The pressures on mums are never – ending, the expectation to have a job, be a mum, be happy and smile and hold it together for themselves and for others in the face of adversity is testament to societal pressure that often expects women to do it all and not complain about it.
Inequality in the home and the assumption that childcare and domestic responsibilities are a woman’s responsibility is still the lived experience of many women. However, when stress, pressure and trauma impacts on a woman’s mental health, the support has, until recently been minimal and there are still significant shortfalls.
Having a baby is a significant time in a woman’s life when life as we know it changes forever, physically our body changed in bringing a whole new person into the world and often no amount of preparation can anticipate what that’s actually going to be like. The change and often loss of a woman’s identity at this time can impact on mental health. It is estimated that up to 1 in 5 women will have a perinatal / maternal mental health problem. In reality, it could be much higher with data from the Maternal Mental Health Alliance indicating that up to 70% of women will play down or hide a mental health issue.
The difficulties for women in disclosing a mental health problem are multiple, with a fear of the consequences of disclosure a barrier for women seeking help when they need it. Women often fear being seen as an unfit mother due to their mental health problems. This fear is often further exacerbated for women from areas of high deprivation, many who have said that they feel an additional stigma and judgement. The Mas Matter flyer for healthcare professionals developed by women on the project reaches out to the healthcare service and encourages a trauma informed lens asking for continuity, compassion, communication. An empathetic approach can make a big difference in supporting systemic structures that make it difficult. Mas has been successful in restoring women’s confidence and belief in themselves, creating a safe space for women to be, share, connect with others and recover.
The prevalence of domestic abuse needs to be acknowledged in understanding the potential for it to present as a perinatal mental health problem. It is estimated that 30% of domestic abuse begins during pregnancy, it makes sense for all who support women in the perinatal period to be trained on the impact of being in an abusive relationship on mental health. Routine enquiry should be extended to all healthcare professionals and revisited when speaking with women, with awareness of how disclosure is more likely with continuity and trust.
We welcome the set-up of perinatal mental health services in all 5 trusts in Northern Ireland for women with severe mental health problems. They have been set up for only 2 years, despite maternal mental health being an issue that has impacted high numbers of women, before that specialist care was minimal. The criteria for these services is extremely strict and they are specialized for women with a high level of need. In recent years the Mas project and other peer support charities have set up in community, increasing awareness, visibility of maternal mental health and sending the message out to society that it is okay not to be okay and that includes women and mothers too. There is a continued emphasis in healthcare and research settings on early intervention, it’s a no brainer – address a problem early on to prevent it from getting worse. This is essential for women too and women in the perinatal period. There is currently no statutory funding for mild/ moderate perinatal mental health support. Projects like Mas all receive short- term funding, thanks to the National Lottery Community Fund, we have been able to provide peer support, capacity building, training, support and the opportunity for women to amplify their own voices – a powerful force for healing. Our work in supporting women’s mental health is not government funding. We believe that it should be, to ensure that the progress in the voice and visibility of maternal mental health and the reduction of stigma is not lost and that support is there for women in the future, beyond the life-time of our current funding.
The campaign for a mother and baby unit in Northern Ireland has been going on for over 20 years. A site has been located but until funding is confirmed and the unit is set up, mums and babies continue to be traumatized and their recovery and well-being impacted. The forced separation of mum and baby when a woman is very unwell and the absence of the baby and mother to each other at such an important time is appalling. It’s difficult to understand how this damaging practice has been allowed to continue and is an unsettling reminder of a need that hasn’t been met or prioritized.
The outstanding need in perinatal mental health services root from a patriarchal system that has not prioritized women. The call for a Women’s Health Strategy points to the multitude of varying issues in gynecology, mesh surgery and injury, endometriosis, POS and other health issues specific to women that have also been under- resourced. The absence of a mother and baby unit in Northern Ireland and long- term funding for projects that provide peer support is rooted in gender neutral systems that perpetuate patriarchy by not providing adequate services for women.
It’s time to invest in mothers and their well-being by funding a mother and baby unit so that mums and babies can bond and be together during a woman’s recovery with specialist care and also for early intervention peer support so that women can recover and regain wellness after post-natal illness.
Clare Anderson
Maternal Advocacy & Support Project Coordinator
Call to action: Ask your local Westminster candidate to ask the Health Minister: What is the deadline for the Belfast Trust to produce the business plan for a Mother and Baby Unit in Northern Ireland?
Will funding be confirmed for a Mother and Baby Unit in the next 6 months?
