Vulnerable migrant women and postnatal depression: A case of invisibility in maternity services?
Vulnerable migrant women are at an increased risk of developing postnatal depression, compared with the general population. Although some symptoms are the same as in other pregnant women, there are specific reasons why vulnerable migrant women may present differently, or may not recognise symptoms themselves. Factors associated with migration may affect a woman's mental health, particularly considering forced migration, where a woman may have faced violence or trauma, both in her home country and on the journey to the UK. Vulnerable migrant women engage less with maternity care than the average woman for reasons including a lack of knowledge of the UK healthcare system, fear of being charged for care, or fear that contact with clinicians will negatively affect their immigration status. This article explores the issues surrounding vulnerable migrant women that increase their risk of developing postnatal depression and presents reasons why this may go unrecognised by health professionals such as midwives.
Between 12–20% of women will experience a mental health issue during pregnancy or in the first year following birth. The most common diagnoses are depression and/or anxiety, first diagnosed in the postnatal period (National Institute for Health and Care Excellence (NICE), 2014). A recent report (Knight et al, 2016) demonstrated that maternal suicide accounted for 9% of maternal deaths in the UK; the leading direct cause of deaths in the post-birth to 1 year period. The report shows that, generally, women born outside of the UK are at an increased risk of death in the postnatal period and although not attributed to suicide, women born outside of the UK represented 25% of the total deaths within the report, with 12% being refugee women. These statistics demonstrate that there are stark health inequalities for migrant women, both in physical and mental health.
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