Mental health during and after pregnancy

DOI: https://doi.org/10.58248/PN765

This briefing discusses issues around mental health, suicide, and traumatic experiences spanning pregnancy, birth and baby loss that some readers may find distressing.

This briefing uses “women” and “mothers” to refer to people who have carried a pregnancy, while recognising that some people are not represented by these terms and may face distinct mental health and access challenges (see briefing section on LGBT+ parents).

As health policy is devolved, this briefing focuses on England, although most of the research has broad applicability across the UK.

Risks and impacts of mental health problems during and after pregnancy

Pregnancy and the year after birth (referred to as the ‘perinatal period’) is a time of increased vulnerability to mental health problems, such as depression, anxiety, post‑traumatic stress disorder and psychosis. Approximately one in four women in England experience perinatal mental health problems, approximately 130,000 women each year.

Women’s experiences of maternity care can affect their mental health. Despite improvements in satisfaction with NHS maternity care and mental health support, national reviews show that support can vary across regions and that delayed, dismissive, or poor‑quality care can cause lasting distress.

Suicide is the leading cause of death in mothers 6 to 52 weeks after birth. Without timely support, mental health problems can affect how mothers and infants bond with each other and increase the likelihood of emotional, behavioural and cognitive issues in childhood and adolescence.

Untreated perinatal mental health problems are estimated to cost the UK £8.1 billion annually. However, research suggests that interventions such as health visitor training and cognitive behavioural therapy (CBT) can be clinically effective and cost-effective.

Who is most at risk?

Any parent can experience mental health problems during the perinatal period. Some groups face higher risks of experiencing mental health problems and poorer care, including women with previous mental health problems, women living in poverty, women experiencing perinatal trauma (distress following a traumatic birth), loss (for example, because the baby dies or is taken into care), women involved with children’s social care, Black women and women from minority ethnic groups, and LGBT+ parents.

People may belong to multiple at‑risk groups. These risks can compound and lead to disproportionately worse outcomes and widening health inequalities.

Evidence-based interventions and access to support

Some negative outcomes can be reduced through prevention and early intervention, including through CBT, medication and digital tools.

Midwives and health visitors routinely screen for mental health problems, but their support may be limited by funding pressures and workforce shortages. The government’s Healthy Babies Programme combines health visiting, infant feeding support and perinatal mental health services; however, funding for this varies across regions, which can affect service availability.

Specialist services are available to women who experience perinatal loss, birth trauma and moderate-severe or complex mental health conditions. Researchers have emphasised that voluntary organisations can support people less likely to access mental health services.

Barriers to access

People often face multiple, intersecting barriers to perinatal mental healthcare, such as stigma and fragmented services. These barriers can make people less likely or able to tell healthcare providers about issues and hinder coordinated care, especially for people with complex needs, and from marginalised backgrounds.

Acknowledgements

This briefing was produced in consultation with experts and stakeholders, who are listed at the end of the briefing. It was co-funded by the British Psychological Society. POST would like to thank everyone who contributed their expertise.