[Relevant Documents: The impact of Covid-19 on maternity and parental leave, First Report, HC 526, and the Government’s Response, Second Special Report, HC 770; e-petition 306691, entitled Extend maternity leave by 3 months with pay in light of Covid-19; e-petition 331261, entitled Issue urgent guidance and voucher scheme to save baby and toddler activity sector; and e-petition 551612, entitled Access to specialist mental health support for bereaved parents after baby loss.]
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That this House has considered maternal mental health.
It is a real pleasure to serve under your chairmanship, Mr Robertson, and indeed to have Members participating virtually in this afternoon’s debate. Maternal mental health should be among our principal concerns. Pregnancy and birth can be the trigger for poor mental health among those who did not previously suffer from mental health problems, and they are a major factor in the escalation of existing ones. The first two years of a child’s life are vital in their development, and the right support and guidance for families at this time can make a big difference to their long-term outcomes.
For many women, becoming a mother presents psychological challenges. They might have experienced conflict or abuse in their own childhoods, which resurface when they contemplate the reality of becoming a parent themselves. They might be used to setting high standards for themselves and derive their sense of worth from their ability to meet them, but find that their baby does not comply with their drive to meet their parenting targets. They might simply be overwhelmed by the awesome responsibility of having another human being entirely dependent upon them, and fear that they do not have what it takes to be able to be an effective parent.
Because everybody has had a mother at some point in their lives, we all, knowingly and unknowingly, have formed a picture of what a mother is and what a mother should do. These assumptions about motherhood crowd around every new mother, complicating her own feelings about her new baby and her new role. New motherhood can be extremely lonely, especially in the dark, still hours of the early-morning feeds, and that loneliness creates a fertile space for doubts and anxieties.
Lockdown has exacerbated so many of these issues. I asked for today’s debate so that we can talk about the impact of covid on the mental health of new mothers, and to urge the Government to prioritise this as we come out of lockdown. Loneliness has been a major issue for almost all of us during the past year, but the lack of contact has been particularly acute for those who have had babies during this time. I am enormously grateful to the parliamentary digital engagement team for organising a survey in advance of this debate to ask members of the public for their experiences. We had more than 11,000 responses, with some extremely moving testimony among them. I thank everybody who took the time to share their experiences, but especially those whose experiences were difficult and painful.
It is good to see you in the Chair, Mr Robertson, in this new Chamber, which is a first for us all. I congratulate the hon. Member for Richmond Park (Sarah Olney) on securing the debate. It is good that we have had a number of debates in recent months about maternal challenges during the pandemic, the impact on families and the impact on the mental health of parents and children. There is little that is more important, frankly. It is something that we will have to spend a lot of time concentrating on as we build out of the pandemic in the coming months.
Let me declare my interests. I am chair of the all-party parliamentary group for conception to age two: first 1001 days. Given the hon. Lady’s comments, I think we have a new recruit. If she is not already one of our members, I would be delighted to welcome her along. It is a very active group. I also chair the all-party group for children, and until recently I was the chairman of trustees of the Parent-Infant Foundation charity, which concentrates on the initial 1,001 days and the attachment between parent carers and their children.
I was impressed by the response from the digital teams in the House. It was a very good exercise. As the hon. Lady said, 11,265 responses is not to be sniffed at. Alas, the responses were all too familiar. We have heard similar anecdotes from our constituents about what has been going on during lockdown. There were responses about parents, and particularly mums, feeling lonely. They feel isolated in hospital, particularly if they have to stay in for any length of time because of complications. They have problems even getting their partners—the fathers—to be able to visit them. They feel isolated from family support networks that we normally take for granted. They feel isolated from new mum and baby groups. One of the respondents to the survey called them a safety valve where completely new mums, in particular, learn from other mums—either new mums or experienced mums—and the babies interact too. It was interesting that, for colleagues who gave birth during the lockdown, it was several months before their babies were actually able to meet another baby, and there was a bit of a shock factor there. We perhaps underestimate the impact of that social contact from the very earliest stages after a child is born.
