Perinatal mental health

We have used the term ‘women’ throughout this leaflet. When we use this term we also mean people with female reproductive organs who do not identify as a woman. East Kent Hospitals University Foundation Trust (EKHUFT) is committed to supporting people of all gender identities. Please tell your midwife or doctor how you would like them to address you, so we can be sure to get this right.

What is perinatal mental health?

The perinatal period includes:

• pregnancy

• labour

• birth, and

• the postnatal period, up until your baby reaches 1 year of age.

This leaflet refers to mental health and wellbeing during this time.

Mental health problems affect more than 1 in 10 women during their pregnancy and / or after the birth of their baby. It is possible to experience a mental health problem for the first time during this time. Mental illness can affect anybody, regardless of their previous history. Some women may have ongoing mental health problems and then become pregnant. Whilst others may have had past mental health problems.

How will pregnancy affect my mental health?

Getting pregnant and having a baby will be very exciting for most people. For some, it can come with new challenges and demands. Sometimes the physical and emotional changes of pregnancy and childbirth can be a trigger for mental illness. This can affect those who have not experienced mental health problems in the past.

The most common mental health problems during this time are depression and anxiety. During pregnancy:

• depression affects approximately 12 in every 100 (12%) pregnant women; and

• anxiety affects around 13 in every 100 (13%) pregnant women.

These figures increase in the first year following childbirth. Depression and anxiety will affect around 15 to 20 in every 100 women during this time.

In addition, many parents experience self-doubt as to their abilities in becoming a parent. This may be due to lack of self-confidence or experience. Additional support can help with these feelings.

What happens if I had mental health problems in the past but I am currently well?

It is really important that you tell your community midwife if you had a mental health problem in the past. Tell them even if it was treated and you are now well. Your care during this pregnancy will be managed depending on how unwell you were in the past. There is a risk that pregnancy and childbirth can cause you to become unwell again. This is due to the physical and emotional changes, and the new challenges and demands that having a baby can bring.

If you have experienced a serious mental illness, you will be offered a referral to the Perinatal Mental Health Community Service for extra support. Serious mental illnesses can include the following.

• Schizophrenia

• Bipolar disorder

• Schizoaffective disorder

• Severe depression, needing a stay in hospital

• Psychosis

• Severe anxiety disorder, such as Obsessive Compulsive Disorder (OCD).

The Perinatal Mental Health Community Service (PMHCS)

This team provides specialist support for women with pregnancy and post childbirth mental health problems. This is also known as the perinatal period. PMHCS support women and their families until their babies are up to 2 years of age.

PMHCS is a multi-professional team that includes:

• doctors

• perinatal mental health nurses

• psychologists

• occupational therapists

• nursery nurses

• social workers

• peer support workers

• administration, and

• pharmacists.

They specialise in the:

• assessment

• diagnosis; and

• short-term treatment of women affected by a moderate to severe mental health problems.

This may be:

• new mental health difficulties; or

• a history of depression, psychosis, or another significant mental ill health diagnosis.

PMHCS provide specialist care and pre-conception advice. It is important that referrals are made as soon as possible.

A health professional can refer you to PMHCS, but you can also self-refer by calling 01622 722321. Ask to speak with the duty clinician. PMHCS can offer you a medication review if:

• you are declined medication for your mental health; or

• you are struggling to get an appointment to discuss medication.

What happens if I am currently affected by my mental health?

If you feel that you are affected by your mental health it is important to speak with someone as soon as possible. You can speak with your:

• community midwife

• GP

• obstetrician, or

• mental health professional, if you have one.

Do not stop taking your medication without talking to your midwife or doctor first. You will be referred to a consultant obstetrician, who will form part of your care plan. We will make sure that you have the right professionals involved in your care.

Will I automatically be referred to Children’s Services?

No. You will not automatically be referred to Children’s Services just because you have a mental health problem. However, sometimes we do share your mental health history and current wellbeing with other professionals. This is so a plan of care can be made to help support you and your family in the most appropriate way.

What are the baby blues?

The baby blues refer to a common feeling experienced by many new mothers. During the first 2 weeks following the birth of your baby, you may find you are:

• tearful

• irritable

• low mood

• anxious (worried), or

• sad.

This is normal, due to the rush of hormones, lack of sleep, and changes to your body.

The baby blues affects between 3 and 8 in every 10 women after giving birth (30 to 80%). Please ask for help if these feelings become worse or last longer than 2 weeks. You can speak to your GP, community midwife, or health visitor.

Can I continue to take my medication for my mental health when I become pregnant?

