Perinatal Mental Illness

Paul Williams Excerpts

Thursday 19th July 2018 Westminster Hall

[Dr Paul Williams (Stockton South) (Lab)]

I beg to move,

That this House has considered perinatal mental illness.

It is a pleasure to serve under your chairmanship, Mr Davies. I and my colleague on the Select Committee on Health and Social Care, the hon. Member for South West Bedfordshire (Andrew Selous), are delighted to have secured this important debate, and I thank the Backbench Business Committee for granting it.

Nothing can prepare someone for the challenge of becoming a new parent—the sleepless nights, the new responsibility and the feeling that they suddenly have to put their old life on hold. As I have found since becoming a parent, a few months before my 40th birthday, raising a newborn child can be hugely rewarding. There is little that compares with the joy of seeing a child grow and develop. For most of us, it is a deeply fulfilling experience. Still, becoming a parent can have a dramatic impact on many people, in terms of both the stresses they experience and the impact it has on their relationships and their emotional wellbeing.

I will talk about how the Government can act to improve the lives of thousands of mothers in England who do not receive adequate support for perinatal mental health problems. The perinatal period is the time during pregnancy and the run-up to a birth, and the time immediately following the birth of a new baby. As a general practitioner as well as a parent, I have worked to provide mothers and newborn babies with the support and care they need in the perinatal period. It is a crucial time not only for the mother, but for the development of her child. It is also a time when great pressure is placed on mothers to care for their baby and simultaneously to be happy, excited and on top of life.

According to the mental health charity Mind, about one in five women experience mental health problems during pregnancy or in the year after they have given birth. Those mental health problems can come in many different forms—from eating disorders, to post-traumatic stress disorder, to anxiety and depression. If left untreated, the mental illnesses that these women experience can affect their whole lives, their ability to cope with being a parent and their relationships within and outside their families. The illnesses can affect attachment and bonding with the baby. At their extreme, perinatal mental health problems can lead to suicide and to long-term health problems for a child.

[Lyn Brown (West Ham) (Lab)]

I understand that one fifth of parents stated that they were not asked about their mental or physical health during the six-week post-natal check-up. Does my hon. Friend think that might be because GPs are massively overburdened and simply do not have the time to deal with this essential issue?

[Dr Williams]

I thank my hon. Friend for raising that point. I will refer to it later in my speech. I think the pressure on GP services that she has identified is one reason, but there are some other reasons to do with training and perhaps resources.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

I thank the hon. Gentleman for bringing forward this important debate. To support his case, I will describe the case of Libby Binks, a very brave constituent who came to my surgery. She described how she went through the six-week check without any consideration being given to her wellbeing, despite the fact that she was clearly in distress and had post-natal depression. A health visitor came in at a later stage and filled in a questionnaire with her, which clearly showed she had post-natal depression, but nothing whatever happened until her child’s first birthday. Does the hon. Gentleman agree that we need to make more of that six-week check in particular, to ensure that the mother’s wellbeing, as well as the child’s, is taken into consideration?

[Dr Williams]

I thank the hon. Gentleman for relating the experience of his constituent, which is, sadly, shared by too many other women. Of course, there are many dedicated health professionals who do identify mental health problems, but too many women say that they slipped through the net.

I will talk about why perinatal mental health problems are so important for a child. The first 1,001 days of a child’s life, from conception to the age of two, are absolutely crucial to their social, emotional and cognitive development. Put simply, those 1,001 days are when a brain is built and shaped. During that time, 1 million new neuronal connections are made every second in that child’s brain. When the environment the child experiences, whether inside or outside the womb, is happy, relaxed and stimulating, he or she learns and develops those connections in the brain. The baby grows and adapts in a positive environment.

However, many of the symptoms of mental health problems do not provide that ideal environment. Stress raises the level of cortisol, which can cross the placenta and affect a foetus. When someone is severely depressed, perhaps they do not smile, so a baby does not see the warmth, the love and the reciprocation that they need from their mother. When someone is anxious or has an obsessive compulsive disorder, a baby sees, learns and repeats actions from the environment they are experiencing from birth. They learn to behave like their mother.

A mum’s mental health problem can have such a significant effect on a baby that academics describe it as an adverse childhood experience. Adverse childhood experiences, or ACEs, are stressful events that occur in childhood.