I thank the hon. Member for Richmond Park (Sarah Olney) for securing this important debate today.
Maternal mental health problems are prevalent and are not talked about often enough. One in five women will develop some form of mental health problem during their pregnancy or in the year after giving birth, and research suggests that as many as seven in 10 mothers will underplay the severity of their feelings, due to stigma surrounding mental health.
Sadly, all of this has been exacerbated by the impact of the pandemic. As someone who has spoken in the House about prenatal depression while pregnant with my first child, this is an extremely important issue for me.
From a personal perspective, my second child was only four months old when we went into the first lockdown. My plans for baby yoga, music classes and meeting other mums for coffee to get through the sleep deprivation were suddenly out the window. Instead, the ensuing weeks were spent with him mostly in a sling while I home-schooled the eldest. With much of his little life spent in lockdown, his one-year check was done on the phone, he has not been weighed since he was six weeks old, and I cannot remember the last time he saw a health visitor.
Yet I feel lucky: lucky that he was born just before the pandemic hit, so my husband was able to be there the whole time I was in labour; lucky that he was my second child, so at least I had a vague idea about what I was doing; and lucky that we had those four months together before going into lockdown. For many of my constituents, having a baby during lockdown has been incredibly challenging. One of my constituents, Nina, wrote to me last autumn:
“I was pregnant for the entirety of the first lockdown and had to attend all scans for the twins I was carrying alone. This was bearable when I looked around and saw everyone making huge sacrifices.
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Cherilyn Mackrory (Truro and Falmouth) (Con) [V]
I thank the hon. Member for Richmond Park (Sarah Olney) for securing this important debate.
We have heard some of the shocking figures on maternal mental health and we have heard about the evidence that new mothers have experienced poor maternal mental health as a result of the pandemic. “Maternal mental health and coping during the COVID 19 lockdown in the UK” from the covid-19 new mum study found that more than half of new mothers reported feeling down, lonely or irritable, and that 71% reported feeling worried since the beginning of the first lockdown.
Mental health service guidance from the Royal College of Psychiatrists sets out that perinatal mental health care continues to be essential during covid-19, and that face-to-face contact will be necessary in some circumstances. The Government and the NHS have said that mental health services, including the specialist perinatal services, remain very much open for business during the pandemic, and that providers have looked to how they can maximise the use of digital and virtual channels. I agree that that is not ideal, but I acknowledge that hospital trusts in difficult circumstances have worked extremely hard to reach out to mums.
In Cornwall, the Royal Cornwall Hospitals NHS Trust looks after 4,000 babies and mums every single year. I thank the midwifery team at the RCHT for looking after me and both my babies, one surviving and thriving and one whom, unfortunately, we lost. The trust has been reviewing visiting continually throughout the pandemic, and the latest arrangement of their services is that birthing partners are now available, that both parents may be in neonatal units at any time, and that partners may now attend the 12-week and 20-week scans. If other scans are required, they may also arrange that. That has come on from where we were during the first lockdown, so things are improving.
International data, from high, middle and low-income countries, suggests that perinatal illness is more prevalent among rural women. That is the second dimension that I would like to add to today’s debate, if I may. Cornwall is predominately rural, and the pandemic has absolutely exacerbated an already hidden issue, bringing it into the limelight.
For a new mum who lives rurally, it is very difficult to access baby groups and other new mums, to share stories and get peer support, mostly because of transportation issues. I agree that all new mums are suffering those difficulties in lockdown, but it is particularly an issue for rural new mums. Often, socioeconomically, rural new mums are on a lower income, so they cannot afford to get anywhere. It is also difficult for health visitors to get out and visit them.
I commend the hon. Member for Richmond Park (Sarah Olney) for securing the debate, because the three quarters of a million women who have given birth during this pandemic have not only experienced all the challenges that every woman experiences when they give birth, but have had those problems magnified. Other Members have already set out issues around isolation, anxiety and the need for proper, professional support, as identified by the excellent piece of work done by the digital engagement team for the hon. Lady, which all of us who have been new mums can really relate to. I can only imagine how much more these issues can affect people when they have no family members to call on and no mothers’ group to allow them to pick up personal experience from others who have gone through it before them.
