Women: Postnatal Depression

Earl Howe Excerpts

Thursday 5th February 2015 Lords Chamber

[The Parliamentary Under-Secretary of State, Department of Health (Earl Howe) (Con)]

My Lords, the Government have prioritised improving mental health care and support for pregnant women and new mothers in their mandate to NHS England, with a clear objective to reduce the incidence and impact of postnatal depression. We have taken steps to improve the size and capability of the workforce—there are 2,000 more midwives and 3,200 more health visitors than in 2010. By 2017, specialist perinatal mental health staff will be available to every birthing unit.

[Baroness Royall of Blaisdon (Lab)]

My Lords, that is welcome news. Too many women who suffer from postnatal depression do not seek help because of the stigma attached to mental illness, together with the guilt and shame attached to feeling that they are not being the sort of mother that society expects. I hear what the noble Earl says about specialist care, but what are the Government doing to ensure that specialist mother and baby units can be accessed by these new mothers wherever they live in this country, so that they do not end up on acute psychiatric wards, separated from their babies or partners, or not receiving the requisite help? At the moment, I fear that parity of esteem for mental health is not a reality for these women.

[Earl Howe]

My Lords, we know there is more to be done. There are perhaps two key actions here. One is having a sufficient number of trained professionals in place—I have mentioned the increase in the number of health visitors and midwives—and the other is raising awareness of the risks and signs of postnatal depression with mothers-to-be. Extensive training is available and delivered to midwives, both during their initial training and afterwards. The programme of family nurse partnerships commenced by the previous Government is tremendously important in the follow-up stage after birth to ensure that new mothers are monitored closely.

[Lord Alderdice (LD)]

My Lords, we know that one of the very important elements in support of women in the pre- and post-partum period is the quality of the relationship between the father and the mother of the child, and that where there is a problem in encouraging that, there is frequently difficulty. Given that, is my noble friend satisfied that this element of the relationship is sufficiently addressed, appreciated and nourished in all our facilities?

[Earl Howe]

The role of the father, as well as of course that of the mother, is emphasised in all the guidance—certainly in the healthy child programme but also in the work done under family nurse partnerships, which targets the most vulnerable families. That programme provides intensive support to young first-time mothers and their babies. It explicitly involves fathers—and/or other family members as well—as long as the mother wants the father to take part.

[Lord Laming (CB)]

My Lords, does the Minister agree that two elements need to be addressed? First, there is the safety and well-being of the mother but, secondly, there is the important issue of helping the mother to bond with her new baby. That requires quite intensive work at a critical time in the life of the new baby and of the mother. Could he assure us that these matters are being addressed in these new arrangements?

[Earl Howe]

The noble Lord makes some extremely pertinent points. The family nurse partnership programme that I mentioned is important in this context, and our aim is to expand that to 16,000 places by April 2015. We launched the NHS Start4Life information service for parents. Parenting classes are available through the CANparent network and we are developing a population measure to show child development at two to two and a half years for inclusion in the public health outcomes framework, so that we can measure the progress we are making.

[Baroness Nye (Lab)]

My Lords, would the Minister agree that midwives had a crucial role to play in identifying and helping women suffering from postnatal depression, so it is regrettable that the Prime Minister’s pledge at the last election that there would be 3,000 more midwives during this Parliament has not been met? The increased number of midwives in training is to be welcomed, but does he agree that valuable mental health care support for new mothers is being lost if some NHS trusts do not have the money to employ them when they finish training?

[Earl Howe]

It is positive that the number of midwives has increased by 2,000 since 2010, as I mentioned, and there is a record number in training, as the noble Baroness mentioned. But she is right about the role of the midwife before, during and after the birth. The visits that a new mother can expect from a midwife should contain a session where the right questions are asked of the mother about how she is feeling and how her baby is. The signs and symptoms of postnatal depression are ones that every midwife is trained to pick up.

[Baroness Howe of Idlicote (CB)]

My Lords, as well as the importance of the bonding of the mother and baby, and the other very welcome steps that the Government are taking, I hope the Minister will agree that the needs of the children at home—they are very badly affected, one hears, by a mother who is in a state of mental depression—should be taken into account and met equally.

[Earl Howe]

The noble Baroness is, of course, quite right. Again, midwives and health visitors involved in family nurse partnerships are trained to look at the welfare and well-being of all members of the family.

[Baroness Corston (Lab)]

My Lords, does the Minister agree that there is still a social stigma attached to postnatal depression? I have heard people say, “She’s got a new baby, what’s she complaining about?”. What steps are the Government taking to increase public understanding of the fact that this is a mental illness, unbidden, which affects women who would like to be able to bond with their babies and be proud of them like the rest of us are?

[Earl Howe]

The noble Baroness makes an extremely good point. I think that the stigma attached to mental illness is slowly diminishing, although there is a long way to go. But she is right that there are common misconceptions around the baby blues and postnatal depression. One of the most important things we can do is inform mothers-to-be of the risks and signs of those syndromes. If we can do that and prepare mothers for the possibility that they will experience this, we are more than half way there.