"When Mia* was referred to me, she was 32 weeks pregnant and had not slept properly in two months. Her GP had told her it was just pregnancy insomnia. Her obstetrician said it was normal and suggested she try going to bed earlier with a pregnancy pillow. By the time she sat in my consulting room, hands clenched around a damp tissue, she had been quietly planning how her partner and baby would be better off without her."
"Mental illness is the number one complication of pregnancy and the postnatal period. Not gestational diabetes. Not pre-eclampsia. Up to one in five women will experience a diagnosable mental health condition during the perinatal window the period from conception to one year after birth. Depression and anxiety are the most prevalent, but the spectrum extends to post-traumatic stress disorder after birth trauma, obsessive-compulsive presentations centred on intrusive thoughts of infant harm, and the rare but devastating psychotic episodes that constitute a psychiatric emergency."
"These are not small statistics. If a physical complication affected one in five pregnancies, we would screen for it universally, fund treatment pathways generously, and train every clinician involved in maternity care to recognise it. We do none of these things consistently for perinatal mental health. The gap between prevalence and response is where women like Mia fall through."
A pregnant or postpartum woman may develop psychological symptoms and mention them at an antenatal appointment. Reassurance that symptoms are normal can delay specialist assessment for weeks or months. By the time perinatal psychiatry care is reached, symptoms may have progressed into a crisis, including thoughts of self-harm. Mental illness is identified as the leading complication of pregnancy and the postnatal period. Up to one in five women experience a diagnosable mental health condition from conception to one year after birth. Depression and anxiety are common, with additional presentations including post-traumatic stress disorder, obsessive-compulsive symptoms involving intrusive thoughts of infant harm, and rare psychotic episodes requiring emergency care. Universal screening, funded pathways, and clinician training are described as lacking compared with physical complications.
#perinatal-mental-health #pregnancy-insomnia #postpartum-depression-and-anxiety #perinatal-psychiatry #maternal-healthcare-screening
Read at www.theguardian.com
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