Over recent times you cannot open a newspaper without reading how our maternity services are failing parents both physically and mentally. Women describe loss of power within the birthing process and report that they are ignored, left alone and their wishes overlooked. And all at a time when they are at their most vulnerable with little control over their environment.
The Quality Care Commission report 2023 described the overarching picture of “a service and staff under huge pressure” with staff cover “often fragile, with the rotas relying on every consultant being available” which they are not. The report further highlighted multiple job vacancies, poor communication, and undermined one to one care in labour.
There is a lack in leadership, role rivalry between medics and midwives and this environment is an accident waiting to happen. It puts mothers and babies at risk from physical harm with a poorly controlled and assessed labour over which they have little agency.
Not only does this raise the risk of physical foetal and maternal harm at birth, but the ongoing effect of a difficult delivery on mental health can be disastrous for both mother and baby, especially if during the first year of life bonding and care is disrupted.
Roughly 1 in 4 mothers develop a mental health problem, this may be in isolation, or related to a difficult delivery and physical damage sustained during birth. Often there is little help offered for the physical damage, and all too regularly it is not spoken about due to embarrassment, no services being available or a “it will get better attitude” / “it is just baby blues” narrative.
The impact of this on relationships is huge. Many are left struggling to juggle a newborn while being physically and mentally compromised. The reduction in community mental health care services, community midwives and health visitors, further exacerbates the issues. They are not being identified at an early stage and appropriately referred and treatment commenced. The result is that by the time Mothers are seen they are often profoundly ill.
The Annual Confidentiality Inquiry into Maternal Death 2023 highlighted that suicide is the leading cause of death between six weeks and 12-month post-partum which is a catastrophic for mother, baby, relationships, and the wider family but shows the seriousness of the present situation that we must deal with as a matter of urgency.
These issues highlight the huge importance of readily available mental health care provision.
Within that, relationship and psychosexual support should be provided to enable the recovery and support of mothers following delivery. Specialist Psychosexual and Relationship Therapists are best placed to provide the tailored support often needed. And increasing their role as specialist providers within the NHS could prove vital in improving parental and children’s outcomes.