Outside of the pandemic, around one in five women experience perinatal mental health problems, which impact not only them but their children, and as my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) said, that can cost the economy some £8 billion every year. I will add to the debate the conditions that create a higher likelihood of mental health problems emerging in the first place, which according to research is particularly stressful life events.
We know that, during the pandemic, people have been highly anxious—far more than they might have been otherwise. Indeed, some research suggests that around three in four pregnant women have had significant anxiety, and up to 40% have experienced depression. One of the biggest anxieties for any new parent has to be money—finance, income; making sure that they can care for their new family. Most families now have two working parents, and families depend on both incomes, so the fact that more than 50,000 pregnant women a year suffer discrimination that leaves them with no option but to leave their job should sound alarm bells, not only for our economy, but for its potential to trigger mental health problems, depression or anxiety.
Order. Because Members have gone on beyond five minutes, I have to reduce the time limit again, otherwise not everybody will get in. The time limit is now four minutes.
It is a pleasure to serve under your chairmanship, Sir Edward. I am glad to have the opportunity to take part in this important debate, and I begin by congratulating the hon. Member for Richmond Park (Sarah Olney) on securing it.
Most mums look forward to having a baby, and the birth of a child to family, friends and people we know is something that we all greet with joy, pleasure and anticipation for the future of the child. We know that for some women, however, pregnancy and the time after birth can, sadly, be difficult. They may not have been able to talk to people about it when everyone imagines that they are having a happy time. This year, it may have been more difficult than ever as a result of covid-19 and the social isolation that it has brought for so many. They have not had the support of, or been able to share the joy and workload with, family and friends, and it has been difficult to get the face-to-face support that they really need. Let us not forget that many have lost out on financial support that has been offered to others, as the campaigning organisation, Pregnant Then Screwed, has evidenced.
Low mood, anxiety and depression are common mental health problems that occur during pregnancy and in the year after childbirth. The pain that these conditions cause women and their families is significant, as is the negative impact on their health and wellbeing. The Royal College of Obstetricians and Gynaecologists states that up to one in five women develop mental health problems during pregnancy or in the first year after childbirth, and around a quarter of all maternal deaths between six weeks and a year after childbirth are related to mental health problems.
Sometimes, hearing in this House the lived experience of constituents really brings home the issues that we are discussing, and the need to address them. A constituent of mine has asked me to tell her story.
“In 2017 I became a Mum for the first time, I knew that I needed to provide for my child but I felt no more attachment than for someone I had just met. I started to Google ‘how to have my child adopted’ and felt like I was a failure as a woman.
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The overwhelming theme of the responses was how difficult isolation had made the experience of giving birth and caring for a newborn. I was particularly struck by the experience of Zilia from the south-east when she told us:
“All appointments attended alone and in sterile conditions. Childbirth alone, no visitors in hospital, no family able to meet your newborn and help you out thereafter. Just the most isolating and lonely experience I have been through.”
Reflecting on my own experiences, I overcame the early challenges of motherhood with a combination of a supportive partner present at the birth, a delighted family who rallied round with practical help, professional health support delivered through home visits, and a peer group of other new mothers in the neighbourhood. To have been denied any one of those would have made the job of adjusting to motherhood considerably harder. We now have thousands of mothers battling through the early months of motherhood without having had any of those essential forms of support, and this has taken its toll on their mental health.
This is how Emily from Scotland describes the impact on her:
“My mental health is awful. I have never felt so lonely or isolated. I shielded from March until June last year and saw nobody for my second trimester other than my husband. My husband’s family are yet to meet our baby, who is our first, and he is coming up to six months old. I have developed post-natal OCD, which is horrendous, and I am still waiting for professional help to cope with this.”