[Mohammad Yasin (Bedford) (Lab)]

My hon. Friend is making a powerful speech. I was interested to hear the evidence put forward by the National Childbirth Trust to the all-party parliamentary group for the prevention of adverse childhood experiences that depression among 16-year-olds is usually linked to their mother’s pregnancy. I realise that the research is more complex, but given the worrying rise in the number of children and young people with mental health problems, is he as concerned as I am that one quarter of women are unable to access specialist perinatal services in the UK?

[Dr Williams]

I thank my hon. Friend for making several points, including that a child whose mum experiences mental health problems is more likely to develop mental health problems themselves. Despite significant Government investment in specialist perinatal mental health services, significant inequalities remain throughout the country and there are still areas where, as he said, one quarter of women with significant mental health problems are not able to access specialist facilities. I hope we will get the chance to talk more later about access to specialist services.

Other adverse childhood experiences include domestic violence; parental separation or divorce; being a victim of physical, sexual or emotional abuse; physical or emotional neglect; or growing up in a household where there are adults experiencing alcohol and drug problems. Mental health problems in a mother can have as significant an impact on a child as some of those other problems. The term ACEs was originally developed in the US, but other studies have reported similar findings in England and Wales. Those ACEs have, as my hon. Friend has said, been found to have lifelong impacts on health and behaviour. They are relevant to all sectors and involve all of society.

An ACE survey of adults in Wales found that, compared with people who had experienced no ACEs, those with four or more were more likely to have been in prison; develop heart disease; frequently visit their GP; develop type 2 diabetes; have committed violence in the last 12 months; and have health-harming behaviours, such as high-risk drinking, smoking or drug use

Children’s exposure to adverse and stressful experiences can have a long-lasting impact on their ability to think and to interact with others, and on their learning. Health and societal inequalities that develop during early years stick with children for life. That is why I chair the APPG for the prevention of adverse childhood experiences. It is also why the identification and treatment of maternal mental health problems is not only important for the individual mother but crucial for all of us in society.

National Childbirth Trust research shows that as many as half of new mothers’ mental health problems are not picked up by a health professional. That is not to say that health professionals are not asking—they often are. There are many fantastic nurses, GPs, midwives, health visitors and others who provide care during pregnancy and during the post-natal period. However, those services, as my hon. Friend the Member for West Ham (Lyn Brown) has said, are overstretched. We all know how hard-pressed GP services are. The Government have acknowledged the problem and have promised to recruit an extra 5,000 GPs by 2020. However, they are failing miserably and are struggling to even maintain GP numbers. NHS Digital reports a decrease in full-time equivalent GPs from March 2017 to March 2018.

Perhaps a little less well known is the dramatic fall in the number of health visitors. Since 2015, there has been a loss of more than 2,000—almost a 20% drop—so each health visitor has to work harder. I commend health visitors for the work they do but, overall, women are experiencing a drop in services.

Staff numbers are part of the problem, but there are many other reasons why the problems of almost half of women with perinatal mental health problems are not identified. Stigma, and the societal pressure to be seen to be coping, makes it hard for some women to disclose that they have a mental health problem. Also, as the hon. Member for Thirsk and Malton (Kevin Hollinrake) has said, health services do not always ask women about their mental health in the most sensitive way. That is sometimes because they are pushed for time and sometimes because they have not been trained to sensitively and gently probe behind the “I’m okay” response that people are primed to give.

As a result, the hidden half of new mums with mental health problems struggle on alone, often afraid to reach out for help. The overwhelming majority of women who experienced a mental health problem said that it had an impact on their ability to cope or look after their children, and also on their family relationships. The mother of a woman suffering from post-natal depression told me:

“As a parent, watching a child go through that and feeling unable to make it better is a horrible experience. Health professionals need to make sure that husbands, partners and the family know about the likelihood of such depression…and know where to get support and help.”

Perinatal mental illness has an immediate effect not only on mothers; it can have lasting consequences for relationships in the wider family. With the added pressure to be a perfect mother, and the expectations from many that come along with that, it is no wonder that so many women feel unable to cope. One constituent described this to me:

“I remember comparing myself to the younger mums who would turn up to the mother and baby groups looking fresh and without a care in the world, making motherhood look like a walk in the park. Although my son was thriving, I felt like I was failing, because I wasn’t like the young mums or the ones in those perfect baby ads. I didn’t want to share my feelings because I felt I’d been a failure in comparison to them. I believe the pressures of our professions and the guilt of parenthood traps us into a dark place.”