Speak with your GP or mental health professional as soon as you find out you are pregnant. They will give you advice regarding your mental health medications. Do not stop taking your medication until you have had this important conversation.

Sadly, there is a lack of evidence regarding their effect on the unborn baby and breastmilk. However, this is also the case with many medications, not just those to support mental health. Generally, our advice is that babies do better with well mothers.

Further support and advice

• Specialist perinatal mental health midwives

  At East Kent Hospitals we have two specialist perinatal mental health midwives. These midwives have expert knowledge and additional training about perinatal mental health. If your midwife or obstetrician feels that you need extra support, you may be referred to them.

  Depending on your needs, the mental health midwives can help co-ordinate your care. They may also refer you to services that may be more appropriate and specialist.

• HUGS

  HUGS is an online antenatal group that takes place every week on a Friday morning. They offer support for people with mild to moderate anxiety and depression. If you feel you might benefit, you can ask your midwife for more information. If you would like to refer yourself, please email the mental health midwives.

• Mental Wellbeing Antenatal clinics

  At East Kent Hospitals we have obstetric consultants who have a special interest in perinatal mental health. We may offer you a referral to their clinic called ‘The Mental Wellbeing clinic’, so that you have an obstetric consultant supporting you throughout your pregnancy.

• Urgent mental health advice and support

  • Please contact NHS 111 and select option 2.

  • Go to your nearest Emergency Department.

  • For life threatening emergencies, please contact 999.

• Mental Health Matters Helpline

  Text: Kent to 85258

  Phone: 0800 107 0160 for free confidential support at any time.

  This helpline is available 24 hours a day, every day. The helpline covers problems including:

  • anxiety

  • suicidal thoughts

  • financial concerns, and

  • relationship issues.

• Kent's Perinatal Mental Health Helpline service

  Telephone: 0800 107 0160.

  Opening hours: Tuesday 12 to 5pm; Friday 4 to 9pm; Sunday 5 to 9pm. 

  This is a free professional listening service for parents of 0 to 2 year olds. You may want to discuss the challenges you may be facing. This is a confidential service.

  If you need someone to talk to outside of these times there is always someone to talk to. This number is also the contact for the Release the Pressure Helpline. Their service is available 24 hours every day. Call 0800 107 0160

• Samaritans

  Telephone: 116 123 (24 hours a day)

• Bump, Birth and Beyond

  The Kent and Medway Local Maternity and Neonatal System (LMNS) works with families. It aims to improve maternity services, and has resources for expectant parents and professionals. Includes ‘dad pad’ and financial support information.

• Birth Afterthoughts

  At East Kent Hospitals, we offer a ‘Birth Afterthoughts’ service. Birth Afterthoughts is a confidential service run by specialist midwives. You may have questions about the birth, days or even many months or a year or two after the birth of your baby or babies. We are able to offer you and / or your support person a debrief with a specialist midwife.

  They will review your notes with you, and help to answer any questions you may have. Some parents may choose not to talk about their birth experiences, as it is too soon after birth. You can always use our Birth Afterthoughts service when the time is right for you. Please self-refer via the Birth Afterthoughts web page.

  If you need help completing the self-referral form, please call 01227 864152 (open 9am to 2pm). Please ask for a birth afterthoughts referral.

  During your stay in hospital, you can talk to us at any time and ask any questions you may have. You can speak with your community midwife once you have gone home.

• Thrive: psychological support for birth trauma and loss

  Support is available for PTSD (post-traumatic stress disorder) due to:

  • perinatal loss or birth trauma

  • repeated unsuccessful IVF (in vitro fertilisation)

  • TOP (termination of pregnancy)

  • tokophobia (fear of childbirth); and

  • parent infant separation at birth for any reason, such as:

    • an unwell mother / baby

    • safeguarding; or

    • a long hospital stay for baby.

  Speak with your midwife if you feel this service would help you. Treatments include:

  • Cognitive Behavioural Therapy (CBT); and

  • Eye Movement Desensitisation and Reprocessing (EMDR) therapy.

• Women’s Health counsellors

  Email: to be referred to the counsellors.

  East Kent Hospitals offers a confidential NHS funded counselling service. It is available to women and their partners, who:

  • are under the care of the Women's Health Services within the Trust; or

  • have been within the last year.

  The counsellors will use the therapeutic process, including Talking Therapy and EMDR Therapy. They will use these processes to help you understand and explore your:

  • grief

  • bereavement and loss

  • trauma

  • issues around fertility

  • pregnancy or birth; or

  • issues around gynaecological and obstetric surgery.

  They will work towards improving and maintaining your mental and emotional stability.

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• Patient Voice Team
  Telephone: 01227 868605
  Email