Other covid-19 factors that have worsened the experience for new mothers in lockdown are financial uncertainty, lack of access to childcare, and bereavement. The industries worst hit by the lockdown employ a large proportion of females. Some 20% of mothers have lost their jobs during the pandemic, compared with 13% of fathers. The closure of schools has left many mothers trying to juggle home schooling for older children with looking after a newborn, and many families are dealing with the trauma of losing family members to covid.
The impact of the pandemic has changed the way that we all access healthcare, as resources are prioritised towards emergency admissions and efforts are made to reduce contact. In some parts of our healthcare system, it has led to an increase in digital and telephone consultations. In many parts of the country, this has included perinatal care. Many of the respondents to the survey reported receiving follow-up care in this way, including Jennifer in the west midlands, who reported:
“Very limited midwifery care. I didn’t see a midwife at all until I was 28 weeks. No health visitor service whatsoever. Apart from one very brief phone call, I have had no contact from a health visitor. My baby has not been weighed since 10 days old, and they are now almost six months. Overall, my pregnancy experience has been unnecessarily stressful and left me feeling constantly anxious and unsupported.”
In my conversations with new mothers in my constituency, many of them brought up how difficult they found the lack of professional support. They were unable to access guidance about breastfeeding or sleeping, and unable to ask questions or seek reassurance. Many of them found that they experienced much greater anxiety about their babies as a result. I have at least one case in my constituency where the lack of a physical examination led to a major genetic condition being missed—one in which, tragically, early intervention can make a significant difference to the quality of life.
The survey we conducted found that, of those mothers who had received an online consultation, 60% said they were not affected, compared with only 3% who said they were affected. I have spoken to the Institute of Health Visiting and the Royal College of Psychiatrists, and they have confirmed to me how vital such face-to-face support is for new mothers in the first weeks. The value of the home visit is that the mother does not need to identify the need for help and then go out and seek it for herself; someone comes to her and asks her how she is. A trained and experienced health visitor can observe mother and baby and identify whether additional support is needed. That kind of support cannot be replicated on Zoom or over the phone. Furthermore, as the Royal College of Psychiatrists has highlighted to me, it is much harder to identify whether there are issues of domestic violence or coercive control between a mother and her partner when contact is one-dimensional.
The impact of perinatal mental illness can have long-lasting impacts on families. Stephanie from the east midlands told our survey:
“I have previously not had any mental health issues, but I have really struggled with my mental health since having my baby. I have severe anxiety and now perinatal OCD. I have intense fear and stress about leaving my child, and I am not receiving anywhere near enough support.”
The long-term societal cost of perinatal mental ill health is estimated at £8.1 billion annually for each one-year cohort of births, and about three quarters of that is the cost of the impact on children. The financial value of early interventions to support struggling families is clear, and there is also the very human value of building loving and supportive families.
We already have the structures and mechanisms to provide support through the health visiting service. I should declare an interest here: my mother was a health visitor for many years, so I have learned at first hand from her about the times when a friendly knock on the door made all the difference to an overwhelmed new mother. However, it is a service that was already chronically underfunded and understaffed before the pandemic took hold. There has been a 31% decrease in the health visiting workforce since 2015, and many local authorities target their scarce resources at those deemed most at risk.
I believe that only a universal health visiting service can properly identify and support mothers who are suffering from poor perinatal mental health, and that the Government should allocate sufficient resources to enable this to happen. We need better mental health support for all ages and stages, and better training throughout our health service to identify and support those who are struggling, but providing support to new mothers should be a priority, because of the long-term impacts that their poor mental health can have on the development of their children and on the rest of their family.
The first step is to address the shortage of health visitors. There cannot be quality service provision when 65% of health visitors have case loads of more than 500 children each. We also need to urgently address the staffing shortage among midwives, who have a critical role to play in supporting women’s emotional wellbeing during pregnancy, childbirth and beyond. The Royal College of Midwives has found that there is currently a shortage of 3,000 midwives. Alongside that, we need to increase training and specialist mental health support for midwives, so they are well equipped to deliver the necessary support.
