New mothers’ mental health problems ignored, committee hears

There are just three part-time perinatal psychiatrists in Ireland, all based in Dublin, and there is no mother-and-baby unit for severely depressed mothers, the Joint Oireachtas Committee on Health was told on Thursday.

Retired obstetrician Dr Peter Boylan, chair of the Institute of Obstetricians and Gynaecologists, said the lack of provision for mental health services for new mothers was “not acceptable in 2017”.

He contrasted the absence in the State of any mother-and-baby unit for women with postnatal mental health problems – despite the clinical evidence that such units are of benefit – with the situation in the UK, where there are 20 such units.

In its submission to the committee, which is examining the national maternity strategy for the next 10 years, the Association for Improvements in the Maternity Services (Aims) Ireland said perinatal mental health was “almost completely ignored in our maternity hospitals”.

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Birth trauma

Aims Ireland estimated that 30 per cent of mothers experience mental health problem during or after pregnancy. Between a sixth and a third experience birth trauma.

Yet new mothers having mental health difficulties are often given drug therapies which do not deal with the underlying issues and leave women vulnerable to similar difficulties in subsequent pregnancies, it said.

Aims Ireland vice-chair Breda Kearns told the committee that former UK chancellor of the exchequer George Osborne had allocated £1.2 billion (€1.4 billion) for mental health services for mothers of new babies.

She said a recent London School of Economics study found mental health issues in mothers with newborn babies cost the UK £8.1 billion (€9.5 billion) a year and could have lifelong consequences for mother and child.

Aims Ireland chair Krysia Lynch said research suggested 17-18 per cent of mothers experienced antenatal depression and 18-19 per cent experienced postnatal depression, though these were probably conservative figures.

Women were very reluctant to admit they had perinatal issues, fearing their babies would be taken away from them, she told the committee.

“That is a known factor in the underestimation of the number of women with perinatal mental health problems.”

‘Gross inequality’

Louise Kenny, professor of obstetrics at University College Cork, said there was a "gross inequality" nationwide in antenatal screening services.

In other OECD countries the uptake of foetal anomaly scans performed at 19-22 weeks was close to 100 per cent, but 36 per cent of Irish women attending antenatal services in Ireland did not get one.

At present almost two-thirds (62 per cent) of all maternity units in the State offer the service selectively or not at all.

Prof Kenny said the reasons why some hospitals offer foetal anomaly scans and others do not is a matter of governance. “In maternity hospitals without ring-fenced budgets and robust independent governance, women’s healthcare competes with other clinical priorities and international experience demonstrates that it is always the first to be cut.”

She said the number of consultants in maternity care in Ireland was the lowest in OECD countries at 3.66 per 10,000 deliveries. Another 100 consultants would need to be appointed to bring the State up to international norms, she added.