It is often the most vulnerable who receive the least support, with evidence suggesting that those in areas of higher deprivation are less likely to be asked about their mental health. In dealing with this issue, the Minister has the chance to fulfil two parts of her ministerial brief, because investing in perinatal mental health will help to improve mental health and reduce health inequalities.

I have described the problem, but what are the solutions? Identification is key. Regardless of what services may or may not be out there—from specialist mother and baby units, to secondary care perinatal mental health teams, to cognitive behavioural therapy and the prescription of medication—half of women with the problem are not even identified. That is where I believe we need to start.

The disinvestment in health visiting is significant; there can be no solution to the problem while health visiting is not properly resourced. Will the Minister say what she intends to do within her Department to ensure that local authorities are adequately funded and supported so that there is investment in crucial services for children aged 0 to 19, rather than the cuts that we have seen in the past three years?

However, there is another, relatively low-cost opportunity to identify the hidden half. About six weeks after giving birth, new mothers see their GP for a six-week baby check, with many practices also offering a maternal health check. Official National Institute for Health and Care Excellence guidance encourages doctors to do that and inquire about a mother’s emotional wellbeing, providing an opportunity for them to spot the development of any mental health problems. That check could be the last time a mother sees a health professional for a routine appointment in which there is the opportunity to focus on the mother, rather than her baby.

While some women get an excellent six-week check, showing its potential, other women miss out. A fifth of women questioned in a recent NCT survey said that they were not asked about their emotional or mental wellbeing at that appointment. Some women’s checks are all about their baby. Why do all women not get the check that they need? Despite the six-week baby check being part of the GP contract, for which they receive funding, doctors do not receive any funding for the check on the mum. It is a credit to many practices that they offer the checks without funding, but making the time for a full appointment can be challenging, meaning that there is little opportunity to encourage a mother to talk about how she feels, which takes time. A rushed appointment can make many, like the constituent of the hon. Member for Thirsk and Malton, feeling dismissed, or like it was a tick-box exercise.

One woman I heard from recently said her appointment made her

“feel like she was a burden”.

Another of my constituents spoke movingly of her experience:

“I knew there was something very wrong almost as soon as my son was born. Nothing I was ‘supposed’ to be feeling was happening. All I wanted to do was cry. I was feeding him and taking good care of him, but I felt empty inside, and so sad. I can’t remember anyone asking me how I was. I only saw my health visitor once, and that wasn’t in private so there was no opportunity to confide in her.

I told my GP I had postnatal depression and that I needed some help. He told me ‘you have a good family, you should be grateful—you need to pull yourself together.’ I don’t think I have the words to explain how damaging that was. I felt too ashamed to see him again so I changed to another medical centre. My first appointment was with a GP who listened to me. I found the courage to confide in her and she offered me support straight away. I remember very little of my child’s first year of life and I’m sure that is because of the trauma and deep depression I experienced.”

That could have been prevented if my constituent had been seen early on in the post-natal period, and if that first GP had delivered open, supportive questioning that reassured her, rather than made her feel ashamed.

Another constituent told me:

“I sat down with my GP, who had a check-list printed out and placed on his desk. He ran through the questions at a rapid rate, didn’t listen to my answers at all and placed ticks in the boxes after he asked the questions—not based on my reply. Hopefully a separate check for mothers can be achieved, as mothers just want someone to talk to who will not judge them for their feelings.”

About 30% of women diagnosed with post-natal depression still have depression beyond the first year of childbirth. If problems are not identified and treated early, they can worsen and develop into a much more severe mental illness. That underlines the need for an early check. If depression was recognised and treated appropriately within the perinatal period, it could prevent some effects that are much harder to treat in the long run.

[Lyn Brown]

I am sorry to intervene again. I intended to make a speech, but I am needed elsewhere, so I will ask a question. I have a lot of time for the Minister and I am wondering how we can help her to make the necessary case to the Treasury. Is it not true that if we look after the parent and the child as early and as well as possible, that will save massive amounts of money in the long term? This is an invest-to-save opportunity, and it would be welcome if the Government took it.

[Dr Williams]

I thank my hon. Friend for her intervention. I have avoided, as much as I can, talking about money in the debate—not all of this is about money, but there are many opportunities to make a massive difference. If we can draw a direct link between a mum’s experiencing mental health problems and the damage that that may do to her child—it increases the child’s chance of developing health problems and even of being involved in crime later in life—there are certainly opportunities to invest to save.

