Rachel Butler experienced a tipping point last Christmas when she was about to leave home with her two-month-old son. Because Butler received no support for her anxiety during her pregnancy, Butler’s mental health deteriorated postpartum due to the placement of her baby in the neonatal unit shortly after his difficult birth. After weeks of embarrassment and thinking that her son would be better off without her, Butler broke down her partner and told him she was afraid she would pursue her suicidal thoughts.
Luckily, Rachel’s story has a happy ending. With the help of her doctor, her therapist, and the crisis team, Butler was referred to the perinatal mental health team that same day, where she finally received the support she needed to recover. But a recent report Mothers and Babies: Reducing Risk Through Auditing and Confidential Investigations (MBRRACE) by the National Division of Perinatal Epidemiology, which tracks perinatal mortality in the UK, shows an alarming rise in maternal suicide. In 2020, women were three times more likely to commit suicide during or within six weeks of pregnancy compared to 2017-2019.
It would be easy to attribute this increase to the effects of the Covid-19 pandemic alone, but is there more to it? What does the rising maternal suicide rate really tell us about postpartum support for new parents, and how does this fit into the larger context of the motherhood crisis?
“Having worked in this field for a very long time, I have made great strides in perinatal care, so it was a shock to see such changes. Covid certainly had some impact on people’s support as the meetings were held online and not in person,” the doctor said. Rebecca Moore, perinatal psychiatrist and co-founder of Make Birth Better.
“It is very difficult to judge a seriously ill person, especially if you have never met him before. He emphasizes that above all [in perinatal mental health]There is no substitute for meeting people face to face.”
For 43-year-old Catherine France, the impact was huge. She gave birth to her second child on March 24, 2020, less than 24 hours after Boris Johnson announced the country would be on lockdown. “It was probably early enough during the pandemic that the birth didn’t feel particularly different. The next day I was fired, but after that I didn’t hear anyone, I didn’t see anyone, there was nothing,” she says.
Two or three weeks later, France received a call from a health visitor who was examining her child without seeing him, and later had two personal visits to weigh him. On the first visit, she recalls, “this health visitor came to the door wearing a full set of personal protective equipment, such as a hazmat suit, and wanted to rock the baby on the curb. I refused, so he reluctantly entered the dining room. But after the second of those visits, about six weeks later, I didn’t hear anything about them at all until my son’s two-year visit, when he was two and a half years old.”
This, according to her, “was very difficult psychologically. There are parts of 2020 that I can barely remember because I am so tired of homeschooling my daughter while caring for a newborn. Emotionally, it was all I could literally go through every day, hour after hour.”
However, Frans adds, “It took me a long time to ask for help – perhaps much later than I should have – but finally, when my son was about 18 months old, I had to go to the doctor and just say, ‘ Look.” I can’t handle it. I also had to do it over the phone, but I was prescribed antidepressants and most recently referred to a surgical consultant.
France’s experience of feeling abandoned after giving birth is far from unique – many other women have had similar experiences. One of them, 32-year-old Claire Edge, tells the story I She struggled emotionally after her first child was admitted to the intensive care unit hours after her birth in October 2020. After she and her daughter were released, Edge turned to her health visitor for help in processing her experience. “I told her that I had all these thoughts and feelings about what I went through. She said I could talk to her, but she’s not a psychiatrist and I felt like I needed more,” she says.
Although her health visitor promised to take care of it, Edge says she never heard from her again. “I just thought, of course, it doesn’t really matter.”
While the pandemic has undoubtedly tightened barriers to postpartum mental health care, it is important to note that this is not a new problem. “Postpartum support has always been the Cinderella of ministry,” said Janet Fail, a midwife and professional policy advisor at the Royal College of Midwives (RCM). This is a political decision, she said, and the situation is only getting worse as more midwives leave the profession due to concerns about working conditions, patient safety and pay.
“There is no public investment in childcare services, and midwives can no longer support women in the way we are used to and want to support them,” she says.
While the role of the midwife – a word derived from the Anglo-Saxon word meaning “with the woman” – has traditionally been to support mothers more holistically during pregnancy, childbirth, and postpartum, according to File, midwives today are so thin that the priorities should have been installed. change.
“Midwives are mainly used in areas where there are many lawsuits in case of poor performance. They are used in hospitals to make sure the pregnancy goes well, prenatal screenings are done and live babies are born.”
She adds: “It’s the physical, psychological and social side of pregnancy and childbirth that we really need to think about a lot more seriously. If we had more time and resources to prioritize postpartum care, perhaps we could target the women who, unfortunately, appear in the suicide statistics.”
Suicide has been the leading direct cause of maternal death in the UK between six weeks and one year after the end of pregnancy since the 2016 MBRRACE report, when it was reclassified as a direct (rather than indirect) cause. Prior to this, the maternal suicide rate had remained unchanged since 2003. Today, mortality from all mental health problems (both suicide and substance abuse) accounts for nearly 40 percent of all maternal deaths in the first year after pregnancy.
Another recent report examining maternal mortality rates in eight European countries found that both suicide and cardiovascular disease were the leading causes of maternal death in Europe. Yet the United Kingdom ranks second in maternal mortality from all causes: British mothers are three times more likely to die during or shortly after pregnancy than mothers in Norway.
The 2022 MBRRACE report also highlights persistent racial disparities in maternal mortality, with black mothers in the UK still nearly four times more likely to die during or in the months following pregnancy than white mothers.
It is clear that improvements are needed in all areas, not least to urgently address the crisis in the midwifery workforce and provide adequate postpartum support.
“Fifty percent of women with perinatal mental illness never report it. People are afraid of being judged, being seen as a bad mother, or even having their child taken away from them, so seeking support is stigmatized,” says Moore.
“As caregivers, we must constantly ask new mothers how they feel. We know the six to eight week investigation was wiped out during Covid – many women didn’t have it or everything was on the phone and everyone was focused on the baby. We also know that foster care services are understaffed, but I think all caregivers who come into contact with new parents should be less afraid to ask these questions. We also need women to feel more comfortable stepping forward and be more creative in how we reach out to people,” she added.
It is also clear that we urgently need support when women ask for it. “It’s not enough to understand how quickly people can regress and become suicidal, and that sometimes it’s quite temporary,” Moore explains.
“One of the first patients I saw, and who will stay with me forever, never had a mental health problem before. For two weeks after the birth of the child, she made suicidal plans, and then, with the right support, she recovered again.
Having recovered from his own crisis, Butler now works for PANDAS, a perinatal mental health charity that has a toll-free helpline and online and offline support groups. She firmly believes that her postpartum experience would have been very different if she had received support during pregnancy, as she requested: “We should never get to the point where we have suicidal thoughts before help is available” .
Source: I News
I’m Raymond Molina, a professional writer and journalist with over 5 years of experience in the media industry. I currently work for 24 News Reporters, where I write for the health section of their news website. In my role, I am responsible for researching and writing stories on current health trends and issues. My articles are often seen as thought-provoking pieces that provide valuable insight into the state of society’s wellbeing.