PREGNANT women and new mothers with mental ill-health problems in Scotland still face insufficient medical and nursing support ten years after key recommendations were drawn up to improve patient care, research by a leading children’s children has found.

The NSPCC Scotland’s report Getting it Right for Mothers and Babies, published yesterday, found almost three-quarters of health boards do not have any midwives trained in the field, while only just over a third had a specialist community perinatal mental health service.

Despite a strong understanding of the need to promote secure bonding or attachment between mother and child in the early days and weeks of a baby’s life, two thirds of Scots health boards do not use a specific programme tool to assess infant attachment, the study found.

The report also said that only four out of Scotland’s 14 health boards have established standards, advice and guidance on prescribing mental health medication in pregnancy and breastfeeding.

Doctors believe depression and anxiety affects between 10% to 15% of pregnant women and new mothers in the year following the birth of their baby. Most suffer from mild illnesses but some pregnant women and new mothers become seriously unwell.

The NSPCC called for more resources for specialist training, arguing the benefits to patients would improve the lives of their children.

Matt Forde, head of NSPCC Scotland services said while the country was making more progress in supporting pregnant women and new mothers with mental health problems than the other UK nations it was crucial that shortcomings in the area were addressed.

“We know that children of mothers experiencing mental illness while pregnant are at increased risk of prematurity, low birth weight and sleep problems,” he said.

“The relationship between a baby and their primary caregiver can affect their self-esteem, resilience and ability to socialise. This in turn can affect a child’s behaviour and academic abilities when they get to school.”

Elaine Clark, chair of Maternal Mental Health Scotland, a forum for health professionals who work with pregnant women, new mothers, and their families, raised concerns about the inconsistent level of care across health boards.

She said: “All women should have equal access to services wherever they live in Scotland.”

The NSPCC’s research was based on results from a questionnaire sent to Scotland’s 14 health boards last October.

The report made a series of recommendations for the authorities, including calling for all NHS boards to have specialised perinatal mental health services and that all health professionals working with pregnant women and women who had given birth should have up-to-date knowledge on maternal mental illness. It also recommended that women whose pregnancies are likely to be complicated by serious pre-existing mental health conditions, or who develop new significant mental ill health issues, should be immediately referred to appropriate specialist services.

There are a range of mental health conditions which pregnant women and new mothers can suffer from.

Post partum psychosis is the most serious and is suffered by two in 1000 mothers. It can put the mother at risk of self-harm and the baby at risk of being hurt by his or her mother. It typically affects women in the weeks after giving birth, and causes symptoms such as confusion, delusions, paranoia and hallucinations.

Chronic serious mental illnesses such as schizophrenia or bipolar disorder, which a women may have suffered from before becoming pregnant or having a baby, may be more likely to develop, recur or deteriorate in the perinatal period and also affect around two in 1000 mothers.

At the mildest end of the spectrum adjustments disorders relating to pregnancy, birth or becoming a parent affect up to 300 out of 1000 pregnant women and new mothers.

Case Study: "I am so lucky to have had such support"


CLARE THOMPSON was referred to a specialist unit for support when she confided in her midwife about her feelings of anxiety when she was pregnant.

The expectant mother attended the perinatal mental health (PMH) unit at the Southern General Hospital in Glasgow, but after having her baby girl Zoey by emergency Caesarean section her condition deteriorated. “When Zoey was nine weeks old, my midwife suggested we stay in the specialist perinatal mother and baby unit (MBU). I felt so guilty.

“This was supposed to be a special time for us to all bond as a family and I was taking Zoey away from my partner,” she said.

“Every morning in the unit I’d get Zoey up, give her milk, change her nappy, shower, eat breakfast then get Zoey dressed. Everything seemed impossible. It took most of the morning.

“Most days they’d try and rally us for a walk. At the time it was hard. It was autumn, the leaves were falling on the ground and it was getting colder. Now I remember those walks with nostalgia: they helped get me through.”

Clare, a librarian who lives in Glasgow, said that the group sessions in the unit helped her realise that she wasn’t alone and that other mothers had similar feelings.

After leaving the unit she had weekly home visits from health professionals and her family also rallied round making sure she had company during the day. Clare said she is now getting better and has a close bond with Zoey.

She said: “I am so lucky to have had such support. Lots of midwives and GPs don’t know what specialist services are available and there aren’t enough.

“It is a postcode lottery, with too many women suffering in silence.”