We must not forget, either, that perinatal mental illness has serious consequences for the mother. Suicide is the leading cause of direct maternal deaths occurring within a year after the end of pregnancy in the UK. It is at least possible that if an effective six-week check were in place, some of those deaths would be prevented. Of course, this is, as many hon. Members have said, a complex issue. Diagnosis and treatment are complex, but in addition some health services undoubtedly do not give women the care that they need. Women feel that they are still being dismissed, stigmatised and ignored. However, we should not blame the individual GPs and health professionals who carry out the checks; we should look to change the guidance, the system and the structure in place.

From its research, the NCT has made three recommendations. The first is to fund the six-week maternal post-natal check so that GP surgeries have the time and resources to give every new mother a full appointment for the maternal check. At the moment, although the check focusing on the baby is contracted for and there is funding available for it, there is no requirement for a six-week check on mothers. Checks on mothers, if they are done, are often compressed into the baby’s check, so conversations about mental health may be rushed or sidelined completely.

A constituent got in touch after I said that I was going to speak in this debate. Her response was surprising. She said:

“After the birth of my first child, I suffered terribly with post-natal anxiety—something I didn’t even know was a thing. I don’t remember anyone ever picking up on how I was feeling and no one ever really asked.

Then after the birth of my second child I believe I was depressed. When he was born I didn’t feel anything which then made me feel guilty”—

a common theme—

“and I struggled to bond with him over the first year.”

She then said:

“I believe I met you”—

meaning me, because I was working as a GP in the constituency at the time—

“at my six-week check with him and I remember you asking how I was feeling. After telling you I think I may have needed to”

get some extra help

“for more therapy, you agreed it was a good idea and told me to come back”

for follow-up. She continued:

“I think women need to know where they can go for help and what signs to look out for. I was too scared to tell anyone that I didn’t feel any bond with my son because I think there’s still such a stigma around mental ill health.

I do think the idea of a separate appointment for the mother would be a good idea and more signposting to support groups, how to self-refer, confidential information and advice.”

That experience with my patient, who is now my constituent, demonstrates the value of making time to identify and explore perinatal mental health issues. It might be argued that GPs should be doing that anyway, even if it is not contracted for. I would respond by saying that some are and some are not. GPs do many things that are not in their contract. But the only way of getting true national coverage and the time needed to do a proper job is to resource it.

[Kevin Hollinrake]

The hon. Gentleman will be aware that £365 million has been set aside for perinatal mental health services. He is not too far away from North Yorkshire himself, and North Yorkshire has just secured £23 million of that to help with perinatal mental health services for new and expectant mothers.

[Dr Williams]

I do give credit to the Government for making investments in this area of provision. We started from quite a low baseline. There has been significant investment. Too many women are still missing out on these specialist services; the coverage throughout the country is patchy, but I acknowledge that things are improving. However, if we are not identifying half the women with perinatal mental health problems, that is a significant problem in itself.

The investment required to identify problems through the six-week check is estimated by the NCT to be about £20 million a year. That is a very small amount in the grand scheme of the NHS’s budget, but it could make a huge difference to many new mothers. Secondly, in addition to the funding for the six-week check, the NCT recommends improved guidance for GPs on best practice on mental health, specifying a separate appointment for the maternal six-week check and the best methods of encouraging disclosure of maternal mental health problems.

A separate check involving supportive, open and encouraging questioning would provide an opportunity for women to come forward with any problem that they may be having. It might also help to eliminate some of the feelings of stigma or shame; 60% of women said that they felt embarrassed, ashamed or worried about being judged. Just because it is in a GP’s contract does not mean that a doctor has to do the work; with the right training in place, it can just as effectively be undertaken by a practice nurse or other suitably qualified healthcare professional. What is important is that it forms part of the ongoing relationship that a new mother has with her GP practice.

The third NCT recommendation covers NHS investment in and facilitation of GP education. It is important that GPs are trained to recognise the symptoms of post-natal depression and differentiate them from “the baby blues”, which resolve on their own; and it is crucial that mothers are reassured and valued, not dismissed.

These three relatively straightforward measures—a contractual obligation, guidance, and training—could make a huge difference to many women’s and children’s lives. They could eliminate some of the preventable problems encountered by women suffering from perinatal mental illness. The average cost to society of one case of perinatal depression is estimated at £74,000. With an already overstretched NHS under immense pressure, these measures could alleviate some of the stresses placed, later, on mental health services; they will inevitably have to deal with the consequences of undiagnosed and untreated perinatal mental health problems.

