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ARTICLE OF THE MONTH Perinatal mental health and wellbeing: policy and practice

Anna Gaudion

Midwife and Researcher at the Polyanna Project, London

Claire Homeyard

Consultant Midwife (public health) at Barking, Havering and Redbridge University Hospitals NHS Trust


 (September 2017)

In the first article of our new series on perinatal mental health, we provide an overview of the relevant policy landscape in England. Future papers in this series will include a discussion on pathways for mothers affected by more severe mental health conditions; information provision and tools; fathers; and a review of a creative engagement exercise carried out in South London.

Mindfulness: an intervention to promote maternal and infant wellbeing

Tracy Donegan

Midwife and childbirth educator in California and founder of GentleBirth

2017;20(9): ePub 26 September 2017

 (September 2017)

  Small pilot studies exploring pregnancy and mindfulness suggest this intervention is associated with lower levels of psychological distress, including less anxiety and depression (Duncan et al 2017). In non-pregnant populations there is a growing body of research demonstrating the positive effects of mindfulness on physiology, emotional wellness and mental cognition. Perinatal mood disorders during pregnancy increase the risk or labour complications and postnatal mood concerns and may interfere with attachment and child development (Muzik and Borovska 2011). Anxiety and stress during pregnancy have been linked with premature birth, low birth weight, and neonatal morbidity and mortality.

Twins, postnatal depression and me


Second year student midwife

 (December 2016)

I am a mother to four-year-old twin girls. Life since their birth has not been easy and postnatal depression has blighted our relationship. So, too, has it affected the relationship I have with friends, family, my husband, myself. My reasons for becoming a student midwife were numerous, but my experiences as a pregnant woman and a new mother were pivotal in that decision.

A midwifery approach to emotional wellbeing and mental health in pregnancy

Jilly Ireland

Community Midwife, Supervisor of Midwives and RCM learning representative at Poole NHS Foundation Trust and Honorary Research Fellow at Bournemouth University

 (December 2016)

Mental health and emotional wellbeing in pregnancy and early motherhood are important issues for women all over the world, with poorer women suffering the most. In Nepal the maternal mortality rate is around 258/100,000 compared with the UK's 9/100,000. However, the proportion of women dying from suicide is fairly similar at about one in six/seven of all maternal deaths. Professionals are not picking up on over 50 per cent of mental health issues in the UK, despite the recommended routine use of the Whooley questions (Whooley et al 1997). In addition, midwives are reporting stress as a cause of work absence in alarming numbers. We need to get people talking about mental health issues. This paper describes a simple tool to do just that. The tool has been used in two very different settings: rural Nepal and in one of the less affluent areas of Poole in the South of England.

Understanding eating disorders in midwifery practice

Fallon Dyer

Second year student midwife at the University of Central Lancashire and Practitioner at Progress Theatre Midwives

 (July 2016)

Eating disorders (ED) are characterised as a severe disturbance in an individual's eating behaviours and are one of the most misdiagnosed and overlooked mental health conditions in the United Kingdom. Six-eight per cent of the general population are reported to be affected by an ED, although the number is rising. There are two main diagnostic categories of ED: anorexia nervosa and bulimia nervosa, though those that do not meet the specific criteria are categorised as having an 'eating disorder not otherwise specified' (Dooner 2015). Eating disorders predominantly present in women of childbearing age and, although many women experience alleviation of their symptoms during pregnancy, they are at significant risk of relapse in the postpartum period. This article aims to explore the impact that an eating disorder has on the woman and her family, with a focus on the postnatal period, as well as the challenges that midwives may face in identifying and caring for women with the condition.

Court-ordered caesareans

Elizabeth Prochaska

Barrister and founder of a charity dedicated to the improvement of women’s experiences of pregnancy and childbirth

Sara Lomri


 (November 2014)

Court-ordered caesarean sections are in the news after a number of recent legal decisions authorising surgery for women who lack mental capacity to consent. The decisions have not always been based on good evidence and they raise serious concerns about the protection of the rights of mentally ill women. The authors explain the legal process and question the wisdom of recent judgements.

Striving for better maternal mental health

Mary Steen

Professor of midwifery at the University of Chester and adjunct professor of midwifery at UniSA, Adelaide

Scott Steen

PhD student in the centre for psychological therapies at the University of Chester

 (March 2014)

Mental health is an integral part of health and a state of wellbeing. The concept of ‘parity of esteem’ increases awareness that mental health needs to be treated as seriously as physical health. During the childbirth continuum, women and their partners can be at increased risk of mental health problems; therefore it is important to embrace the ‘parity of esteem’ concept. This article highlights links between mental and physical health problems and discusses the vital role that midwives can play in promoting better maternal mental health. It considers the challenges this can present to midwives and maternity services.