BabyCentre. Mental health stigma masking prevalence of antenatal depression. 2015. (accessed 26 October 2015)

Brown A, Rance J, Bennett P Understanding the relationship between breastfeeding and postnatal depression: the role of pain and physical difficulties. J Adv Nurs. 2015;

Royal College of Midwives. Maternal mental health: Improving emotional wellbeing in postnatal care. 2014. (accessed 26 October 2015)

Supporting mental health and wellbeing

02 November 2015
Volume 23 · Issue 11

Perinatal mental health is a priority issue for health professionals involved in the care of women during pregnancy and the postnatal period. Two recent publications have highlighted areas where midwives and other professionals could be doing more to help tackle perinatal mental health issues. Firstly, a recent survey by website BabyCentre (2015) found that almost half of expectant mothers do not tell their midwife or another health professional that they have experienced symptoms of antenatal depression. Of the 1000 UK mothers surveyed, 44% said they did not seek help for their symptoms because they did not want to be labelled mentally ill. The survey also found that 30% of the women had frequently experienced five or more key indicators of antenatal depression—suggesting that the official figure of 10–15% of women who experience depression and/or anxiety in pregnancy may fall short of the actual number.

The fact that so many women do not feel comfortable enough to tell their midwife about symptoms of depression is a cause for concern. Building a trusting relationship with the women in one's care is a key element of midwifery practice, and is essential in order to foster an environment in which women feel able to talk openly about any problems they are experiencing. It is clear from the survey's findings that the stigma attached to mental illness affects many women's decision to disclose symptoms, so it is crucial that midwives can support women and reassure them that there is no shame in feeling depressed or anxious during pregnancy or in the postnatal period. The Royal College of Midwives (RCM) report on maternal mental health, published in 2014, offers recommendations for supporting women (RCM, 2014).

Meanwhile, a study published in the Journal of Advanced Nursing has found that women who stop breastfeeding earlier than they have planned because of pain or physical difficulties have an increased risk of postnatal depression (Brown et al, 2015). The authors conclude that it is crucial to understand a woman's specific reason for stopping breastfeeding, rather than simply looking at breastfeeding duration, in order to provide appropriate emotional support. The finding that pain and physical issues were predictive of postnatal depression emphasises the importance of supporting new mothers to breastfeed and maintaining that support in the early weeks and months after the birth. For consistent care to be provided, it is essential that midwives and maternity support workers collaborate with health visitors and peer supporters so that women have access to help when they need it.

Finally, on the subject of breastfeeding support, an award for Midwife or Peer Supporter in Improving Breastfeeding is one of four brand new categories in the BJM Awards 2016, along with Innovation in Practice, Promoting Neonatal Wellbeing and Midwifery Researcher. Other categories at the awards, which take place on 8 February 2016, are: Midwifery Leadership, Contribution to Midwifery Education, Contribution of a Non-midwife to Midwifery Practice, Contribution to Supporting Pregnant Women with FGM, Student Midwife of the Year, and Midwife of the Year. This month sees the closing date for entries, so if you would like to enter yourself or a colleague and share your achievements, now is the time! For more information or to enter, please visit