The pandemic has forced us to use digital tools in every area of our lives. We may find that we continue to use some of them even after face-to-face contact is possible again. If I could make one plea to the Minister, however, it would be that we should not allow digital and telephone perinatal check-ups to become the new accepted standard. The Government should fund and resource home visits by health visitors to all new mothers so that we can properly address the issue of maternal mental health.
In particular, as the hon. Lady mentioned, there is the isolation from health professionals on a face-to-face basis. I know that there have been a lot of substitute virtual visits, but they are not a substitute and they must not become the norm. We need to build back our health visitor numbers, as we did so well in the coalition Government between 2010 and 2015, when we produced 4,200 additional health visitors, who were absolutely invaluable. They are the friendly face that new parents will welcome across a threshold, where they may be more suspicious of a social worker or other care workers. They are also an early warning system for problems that may be going on with a new parent and ultimately any safeguarding issues.
A report that the First 1001 Days Movement produced last year, called “Working for babies”, said that services supporting nought to twos were highly depleted during the first spring lockdown last year. The majority of services for nought to twos did not bounce back quickly as lockdown measures were eased. We need to make sure that mistake is not made again this time.
This lockdown has been especially stressful for first-time mums, single mums, and families having to balance working remotely, new forms of working and working covid-safely, and juggling home schooling if they have other children too—thank goodness all my children are above school age and we have not had that additional challenge. Even before the covid pandemic, at least one in six mums suffered from some form of perinatal mental illness—commonly anxiety disorders and depression. We know that the pandemic and lockdown have impacted on the mental health of just about everybody, but particularly on that cohort of mums.
A survey by the excellent baby charity Bliss found that, among its members who had received neonatal care during the pandemic, 90% of parents said they felt more isolated as a result of having a baby in neonatal care during the pandemic; 70% said their mental health was negatively affected as a result of the experience; 56% said the mental health of their partner and wider family had been affected; and 47% said they were not offered support for their mental health while their baby was in neonatal care. We know that, in extremis, suicide is the biggest cause of maternal death. We must do so much more to ensure that women do not get in that position and that support is there and accessible.
The shortage of health visitors is a false economy. I have always said that; we had a debate specifically on that last year. I pay tribute in particular to Cheryll Adams, who set up and has led the Institute of Health Visiting. She is retiring at the end of the month. The service she has given to that area has been extraordinary and has informed many debates in this place. I put on the record our thanks and gratitude to her.
There is also the whole issue of increased domestic abuse during pregnancy. The figure that I always find hard to take on board is that a third of domestic abuse happens during pregnancy as well, and we know that domestic abuse has gone up during the pandemic, so all the additional pressures on women who are about to give birth or who have just given birth are extraordinary.
The cost of perinatal mental illness, as calculated by the Maternal Mental Health Alliance some years ago—it still holds true, and today it is probably an underestimate—was £8.1 billion each and every year. On top of that, the cost of child neglect is £15 billion, so we as taxpayers are paying £23 billion-plus into the health service to get it wrong. To prevent us getting it wrong, if we spent a fraction of that on the support services—the health visitors and those networks—being there in the first place, that would be money well spent and well saved.
Of course, the key is good attachment between babies and their parents or primary carers from those very earliest stages and during conception, hence the founding of the First 1001 Days Movement. My right hon. Friend the Member for South Northamptonshire (Andrea Leadsom) launched the 1,001 critical days manifesto back in, I think, 2012, which was signed up to by colleagues across parties, the royal colleges, clinicians, academics and children’s charities alike. It is still relevant today.
To quote research by the First 1001 Days Movement and the Parent-Infant Foundation—I pay tribute in particular to Sally Hogg, who does so much of the good work there—it is estimated that 10% to 25% of young children experience significantly distorted relationships with their main carer or carers, and from that a range of poor social, emotional and educational outcomes in childhood and across the life course can be predicted. Maternal mental illness in pregnancy and the early years of a child’s life can have adverse effects on the child’s brain development and long-term outcomes. Maternal mental illness can affect children both directly and indirectly. For example, exposure to stress hormones in the womb is thought to affect the child’s developing stress response systems, and mental illness after birth can affect a mother’s ability to care for her baby, her parenting style and her developing relationship with her baby. Even relatively mild mental illness, if untreated, can inhibit a mother’s ability to provide her baby with the sensitive, responsive care that they need.
