After nearly 10 years of on/off mental health issues, I have just turned 40 and I finally feel well. My 30s saw me diagnosed with burnout and signed off sick for 6 months, 4 years of infertility treatment resulting in IVF when my twins were conceived and then pre and postnatal anxiety and later on postnatal depression. I'm quite thankful to see the back of my 30s which were blighted by mental health and the constant struggle of trying to get the support I needed to recover.
Today while listening to many esteemed colleagues and speakers from the world of Perinatal Mental Health, I have reflected on my own experiences of care and think about my hopes for the next few years. I feel the time is now and that perinatal mental health is higher up on the agendas of maternity services, primary care and commissioners than ever before. I hope that the experiences I went through with struggling to access support will improve over the coming years as more money starts to come in to the systems.
Having gone through the pain of infertility and the emotional and physical pain of multiple operations and IVF, I finally conceived my twins. Whilst I was overjoyed at my pregnancy, I was given some scary statistics about the likelihood of my twins making it into the world. I went on to develop pre-natal anxiety and suffered many panic attacks from 28 weeks up until the night before my induction. I was to undergo a birth that was entirely out of my control. Twin pregnancy = consultant-led = no choices. I therefore didn't prepare a birth plan as I really didn't feel that my wishes would have been honoured. Other people were now in charge of my body and babies.
I don't recall ever been asked about my emotional/mental health during pregnancy, birth or afterwards. The first time I was asked how I was feeling was 9 months after the twins were born by a HV. I filled in the required Edinburgh Postnatal Depression questionnaire and scored high for anxiety and moderate for depression. By this point, I knew I had it before the questionnaire confirmed it but was hopeful I could fight the demons myself. But I couldn't. .... No questions or support we're offered until I went to the GP when the twins were nearly one. By this point I had lost my job due to PND and was really struggling with anxiety and depression. My illness was now having an impact at home and my husband was struggling to hold down a very demanding full time job and look after the 3 of us. We were lost and scared and had no idea what to do. I was on medication now and was hoping that would be the answer but with very little sleep and no support, our lives were starting to fall apart. I knew nobody with this illness. I was socially isolated and alone.
It was shortly before the twins turned one when I opened an email from the local children's centre. They are asking for parent volunteers to come forward to begin a peer support group for parents with low mood and depression. GPs in the area were seeing an increase in diagnoses and felt more support was needed. I went for it and started up a peer support group called Parents Supporting Parents over 4 years ago. This was the beginning of my recovery. It gave me a purpose outside of being a mum and I began to meet like-minded people who were going through similar things.
4.5 years on, the mothers we see are still struggling with the same things and with a healthcare system which doesn't see the importance of a mother's mental and physical health. Today we heard from Dr Alain Gregoire and many others who painted a grimm picture of the importance maternity services place on mental health. Midwives are focused mainly on the physical health of mums and babies. Continuity of care is still not in place for many mums and this was my experience. I saw multiple midwives and consultants and didn't form a relationship with any of them. I was never asked how I was feeling. I would have readily opened up had that question been asked. We have mums that come to our support group (now Poynton PANDAS) who struggle to get a booking in appointment with their midwife and don't have a Health Visitor.
My hopes for #HopeDec09 are to put the basics in place.
#1 During booking in appointments ask questions to establish if baby was conceived through fertility treatment. IVF and infertility treatment should be a warning sign that parents have been through the mill and will need extra emotional support
#2 Ask about history of mental health of both partners at the booking in appointment
#3 Find out if the parent/s have social support networks. Social isolation is a major contributor to perinatal mental health
#4 Ask how the parents are feeling at EVERY pre and postnatal appointment
#5 Allow a woman to be in control of her body and her birth. Give choice.
#6 Pathways need to be developed to incorporate the 3rd sector. The benefits of peer support are significant and should be offered as part of a recovery plan.
#7 Allow midwives and health visitors to build a relationship with their patients. Continuity of care is critical to parents opening up about their mental health
#8 Every parent to be able to access a GP, Health Visitor and the same Midwife.
Thank you Raja for organising such an interesting day and stimulating debate.
Rhiannon - Poynton PANDAS Support Group
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