Maternal Mental Health

Rosena Allin-Khan Excerpts

Wednesday 10th March 2021 Westminster Hall

[Dr Rosena Allin-Khan (Tooting) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Edward, and it is an honour to respond on behalf of the Opposition in this vital and incredibly moving debate. I thank the hon. Member for Richmond Park (Sarah Olney) for securing the debate. All contributions have been incredibly valuable and have highlighted the urgency of focusing attention on maternal health. Debates such as these can go some way towards breaking down the stigma that still persists around mental health and the often harsh reality of pregnancy, birth and motherhood. It is simply heartbreaking that suicide is the leading cause of maternal death. More people are starting to speak up publicly about their experiences, but we need action from the Government.

The coronavirus crisis has had a disastrous impact on many women. I was honoured to listen to colleagues sharing their heartbreaking experiences of baby loss in a recent debate. My heart breaks for all the women who have had to go through that alone at any time, especially during the pandemic. It is simply inhumane. Will the Minister outline what mental health support will be offered to women who have experienced baby loss without their partner by their side? Such tragedies have a long-term impact on partners and families, too. Will any support be extended to families? We heard described today, very eloquently, the importance of also considering fathers and other partners in such circumstances.

Within maternity services, there are huge inequalities. Black women are four times more likely than white women to die in pregnancy or childbirth. Pakistani women are more likely to have a premature baby or a neonatal death in the UK compared with their country of origin. Women from all ethnic minority groups in the UK receive fewer home visits from midwives and are more likely to give birth by emergency caesarean sections. What are the Government doing to address those discrepancies and to ensure that culturally appropriate mental health support is provided? Such racial inequalities are deep rooted and are further entrenched by covid-19. People from ethnic minority backgrounds are more likely to be adversely impacted financially by the pandemic, and the risk of death is much greater.

The Government’s only response so far to those shocking statistics has been to commission further research, but we need action now. The evidence is already clear that there are persistent inequalities in maternity outcomes and experiences, and that discrimination bias and a lack of cultural understanding are driving that. What action are the Government taking to eradicate these gross examples of health inequality? The five-year forward view for mental health made a recommendation that by 2020-21 in England 30,000 more women each year should be able to access evidence-based specialist mental health care during the perinatal period. During Monday’s statement on women’s health, I asked the Minister if she could tell us whether that target had been met. We did not get an answer, so will she provide one today?

Furthermore, the NHS long-term plan outlined that an additional 24,000 women per year with moderate to severe perinatal mental health difficulties and a personality disorder diagnosis would benefit from evidence-based care by 2023-24. Will the Minister please outline how many women are now benefiting from that? We also know that Health Education England was provided with £1.2 million of funding to increase skills and awareness around perinatal mental health. Will the Minister outline the progress on that and tell us where training initiatives might have been hampered by the pandemic?

The pandemic has had a profound effect on people’s mental health. We know how difficult and stressful pregnancy and birth can be at the best of times. Even outside of covid-19 it is vital that perinatal mental health services should promote prevention, early detection and diagnosis of mental health problems. Many women have been struggling to access the services they need during pregnancy, leaving them having to go through A&E. That is hugely distressing and can cause a great deal of anxiety for expectant mothers and their partners. It is therefore vital that those most at risk get the support they need now. Will the Minister outline what delays there have been during the pandemic in accessing perinatal services?

Working in a hospital, I have seen the fear that so many people present with: fear of contracting the virus, fear of taking the virus home and fear of wasting NHS time. Preventive measures around mental illness are crucial, especially now, for those most at risk. With more than half of new mothers having reported feeling down, lonely or irritable, and 71% reporting feeling worried since the beginning of the first lockdown, what steps is the Minister taking to ensure that new mothers know where to go to seek help?

A University College London report found that, during the pandemic, there was a redeployment of up to 80% of health visitors in some areas. That prevents the much-needed visits that we heard about earlier. Face-to-face visits are crucial in recognising issues early and in providing assistance. Will the Minister tell me what delays families have faced at this time and whether any additional resources will be offered to those who missed out on face-to-face visits?

As a mother of two under two at one point, I know how desperately stressful it can feel to have one baby already and have a new one arrive. I know what it is like to feel as though you are failing at motherhood and at being a working mother. I know just how challenging it can be, but I cannot imagine for a moment what it would have felt like to do that through the pandemic. We rely so much on being in playgroups, having other mothers and fathers telling us we are doing okay, and phoning the breastfeeding helpline at 2 am worried that you cannot make enough milk for your baby and having someone say, “Don’t worry. We can get a health visitor to come and see you tomorrow.” These are normal things, but for so many mothers they have been lacking throughout the pandemic. I fear for the effect that that will have on them, their families and their children in the long term.

My hon. Friend the Member for Sheffield, Hallam (Olivia Blake) asked last year about the additional counselling and support being provided for those who gave birth during lockdown. I noted that there was no clear answer on the proactive work that the Government have done to provide support to new parents. I ask the Minister whether that was because no additional resources have been provided. Does she recognise that maternal mental health has been overlooked in this crisis?

Pregnancy and childbirth can be such a beautiful time in people’s lives, but I know what it can feel like when it goes wrong. I know the fear of stepping into a hospital afterwards—the memories come flooding back. Your heart rate goes up, and you cannot even imagine what it would be like to be pregnant and to go through childbirth again. These things can be overcome, but not without the specialist help that people really rely on. I cannot imagine what it must be like for women going through this during covid, and yet it is another barrier in the way of getting the help that they and their families desperately need.