A “deeper conversation” is needed around pregnancy and motherhood which does not stigmatise women struggling with mental health issues after giving birth, an expert in maternal health has said.
Trinity College Dublin professor in midwifery Deirdre Daly said ending a woman’s postnatal care six weeks after the birth of her child also means that women struggling with potentially serious mental health issues post-partum are falling through the cracks.
The medical academic was speaking this week as health organisations around the globe marked maternal mental health day on Wednesday. This is an initiative to raise awareness of the unnoticed and often untreated mental health illnesses many new mothers silently endure in the months after their child is born.
“A lot of textbooks say the post-partum period only last six weeks but it doesn’t – you don’t know whether you’re coming or going for at least three months,” said Dr Daly.
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“The prevalence of mental health issues like stress, depression and sometimes anxiety are much higher 12 months after birth than they are in the first three months. Recognising perinatal mental health is something that should be talked about openly and not stigmatised in any way, shape or form.”
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While Irish perinatal mental health services have improved over the past decade, many women are still afraid to disclose they are struggling with depression or anxiety following childbirth, said Dr Daly.
“Women talk a lot during pregnancy about developing a birth plan but they also need a postnatal plan,” she said, with contact numbers for friends, family and healthcare professionals.
“We talk a lot about postnatal depression but mental health and wellbeing is more than that – it’s anxiety and stress as well.”
The State’s lack of concrete data and follow-up with women once they leave the maternity system means the actual number of new mothers suffering in silence remains unknown, said Dr Daly.
“If you’re a policymaker trying to develop health services, without data you have no way of knowing there is a population of women with unmet health needs.”
Research into first-time mothers must include “appropriate equality data”, including ethnic data from marginalised groups such as members of the Traveller community and the Roma community, according to the National Women’s Council (NWC).
In its 2024 Perinatal Mental Health report, the NWC also called for six week post-partum care to be extended to “at least three months” and highlighted the need for further integration of specialist perinatal mental health services in general maternity settings.
“We need political leadership and ring-fenced funding,” said NWC women’s health coordinator Doireann Crosson.
[ Call for overhaul of mental health services for new mothersOpens in new window ]
A dedicated mother-and-baby perinatal mental health unit for women suffering severe or complex mental health difficulties is also urgently needed, she said.
“This is a critical piece of the perinatal health infrastructure. It will be a very small proportion of women who need this unit but we also know that it’s best practice keeping them with their babies.”
In April, Minister of State for Mental Health Mary Butler announced the launch of “feasibility and preparatory studies” for the State‘s first mother and baby perinatal mental health unit, which will be located on the St Vincent’s hospital campus in south Dublin.
However, the HSE acknowledged last year that progress of the unit had been slow and the current absence of the facility means women who require admission must be separated from their babies.
“The wellbeing of mothers, their families and their infants is a public health matter that everyone should be interested in and should have a role in supporting,” said Ms Crosson.
“We know that at least 20 per cent of women are going to experience perinatal mental health difficulties and this is not something that should be stigmatised.”