This, again, is a statistic that I always use. If a 15 or 16-year-old teenager is suffering from some form of depression or low-lying mental illness, there is a 99% likelihood that that child’s mother suffered some form of perinatal mental illness—the connection is that close. So why are we not doing more to support the mother before and soon after she gives birth? The implications of not doing so will be with her child and her for many years to come, and often into adulthood for the child.
It is also important to note that although perinatal mental illness increases the risk of disruptions in early relationships, they are not inevitable. Some mothers can continue to give their babies the sensitive, responsive care they need, particularly with the right support—and good, effective support can be had, if it is available. That is the problem: it is not always there, or not always there at the right time or in the right place.
Other risk factors put early relationships and infant mental health at risk, including families where fathers or other care-givers have serious mental health problems themselves. Again, we underestimate the impact of becoming a father, particularly for the first time, on the mental health of dad. In most cases this is a joint partnership, but fathers often get overlooked. They often get excluded from the whole neonatal process within hospitals as well. They need looking after too, because if they can be looked after, they can look after their partner and there is a mutual benefit from all of that. We need to do more for fathers.
The NHS long-term plan includes a commitment to expand access to evidence-based parent-infant interventions within specialist perinatal mental health services, which is indeed welcome. It will ensure that attention is given to the parent-infant relationship alongside the mother’s own mental health when mothers have moderate or severe mental health problems. We must not just look at the child or the mum in isolation; we are looking at the bonded family.
However, access to mental health services for babies should be dependent on the risks to their mental health and not contingent on other factors, such as their mother’s mental health needs. So, the NHS long-term plan for England also committed to improving access to specialist services for all children from 0 to 25, but delivering that commitment requires specialist provision for all babies who need it, as they are children, too. Such provision would need to be delivered by parent-infant specialists. However, the NHS long-term plan says nothing explicitly about specialist mental health services for the youngest children in their own right.
The solution is that we need specialised parent-infant relationship teams providing therapeutic support where a baby’s development is most at risk due to severe, complex and/or enduring difficulties in their relationships. Such teams focus on the relationship between a baby and his or her parents or care-givers as the main way to improve infant mental health. However, there are fewer than 40 specialised parent-infant relationship teams in the whole of the UK, and most babies live in an area where these services just do not exist; vast areas of the country have no provision.
One of the aims of the Parent-Infant Foundation charity, which was set up by my right hon. Friend the Member for South Northamptonshire, is setting up parent- infant projects around the country, where practitioners are available, to work on the attachment of parents and their children. We just need it to be mainstream across the whole of the national health service.
As the Royal College of Psychiatrists has said, the need for more perinatal psychiatrists to work in these services is crucial. These specialist services need a highly trained specialist workforce, but the workforce census in 2019 showed that 13% of consultant and perinatal psychiatrist positions remained unfilled. Without more psychiatrists, ambitious plans to transform and expand services will be put at risk.
We are soon to have the Leadsom review, if I may call it that; it does not really ring true as “the South Northamptonshire review”. My right hon. Friend the Member for South Northamptonshire is producing the review; hopefully it will be published later this month. I have been privileged to play a part in it, and chaired a parliamentary advisory group.
Absolutely key to that review are a joined-up support service between the NHS, local government and other key professionals, to give that wraparound service to parents in those crucial early months and years; a digital record, so that all those professions are working from the same information, rather than every visit to mum being a new visit; and a national template of the quality that we need to reach, but with local implementation, so that a service in Richmond, although it may look a bit different from a service in my part of the world on the Sussex coast, is none the less required to produce quality outcomes and clear the same threshold.
We look forward to that report in the coming weeks and months, and I very much hope that the Government will take it on board and produce the goods, because little, if anything, is more important than the welfare, good health and good mental health of our children. And a child is given the very best opportunity—the best start in life—if their parents are in a safe and stable place as well.
