What is Perinatal Mental Health? :: Mersey Care NHS Foundation Trust

Around 1 in 5 women experience perinatal mental health problems in pregnancy or the postnatal period.

With so much information out there, we know some of us are overwhelmed and this can add to stress for professionals. This section has information to support your usual assessment and support of mums and families.

“Peri”- around / before or after

“Natal” - Birth

“Perinatal” – around birth / pregnancy and postnatal period

Perinatal refers to 12 months after giving birth, however, Perinatal Specialist Service can work with mums and birthing people until 24 months after birth.

Examples of some perinatal mental health problems include:

antenatal and/or postnatal depression,
anxiety,
Perinatal obsessive compulsive disorder,
postpartum psychosis
Perinatal post-traumatic stress disorder (PTSD).

These illnesses can be mild, moderate or severe, requiring different kinds of support or treatment.

The Royal College of Psychiatrists have some useful information leaflets on different illnesses on these links:

https://www.rcpsych.ac.uk/members/your-faculties/perinatal-psychiatry/news-and-resources
Postnatal Depression - https://www.rcpsych.ac.uk/mental-health/problems-disorders/post-natal-depression
Perinatal OCD - https://www.rcpsych.ac.uk/mental-health/problems-disorders/perinatal-ocd
Postpartum Psychosis - https://www.rcpsych.ac.uk/mental-health/problems-disorders/postpartum-psychosis

Around 1 in 5 women experience perinatal mental health problems in pregnancy or the postnatal period – that’s so many people!
Research suggests 50-70% of people hide or underplay their illness and symptoms in the perinatal period and are afraid to share with professionals, so it is key that we are trauma informed, sensitive, compassionate and remind mums and birthing people that this isn’t their fault, and they haven’t chosen to feel the way they do
Becoming a parent or having another baby is one of the biggest changes and transitions in a persons life. Everyone needs some support at this time and that is normal
The first 1001 days of a babies life (conception to 2 years old) is a very important time. If people get the mental health help they need early on in this 1001 days, both mum and baby are more likely to have happier and healthier futures
Compassion, kindness and taking the time to create meaningful rapport, trust and understanding can absolutely be the difference to empowering a parent at the very beginning of their healing and recovery; or failing the parent by failing to hear and acknowledge her experience so far
Suicide is the leading cause of death for women and birthing people in the first year after birth
It’s essential that we are aware of and are alert to signs of a range of perinatal mental health difficulties, including the perinatal ‘red flags’ that should be taken seriously.

The most recent Red Flags identified on the latest MBRACE UK report (2022) are:

Firstly, there is no shame or blame in asking for professional support. Women and birthing people have not chosen to feel depressed, worried or distressed in the perinatal period and it is not their fault. There is lots of different support available for lots of different challenges
We know there are lots of women and birthing people who may require some professional support in the perinatal period and the specialist service is always happy to help find that support that is right for them
Sometimes that is with the perinatal service or signposting to another service that can help.
Perinatal mental illnesses /psychological distress are present in people of all cultures, ethnicity, races, ages and social groups
Recent research suggests:
- In black, Asian and ethnic minority communities, only 7% of those with perinatal illness symptoms were referred for specialist care (Firth, 2021)
- Severity is higher in women of ethnic diversity (Jankovic 2020).
So professionals need to:
- make sure we help all people make informed decisions
- consider what barriers may be in place for some communities
- consider bias that may exist in NHS support systems
- adapt our systems to help others access support and services.

We can’t always spot the signs and these illnesses and challenges could be affecting many people in different way. That’s why it is so important to ask and invite mums and birthing people to talk about how they feel in the perinatal period.

For some people, they may not realise they have become unwell or what they are experiencing is an illness. There is lots of stigma and misinformation about perinatal mental health.
Sometimes symptoms of feelings can worsen over many months or weeks and some people and their family may not have realise the severity of their distress or illness and not seek support.
Having that opportunity to speak and say’ actually, no, I’m not ok’ can open doors for early support and intervention.
The first step in supporting yourself or someone else is talking about it and inviting the conversations.
Professionals can phone and talk to the specialist perinatal service for advice and making referrals.

NHS England and NHS Improvement have produced this animated video clip, which is about identifying signs of perinatal mental illness and includes details of perinatal red flags (warning signs).

London Clinical Network produced this 'Building Better Mental Health Services' video to outline how Specialist Perinatal Services compliment the community health and social care input. The short animated video clip outlines where the specialist service fits together with the wider community and details how we can all do our bit.

Best practice screening and detection pathway, produced by members of the Strategic Clinical Network for use in the Antenatal and Postnatal period.
Perinatal emergency pathway, produced by members of the Strategic Clinical Network for use in the antenatal and postnatal period.
The Institute of Health Visiting has produced specific advice about managing familial mental health during Covid-19, which is a useful tool for many working at the universal or primary care service level.