlooked. For me, it is also very personal. In 2021, I lost one of my best and most brilliant friends, Sophie, to suicide. She left behind her wonderful husband and three little girls, aged six, three and just 10 weeks at the time. Her death was an awful shock to us all, and I will never forget the moment I received the message from her husband, which said:

“I do not know how to say this and I cannot believe I am writing this, but Sophie died this morning.”

It was still the covid pandemic at the time. Sophie was very isolated, recovering from a C-section, staying at home, trying to protect herself and her baby from covid, and not wanting visitors, but we were in regular touch on WhatsApp, helping each other to navigate life with a little baby and two older siblings. Sophie was getting more and more concerned about her baby’s feeding, and it was causing her to suffer from increasingly bad insomnia. She took herself to A&E with concerns about the baby’s milk intake, which I suspect were more a reflection of her own anxiety than the baby’s feeding, and she spent a night there before being discharged. I do not know whether they asked her about her own mental health. What I do know is that the next day her messages were increasingly distressed, and two days later she took her own life.

Unfortunately, what Sophie went through is not uncommon. At least one in five people who give birth experience a mental health problem during pregnancy or after birth. In fact, while we hear a fair amount about physical conditions such as gestational diabetes and pre-eclampsia, it is mental ill health that is the most common complication of pregnancy in the UK.

The fact that there are so many Members present is an indication of the importance of this subject. Does the hon. Lady agree that support is an essential component of maternal health and that, for those families who do not have extended support, charities such as Home-Start in my constituency, which have volunteers to go to help, are essential and should be more widely funded to help more young mothers who feel they are drowning to get a lifeline back to the surface?

I agree with the hon. Member; that support is needed, and I will come on to that.

The causes of these mental health challenges are really varied. Some people will have past experiences of mental health problems or difficult childhood experiences. Some will struggle after a traumatic birth. Some will be experiencing stressful living conditions. Some evidence suggests there are biological or hormonal factors, and some people are at higher risk than others: young mums face particular risks, with post-natal depression up to twice as prevalent in teenage mothers compared with those aged 20 or over, and data suggests that post-natal depression and anxiety are 13% higher in black and other ethnic minority mothers than in white mothers.

People’s experiences of mental health are also really varied, ranging from mild to moderate conditions such as low self-esteem, anxiety and depression to more serious conditions including post-traumatic stress disorder and post-partum psychosis. While most people find a way through, perinatal mental health can be incredibly serious, as it was for Sophie.

I thank the hon. Member for bringing this very important issue to the House. With regard to perinatal support, does she agree that it is very important we have those professional teams in place, and that we get the additional value that comes from a physical mother and baby unit, where specialist support can be given to not just the mother and child but the family as well?

I agree: mother and baby units are vital.

For women in the period from six weeks after giving birth to one year after giving birth, the leading cause of death is suicide. While I want to speak more widely today, I want us to be very conscious of that extreme end of the risks that women face. Despite the potential seriousness, the stigma around these problems is huge. Some 70% of women will hide or underplay maternal mental health difficulties, and in turn, they will never get the support they need.

I thank my hon. Friend for bravely sharing the devastating story of her friend. I also have a wonderful friend, Sarah, whose daughter was a month old when the covid lockdown hit. She was so worried about breaking lockdown rules that she did not lean on friends and family and ended up having a mental breakdown. Does my hon. Friend agree that maternal mental health should be a high priority in any future emergency planning?

I absolutely do, and I am sorry to hear of the experience of my hon. Friend’s friend.

What are the consequences of all this? The human suffering is immense, but maternal mental health has economic consequences and costs, too—an estimated £8.1 billion each year in the UK, according to research from the London School of Economics, and nearly three quarters of that cost relates to adverse impacts on the child rather than the mother.

I want to suggest four ways in which maternal mental health support can be improved, and I will be as brief as I can. The first is improving specialist perinatal mental health services. The second is better embedding mental health support in routine maternity care. The third is improving community support, and the fourth is education and awareness raising.

I thank my hon. Friend for the powerful speech she is making, and I am so sorry to hear about her friend. Does she agree that we also need specialist support for those experiencing post-adoptive depression? Although they have not gone through the same physical process as birth parents, it can be equally devastating.

Absolutely—that is one way in which people can experience severe mental health challenges and consequences, and it needs to be considered. I also want to acknowledge that new dads and partners experience mental health challenges too, but given our limited time, I am focusing today on maternal mental health.

Does my hon. Friend agree that stigma around mental health, particularly maternal mental health, can be used by abusers as a barrier to women getting help? Domestic violence during the perinatal period and the effects on mental health require widespread attention, so that survivors can feel comfortable and safe when asking for support.

I agree; we need to shed more light on this, precisely for that and other reasons.

