Perinatal mental health

What is perinatal or maternal mental health?

You may have heard the terms ‘perinatal mental health’ and ‘maternal mental health’ being used interchangeably. Both refer to mental health during pregnancy and up to two years after giving birth.

You may also be familiar with terms like ‘post-natal depression’, or ‘baby blues’. At FTWW we tend to use the umbrella term ‘perinatal mental health’ because that encompasses the wide range of different mental health problems that may be experienced during and up to 2 years after giving birth.

• Mental health issues emerging during and after pregnancy is a very common occurrence, affecting around 1 in 8 women and people registered female at birth in Wales.
• Those with a previous history of mental health problems or psychiatric disorders can be at more risk of developing a mental health issue during or after pregnancy.
• Perinatal mental health problems can include postnatal depression, anxiety disorders, obsessive compulsive disorder (OCD), and postpartum psychosis. More information about all of these can be found on the NHS Wales website.

It’s worth pointing out that pregnancy and the post-natal period are times full of change – physically, mentally, and hormonally so, whilst it isn’t unusual to feel differently at this time, if you or a loved one find yourselves struggling, please seek advice from a professional.

More information about maternal mental health symptoms and treatments can be found at on the NHS Wales website here.

For additional advice, you can visit the Maternal Mental Alliance, who can signpost you to organisations offering support in your area.

Despite how common perinatal mental health problems are, it is only relatively recently that health boards in Wales have started to set up mental health services to support women in their local communities. Some women will be very severely affected and need inpatient care, in a hospital. However, at present, only one health board in Wales (Swansea) has a specialist mother-and-baby unit, where women and their babies can stay together whilst receiving specialist care or treatment.

What are we calling for?

Our overall aim is to ensure that those affected by perinatal mental health issues can access timely specialist mental health support no matter where in Wales they live.

We are concerned about widespread inequities in terms of access to specialist perinatal mental health services. At present, women who are at their most vulnerable and in need of support, when they are pregnant or soon afterwards, can find themselves sent anywhere in the UK where there is an available place in a mother-and-baby unit. This can be hours away from their families and local support services close to their homes.

In Wales, there is not adequate recognition of the potential long-term impact of perinatal mental health issues on those affected and a lack of investment into the services needed to support them.

• The only specialist mother-and-baby unit in Wales currently is in Swansea Bay Health Board. This is an inpatient unit, with 6 individual rooms for mothers and babies to stay whilst receiving care. If there is not enough space in Swansea, patients from Wales can find themselves travelling for many hours to far-distant units in England. For those whose first language is Welsh, or who have additional needs, this runs the risk of their not being able to access the type of care they need to recover fully and well.
• Not only is this one unit not enough for the whole of Wales, Swansea is several hours away by car or public transport for those in North or parts of Mid-Wales. To help address this disparity, a mother-and-baby unit is currently being built at the Countess of Chester Hospital in the north west of England with a planned opening date of October 2025.
• Betsi Cadwaladr Health Board is working with NHS England to develop the unit, and two of its 6 beds will be allocated specifically to women from North Wales. The unit will have bi-lingual (Welsh and English) information, and Welsh-speaking staff will also be employed.
• Despite these commitments to more specialist care,  FTWW is also concerned at cut-off points for community perinatal mental health services in Wales. Most usually, it is expected that a healthcare professional will refer women who need support to the local perinatal mental health team. But eligibility for this service stops at 6 – 12 months after giving birth.
• Unfortunately, because perinatal mental health problems are so often seen as taboo, with women and families anxious or afraid to speak up about their struggles, this can delay help-seeking. Healthcare professionals might not realise that women need support and so, when the referral is eventually made, it might be refused because it is beyond the cut-off point.
• The 6-12 month post-birth cut-off point for perinatal mental health services also means that if the person affected hasn’t recovered sufficiently within that time-frame, they will be transferred into adult mental health services.
• The waiting list for adult mental health services can be extremely long, with some patients reporting waiting for psychological therapies for years. At a time when women might have a lot of responsibility, including young families, this is extremely concerning. For some, it might mean they struggle with mental health difficulties for many years, affecting their lives long into the future.

What have we achieved?

Our campaign activity to improve the lives of those experiencing perinatal mental health issues is extensive. Some of our achievements are outlined below:

Maternal mental health stories

Many women find it difficult to discuss health issues and seek support, even if these health issues are having a significant impact on their lives.

We're working with our community to develop tools and tips to help women to speak up, and provide guidance for people who would like to support their loved ones, friends, colleagues or patients who are living with health conditions.

Useful links and documents