With this debate, we are already raising awareness and challenging some of the stigma surrounding perinatal mental health, but we also have a unique opportunity to do something practical to address the problem. Negotiations for the new GP contract begin in September, and by holding this debate today, we want to gain wider support for these important recommendations to be included in the new contract.

There are many other areas of perinatal mental health that I hope we get the chance to explore in this debate. We have already discussed the availability of specialist perinatal mental health services. I hope that we also talk about the variable access to psychological therapies, which are excellent in some parts of the country; in other parts of the country, women struggle to access those services, too. I am very grateful to the other hon. Members who have come today to speak and contribute.

I consider myself to be a fortunate father, one whose experience of parenting has so far been very positive. Many parents are not so lucky. When I hear the heartbreaking stories of women whose post-natal depression has blighted their and their family’s experience of parenthood, I am reminded of just how fortunate I have been. I am also acutely aware of how damaging it will be to wider society over the longer term if we do not improve the way in which we handle this issue. We need to bring the hidden half of these women out of hiding. Post-natal mental illness is not just a problem for new mums. If we fail to tackle it, we risk failing the next generation of children, too.

--- Later in debate ---

[Jackie Doyle-Price]

As I have often said, the real focus of the Green Paper is on schools and measures that we are taking with the Department for Education. However, the hon. Lady and others will be aware that we have committed to extra funding for the NHS and we are working with NHS England on what we can all expect with that extra funding. I am open to representations as we develop that 10-year plan as to what else we can do in this space. As we are in discussions with NHS England, I cannot make any commitments but this is exactly the time when we should rigorously be testing policy suggestions and interventions that we might be able to deliver.

[Dr Paul Williams]

It was reported in the Health Service Journal two days ago that the chief executive of the NHS, Simon Stevens, has outlined five priorities for the 10-year plan and that one is reducing health inequalities. Does the Minister think that a serious focus on reducing health inequalities—particularly those that are embedded from the beginning of life—should be a focus for the 10-year plan?

[Jackie Doyle-Price]

The hon. Gentleman earlier used the phrase “spend to save”, so the answer is yes, because obviously if we make interventions earlier and they help people to help themselves, there is a long-term saving to the NHS. That is the exact spirit in which we are entering the 10-year plan for the NHS. I look forward to hearing suggestions from the APPG—get in touch with us soon.

I thank everyone who has contributed to the debate and hope that we can go forward with the shared objective of doing the best we can for new mothers. By that I mean not only improving services, but giving support in general to women who are going through the experience of motherhood. As many Members have said, we are offered a fairy tale fantasy about how everything is perfect and wonderful, when actually there is a lot of associated vomit, pain and misery—joyful as the experience is overall. We need to tackle the taboo, because the fact that we think that everything is a perfect fairy tale means that the pressure on those women who are struggling makes them feel like failures. They are not: it is all entirely normal.

I am always struck by the fact that one in three women suffers from incontinence. People do not know about it, because everyone suffers in silence and just gets on with it. I often ask, “How would it be if one in three men suffered from incontinence?” We would hear about that a lot more. We need to be generally more open and give women the message: “Do you know what? It is normal to feel you are struggling, and feel miserable, because you have gone through a life-changing experience and a physical trauma. It is inevitable that it will affect your mental health.” Giving them the message that it is normal is half the battle, because they will realise that they are not a failure but just need to manage and work through the situation. We need the right services in place to help them.

--- Later in debate ---

[Jackie Doyle-Price]

I will write to the hon. Lady with some detail on the figures, but the point is that the access is there. Obviously, it will take time to become embedded. We have a good direction of travel to deliver against that commitment and we will continue with that. Community-based provision is key, but we also need to ensure that there are sufficient specialist perinatal mental health beds in mother and baby units for particularly severe cases. NHS England has taken a more strategic approach to commissioning, so that there is a level of access that does not involve wide-scale moving out of area.

As ever with transformation programmes, change takes time, but we are on track to meet our commitments. We are investing £63.5 million this financial year to support the development of those specialist perinatal mental health community services across England. Our pace of change is to enable 2,000 more women to access specialist care. Last year that was exceeded, so we should maintain the pace that we planned in the five-year forward view.