I will touch briefly on my first recommendation, which is to ensure that specialist perinatal mental health services are protected. In the last 10 years, there have been significant steps forward. Mother and baby units in particular can be an important part of someone’s treatment and recovery, as well as having significant benefits for the parent-infant relationship.

Tragically, there are still too many stories of women not being able to access those units. They are perhaps too far away from where a woman lives, or there is not a bed available, or the need for a mother to get that care has not been identified properly. We are still seeing mothers with newborns being put into adult psychiatric units and separated from their babies, despite the national guidance saying that mother and baby units are best practice. Continued support for these services is crucial, both in mother and baby units and in the community, and that must include research to develop the best interventions and robust evaluations of the care provided.

The Mental Health Bill is a sorely needed piece of legislation, and I really welcome it, but I wonder whether it might include a provision to ensure that all women who have given birth within the 12 months prior to admission to a psychiatric unit are given the option of being admitted to a ward where they can remain with their baby. That could help to prevent women from falling through the cracks in the system, as they do currently.

Secondly, I turn to routine maternity care, which is where the mental health support for the vast majority of women can and should sit. Again, we have seen progress, with some vital new services in place, including care for women experiencing baby loss, severe fear of childbirth, birth trauma and loss of custody at birth.

I thank the hon. Member for calling this debate, which is clearly so important to her. In my constituency there is an excellent charity called HeartTalks that works with mothers who have experienced baby loss. Would she agree that post-partum check-ups are really important for all women, but particularly those who have suffered baby loss, regardless of the trimester it occurred in?

I absolutely agree. A recent report from the Maternal Mental Health Alliance highlighted huge variation in the support services available locally, with confusing referral pathways, inequitable referral criteria and long waiting lists—some women have to wait six months for an assessment and up to a year for treatment. Too often, as I have noted, women are cared for unequally. Those who have existing disadvantages experience stubbornly poorer outcomes.

We need better integration of mental health into all routine contacts during pregnancy and after birth for all women who need it. During that period, women have an average of at least 16 routine contacts with health professionals, including GPs, midwives and others, and they are an ideal opportunity to ensure that women are routinely and compassionately asked about their mental health. I wonder if any healthcare professionals asked Sophie not just how the baby was but how she was. I wonder if the discussions about her baby’s feeding were had in a way that sought to reduce her anxiety. I wonder if she was given less attention because this was her third child, and her earlier experiences had been smoother—but I will never know.

In the same way that many physical health complications are dealt with by multidisciplinary maternity services, the same should be true for mental health care. That means midwives, health visitors and others being trained to ask the right questions and assess the risks, and then psychological therapists, equivalent to those employed in talking therapies, integrated into maternity teams to support women’s care where necessary. They would understand the specific needs and risks of the perinatal period, and be able to intervene quickly where that is needed.

Thirdly, I want to acknowledge the importance of community support for pregnant and new mums, as we have heard from other Members, and I recommend its expansion. There are fantastic voluntary groups providing some support, and in some places family support hubs are up and running, but often the postcode lottery kicks in again. We are a long way from the broader and more reliable provision that was established under the last Labour Government—notably the Sure Start model, which all the long-term evidence shows was so effective. As part of our national health mission to shift care from hospital to the community, we need to rebuild those community services, including for pregnant and new mums. We need them to be across the country and widely accessible, with clear maternal mental health guidance embedded in them.

Members should stand if they wish to speak. You have a very short amount of time.

It is a pleasure to serve under your chairmanship, Ms Furniss. I commend the hon. Member for Aylesbury (Laura Kyrke-Smith) for securing this hugely important debate and speaking so eloquently about her friend. As someone who has lost a close friend to suicide, I completely agree that they are not defined by their death, but by the impact they had during their life and the impact they had on other people.

Suicide is the leading cause of death among women in the six weeks to 12 months after giving birth, and maternal mental health in Winchester and across the UK is in crisis. As the Lib Dem spokesperson for mental health, I am hearing more and more stories about this from individual women. Every year, 600,000 women give birth, and one in five of those women will experience a perinatal mental health condition. This is a completely neglected mental health crisis, on an extremely large scale.

Polling from as recently as December 2024, commissioned by the campaign Delivering Better, representatives of which I am pleased are in the Public Gallery today, found that seven out of 10 women who have a negative birthing experience say that it has had a long-term impact on their mental health. A recurring theme is that women are not being listened to—that has been a theme in essentially every major maternity inquiry. Women are not listened to when they raise concerns pre, during and post labour, not listened to when they raise complaints with trusts about their care, and not listened to by successive Governments who have failed to treat this issue with the seriousness it demands. If this crisis is to be meaningfully addressed, far greater emphasis needs to be placed on the voices and experience of women and birthing people.