When I gave birth to the twins in August, continued restrictive rules meant that my husband could not be with me on the labour ward. Add to the mix a fast-moving induction and I ended up giving birth to my babies with only midwives I’d never seen before in the room.
My husband simply wasn’t able to make it in time. If he’d been able to stay on the ward I would have had his much needed support through labour. As it was, I have had to recover mentally from a fairly traumatic experience.
And yet...I brought the twins home while everyone was still ‘eating out to help out’. How can this be right? Why do women’s and particularly mothers’ needs fall so far down the Government’s priority list?”
Nina’s story and many others show the profound impact that the pandemic has had. In September, the Government allowed families with a child under one to form a support bubble and the NHS now allows the birth partner to be present during labour and the birth, but for many families those changes came too late. The Government must be ambitious in their plans to support the babies born in lockdown and their families. That will be a huge task. For example, if health visitors are to catch up with the huge backlog in missed face-to-face appointments and provide a full service, proper funding will be needed. They provide an amazing service and invaluable support to parents, but about one in five were lost between 2015 and 2019 due to public health budget cuts.
As a result, in February, before the pandemic hit, almost a third of health visitors reported that they were responsible for between 500 and 1,000 children. The Institute of Health Visiting considers the optimal maximum for the work to be fully effective to be 250 children. Similarly, since 2010, cuts of 66% have led to the loss of over 1,000 Sure Start and children’s centres, which provide huge support to families, particularly those who are vulnerable or hard to reach. Funding needs to be restored, so that there is a one-stop shop for parents to get support for themselves and their children.
Early years and nursery providers provide huge support for parents, but according to the Institute for Fiscal Studies, they ran at a significant loss during the first lockdown, receiving less than £4 of income for every £5 of costs. In addition, playgroups and baby activities are often run by small businesses, and restrictions mean that their doors have largely been shut. I would like the Government to look urgently at sector-specific grant funding for early years, to maintain the viability of the sector as we come out of the pandemic.
It is clear that the added stresses of lockdown and the pandemic have exacerbated maternal mental health problems. A recent UK-wide study published in the Journal of Psychiatric Research found that during the first lockdown, 43% of new mothers met the criteria for clinically relevant depression and 61% met the criteria for anxiety. Given the consistent evidence that shows that postnatal depression and anxiety are linked to a range of negative outcomes for children’s health, development and behaviour, it is imperative that the Government do everything they can to protect maternal mental wellbeing.
That begins with many of the measures that I have outlined, but also by improving and maintaining access to perinatal mental healthcare. Although NHS resources and staff are under huge strain, investment is needed to ensure that mental health interventions can be timely and effective to prevent the escalation of symptoms and the formation of a larger burden on the NHS and other public services. That is not beyond our capabilities, and we owe it to the babies born in lockdown and their families to put that at the top of the agenda.
[Sir Edward Leigh in the Chair]
When I was a brand-new mum, I did not get a midwife follow-up appointment; I had a phone call. My notes, I think, stated that I was well supported and absolutely fine, and yet eight months later I was diagnosed with postnatal depression. I did not know that I had postnatal depression; I thought I was tired, that I was not doing it properly and that I was not living up to being a real mum, and I did not know who to talk to. Even though I had close family support, I felt that I was not doing it right, until I broke one day. I saw my GP, and at that point I was diagnosed with postnatal depression. Luckily for me, not being in lockdown, I was able to go to group peer support and to meet other mums who were feeling exactly the same way, so I realised that I was perfectly normal and that it was something I would work through.
It is important that we recognise that that will be a growing problem because of covid. For a new mum, it is all about talking—we want to speak to other new mums, and when we cannot do that, we can get lost in our own head and everything feels a bit worse.
I have been working cross-party, and with my right hon. Friend the Member for South Northamptonshire (Andrea Leadsom) and my hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) on the early years review, which I am privileged to be a part of at this late stage. It started its life, as we know, as the review into the first 1,001 days. I will not repeat the words of my hon. Friend, who articulated this work wonderfully, but I look forward to the review coming, hopefully later this month.