I have visited one of the new in-patient mother and baby units in Chelmsford, where there are four new beds. That centre is expanding its capacity. As well as opening new centres, we are expanding the capacity of existing ones to give more support. In Devon, the trust opened a four-bed mother and baby unit in a reused space in April this year while the new unit is being built, so we still have that provision even though there is not the physical space. By the end of this financial year, we will have expanded the capacity of those beds by 49% since 2015 and there should be more than 150 beds available for mothers and babies in those units.

We are also expanding psychological therapy services, which successfully treat many women who experience common mental health conditions such as depression and anxiety disorders during the perinatal period. We have set an ambition for at least 25% of people with common mental health conditions to access services each year by 2020-21, including extending provision to ensure swifter access for new and expectant mothers. However, as we have heard today, getting perinatal mental healthcare right is not just about expanding specialist services in isolation. Many professionals in different parts of the health and care system are well placed to support women in the perinatal period. NHS England is working with partners to ensure that care for women is integrated and joined up effectively. More than £1 million was provided in 2017 to enable the training of primary care, maternity and mental health staff, to increase perinatal mental health awareness and skills.

NHS England has also invested in multidisciplinary perinatal mental health clinical networks, which will include GPs across the country to support that strategic planning, working across services to ensure that those wider services are in place. The role of GPs is central in identifying when someone is suffering from perinatal mental illness, and to ensure that those women are directed towards treatment. The role includes monitoring early-onset conditions, including pre-conception counselling, referring women to specialist mental health services, including access to psychological therapies, and specialist perinatal community teams where necessary.

I am aware of the NCT’s #HiddenHalf campaign; I am grateful for its campaigning on this important issue. The National Institute for Health and Care Excellence recommends post-natal checks for mothers and new-born babies. NHS England expects commissioners and providers of maternity care to pay due regard to the NICE guidelines. My hon. Friend the Member for South West Bedfordshire raised this issue and said that, since this was part of what we should expect from GPs, it seemed anomalous that so many mothers and babies were not getting such checks. We make clear to GPs what we expect of them, as part of their contract, but ultimately we rely on clinical commissioning groups to ensure that GPs deliver against the obligations that we expect of them. This is not the only case where this happens—many GPs are not delivering learning disability health checks either. We need to be clear with NHS England that we expect that obligation to be delivered.

[Dr Paul Williams]

The hon. Member for South West Bedfordshire referred to a maternity additional service that only four general practices have opted out of. Is the Minister aware of what period of time that additional service covers?

[Jackie Doyle-Price]

I will come back to the hon. Gentleman, but this area requires further exploration because we need to be clear about how we deliver on those things.

[Dr Williams]

I will gladly tell the Minister: the period of time covers pregnancy but ends 14 days after birth. Whereas it may be very appropriate for a GP to provide care during that time, the additional service that the hon. Member for South West Bedfordshire referred to ends 14 days after birth. We are talking about a different issue: the opportunity to do a check six weeks after birth. There is no commissioning of that check at the moment. It is helpful that the Minister says that she expects commissioners to commission that check, but is that a commitment from the Government to ensure that commissioners are funded to be able to commission that six-week check?

[Jackie Doyle-Price]

I was coming to that—I was just dealing with the point made by my hon. Friend the Member for South West Bedfordshire.

Moving on from the NICE guidelines, we clearly expect GPs to do their part in identifying and supporting women. We are aware of the campaign, but any changes to GP contracting arrangements to specifically include the six-week check-up would need to be negotiated with the GP committee of the British Medical Association. Those negotiations are taking place and will be completed by September. I cannot give any firmer commitment than that, other than to say that we obviously want to see GPs make their contribution.

--- Later in debate ---

[Dr Paul Williams]

I thank all the Members who stayed here to contribute to the debate. I also thank the organisations—particularly the National Childbirth Trust—that contributed to filling our minds with useful information. I am proud to have brought this issue to Parliament as a man. As many Members said, this is not a women’s issue—it affects us all, and it needs to be taken really seriously. As the hon. Member for South West Bedfordshire (Andrew Selous) said, it is everyone’s business.

We have discussed a very vulnerable time in a woman’s life—the time when she is most likely to develop a mental health problem. We heard about the impact of such problems on a woman, her family and particularly her child. It is heartening to hear that the Government are listening, and I hope that that continues to manifest itself in action—particularly on the GP contract negotiations, but also on the many other things that could be done to improve the lives of these women, their families and their children.

Question put and agreed to.

Resolved,

That this House has considered perinatal mental illness.