Psychiatric disorder following childbirth is common, and much
of it is serious. Following childbirth, women are at increased risk
of suffering from an affective illness, and those with pre-existing
psychiatric disorders may face a relapse or recurrence of their
condition. Psychiatric illness occurring at this time may have an
adverse effect not only on the women herself but on her marriage,
family and in particular on the future development of her
infant.
Perinatal mental health problems should therefore be of
concern not only to those involved in maternal and infant care but
also to psychiatric services, as childbearing women will form a
significant minority of their patients.
This new Council Report updates and replaces CR28 published by
the College in 1992 and a report published in 1996 in conjunction
with the Department of Health. The revision takes into account
developments in national health policy - including new
commissioning arrangements, clinical governance, and the National
Service Framework for Mental Heath - as well as the findings of key
reports including the Confidential Enquiry into Maternal Deaths
(1998) ("Why mothers die"), and Fatal Child Abuse and
Parental Psychiatric Disorder (1996).
The report recommends that:
- Every Health Authority should have a Perinatal Mental Health
Strategy which aims to provide the knowledge, skills and resources
necessary for detection and prompt and effective treatment at all
levels of health care provision.
- Every Health Authority should identify a consultant with a
special interest in Perinatal Psychiatry. This consultant should
take a lead role in promoting these aims and in establishing a
specialist multi-disciplinary team.
- All women with perinatal psychiatric disorder who require
specialist psychiatric care should have access to a consultant and
other mental health professionals with a special interest in their
condition irrespective of their place of residence.
- Mother and Baby Units to serve the needs of a number of Health
Authorities should be established.