My right hon. Friend the Member for South Northamptonshire was quoted as saying that the fact that babies have had little social contact during the first lockdown is clearly a bad thing, and that the repercussions are not yet known. Tackling some of the awful experiences of babies during lockdown and looking at how families can benefit from some of the positive experiences will be at the heart of the review. I look forward to its findings and hope that we can improve conditions for new parents and new babies because of it.
It is my sincere hope that when the new review’s findings come forward and policies are formulated, all parties will take a long-term view of all the important issues that we are discussing today, and that will come out as part of the review. I want to ensure that policy makers cease to use something as vital as the best start in life for babies and the mental health of mothers as a political football. Hopefully we can formulate something wonderful, so that when we look back at it in 20 years’ time we can all see how successful it has been and be very proud of it.
Work by organisations such as Maternity Action and Pregnant Then Screwed shows worrying increases in reports of pregnant women losing their jobs during the pandemic, and we know that more women have been impacted, in terms of job loss, during the pandemic than in other similar economic events. The reported figure of 50,000 pregnant women each and every year leaving their jobs is likely to be the tip of the iceberg, because as well as those reporting leaving their jobs, there will be many more who are silenced from speaking out by non-disclosure agreements.
My right hon. Friend the Minister has done so much to support new mothers, but some women are still let down in the workplace, so as part of this debate I urge her to consider employment policies too, particularly given the impact of coronavirus on women’s employment. No matter how good my right hon. Friend is at her job, in terms of putting support in place, if pregnant women are concerned about losing their jobs, even if they do not do so—and being pushed out of work is not uncommon in the workplace when women become pregnant—the job of the Department of Health and Social Care will be severely undermined if these issues are not addressed.
Other countries have looked at this closely, and I believe we can learn from their experiences. Germany, with a similar economy to ours, prohibits making pregnant women and new mums redundant, for the good of women, their children and their families. I have put into a ten-minute rule Bill the idea of adopting the German laws here in the UK, and I hope that my hon. Friend the Minister will look at it to see whether she could lend it her support.
My final point is that mental health problems on the arrival of a child do not just impact women. Up to one in four fathers may experience mental health problems in the year after the birth of a child. It can be difficult for fathers to manage the transition, and we need to ensure that support is there. In other countries, shared parental leave policies, on a use-it-or-lose-it basis, have been proven to help fathers with that transition. Will the Minister look at why we are still awaiting action following the review in the UK of this policy, which would explicitly help fathers to tackle these difficult issues?
My hon. Friend the Minister has done so much, but she needs her colleagues in the Department for Business, Energy and Industrial Strategy to do more. It is no good saying that we have good maternity protections when the Government know that probably 50,000 women a year lose their job because of how they are treated in the workplace. I ask the Minister to speak to her colleagues in the Department for Business, Energy and Industrial Strategy to look at effective broader policies impacting on pregnant women at work, because one of the most effective maternal health policies that the Government could adopt is stopping women being made redundant in the first place.
I started to have panic attacks, I’d imagine walls falling on my child, people grabbing her and running away. I would lock myself in the house and was terrified to be alone.
It was when I started to record the times that the trains went past my house that I realised that I was seriously contemplating suicide. I went to the GP who made an urgent mental health referral although it was five months after my child was born that I actually got any help…and…anything was done. I was diagnosed with severe post-natal depression and have been receiving help ever since.
When my second child arrived, I realised just how traumatic my first experience has been. The shame and anguish have been replaced by joy and love, and I was finally able to have those special moments with the newborn that people romanticise.”
Since that time, the local Newcastle Gateshead clinical commissioning group has invested in a specialist perinatal mental health service. That provides support, advice and planning of care and treatment following delivery, reducing the risk of significant illness and the potential for in-patient care. However, many women are not seeking the help they need, and the pandemic has had a huge impact on loneliness, making those early days so difficult.
This is an important debate and we must do much more to support women struggling with their mental health, before and after the birth of their child, to allow parenthood to be the joyful, if challenging and tiring, experience that it should be.