Maternal Mental Health

11:00:00

About 10 Members have indicated that they wish to speak or intervene, which is unusual in a 30-minute debate. To make a speech in this debate, a Back Bencher must have the leave of the Member in charge, Ms Kyrke-Smith, and of the Minister. Obviously, there also needs to be time enough. If you wish to make a speech as opposed to intervening and have secured the necessary permissions, please stand as usual when the Member in charge has finished moving the motion and remain on your feet while I assess demand and the need for a time limit. I am expecting that we will need a two-minute limit. I request that other Members seek to intervene very, very briefly and only during the speeches of the Member in charge and the Minister. I will call the Minister to reply at 11.20 am.

11:01:00

I beg to move, That this House has considered maternal mental health. It is a pleasure to serve under your chairship, Ms Furniss. I am so glad to have secured this debate on maternal mental health, which I know really matters to people in my constituency and across the country, yet it is still too easily overlooked. For me, it is also very personal. In 2021, I lost one of my best and most brilliant friends, Sophie, to suicide. She left behind her wonderful husband and three little girls, aged six, three and just 10 weeks at the time. Her death was an awful shock to us all, and I will never forget the moment I received the message from her husband, which said: “I do not know how to say this and I cannot believe I am writing this, but Sophie died this morning.” It was still the covid pandemic at the time. Sophie was very isolated, recovering from a C-section, staying at home, trying to protect herself and her baby from covid, and not wanting visitors, but we were in regular touch on WhatsApp, helping each other to navigate life with a little baby and two older siblings. Sophie was getting more and more concerned about her baby’s feeding, and it was causing her to suffer from increasingly bad insomnia. She took herself to A&E with concerns about the baby’s milk intake, which I suspect were more a reflection of her own anxiety than the baby’s feeding, and she spent a night there before being discharged. I do not know whether they asked her about her own mental health. What I do know is that the next day her messages were increasingly distressed, and two days later she took her own life. Unfortunately, what Sophie went through is not uncommon. At least one in five people who give birth experience a mental health problem during pregnancy or after birth. In fact, while we hear a fair amount about physical conditions such as gestational diabetes and pre-eclampsia, it is mental ill health that is the most common complication of pregnancy in the UK.

The fact that there are so many Members present is an indication of the importance of this subject. Does the hon. Lady agree that support is an essential component of maternal health and that, for those families who do not have extended support, charities such as Home-Start in my constituency, which have volunteers to go to help, are essential and should be more widely funded to help more young mothers who feel they are drowning to get a lifeline back to the surface?

I agree with the hon. Member; that support is needed, and I will come on to that. The causes of these mental health challenges are really varied. Some people will have past experiences of mental health problems or difficult childhood experiences. Some will struggle after a traumatic birth. Some will be experiencing stressful living conditions. Some evidence suggests there are biological or hormonal factors, and some people are at higher risk than others: young mums face particular risks, with post-natal depression up to twice as prevalent in teenage mothers compared with those aged 20 or over, and data suggests that post-natal depression and anxiety are 13% higher in black and other ethnic minority mothers than in white mothers. People’s experiences of mental health are also really varied, ranging from mild to moderate conditions such as low self-esteem, anxiety and depression to more serious conditions including post-traumatic stress disorder and post-partum psychosis. While most people find a way through, perinatal mental health can be incredibly serious, as it was for Sophie.

I thank the hon. Member for bringing this very important issue to the House. With regard to perinatal support, does she agree that it is very important we have those professional teams in place, and that we get the additional value that comes from a physical mother and baby unit, where specialist support can be given to not just the mother and child but the family as well?

I agree: mother and baby units are vital. For women in the period from six weeks after giving birth to one year after giving birth, the leading cause of death is suicide. While I want to speak more widely today, I want us to be very conscious of that extreme end of the risks that women face. Despite the potential seriousness, the stigma around these problems is huge. Some 70% of women will hide or underplay maternal mental health difficulties, and in turn, they will never get the support they need.

I thank my hon. Friend for bravely sharing the devastating story of her friend. I also have a wonderful friend, Sarah, whose daughter was a month old when the covid lockdown hit. She was so worried about breaking lockdown rules that she did not lean on friends and family and ended up having a mental breakdown. Does my hon. Friend agree that maternal mental health should be a high priority in any future emergency planning?

I absolutely do, and I am sorry to hear of the experience of my hon. Friend’s friend. What are the consequences of all this? The human suffering is immense, but maternal mental health has economic consequences and costs, too—an estimated £8.1 billion each year in the UK, according to research from the London School of Economics, and nearly three quarters of that cost relates to adverse impacts on the child rather than the mother. I want to suggest four ways in which maternal mental health support can be improved, and I will be as brief as I can. The first is improving specialist perinatal mental health services. The second is better embedding mental health support in routine maternity care. The third is improving community support, and the fourth is education and awareness raising.

I thank my hon. Friend for the powerful speech she is making, and I am so sorry to hear about her friend. Does she agree that we also need specialist support for those experiencing post-adoptive depression? Although they have not gone through the same physical process as birth parents, it can be equally devastating.

Absolutely—that is one way in which people can experience severe mental health challenges and consequences, and it needs to be considered. I also want to acknowledge that new dads and partners experience mental health challenges too, but given our limited time, I am focusing today on maternal mental health.

Does my hon. Friend agree that stigma around mental health, particularly maternal mental health, can be used by abusers as a barrier to women getting help? Domestic violence during the perinatal period and the effects on mental health require widespread attention, so that survivors can feel comfortable and safe when asking for support.

I agree; we need to shed more light on this, precisely for that and other reasons. I will touch briefly on my first recommendation, which is to ensure that specialist perinatal mental health services are protected. In the last 10 years, there have been significant steps forward. Mother and baby units in particular can be an important part of someone’s treatment and recovery, as well as having significant benefits for the parent-infant relationship. Tragically, there are still too many stories of women not being able to access those units. They are perhaps too far away from where a woman lives, or there is not a bed available, or the need for a mother to get that care has not been identified properly. We are still seeing mothers with newborns being put into adult psychiatric units and separated from their babies, despite the national guidance saying that mother and baby units are best practice. Continued support for these services is crucial, both in mother and baby units and in the community, and that must include research to develop the best interventions and robust evaluations of the care provided. The Mental Health Bill is a sorely needed piece of legislation, and I really welcome it, but I wonder whether it might include a provision to ensure that all women who have given birth within the 12 months prior to admission to a psychiatric unit are given the option of being admitted to a ward where they can remain with their baby. That could help to prevent women from falling through the cracks in the system, as they do currently. Secondly, I turn to routine maternity care, which is where the mental health support for the vast majority of women can and should sit. Again, we have seen progress, with some vital new services in place, including care for women experiencing baby loss, severe fear of childbirth, birth trauma and loss of custody at birth.

I thank the hon. Member for calling this debate, which is clearly so important to her. In my constituency there is an excellent charity called HeartTalks that works with mothers who have experienced baby loss. Would she agree that post-partum check-ups are really important for all women, but particularly those who have suffered baby loss, regardless of the trimester it occurred in?

I absolutely agree. A recent report from the Maternal Mental Health Alliance highlighted huge variation in the support services available locally, with confusing referral pathways, inequitable referral criteria and long waiting lists—some women have to wait six months for an assessment and up to a year for treatment. Too often, as I have noted, women are cared for unequally. Those who have existing disadvantages experience stubbornly poorer outcomes. We need better integration of mental health into all routine contacts during pregnancy and after birth for all women who need it. During that period, women have an average of at least 16 routine contacts with health professionals, including GPs, midwives and others, and they are an ideal opportunity to ensure that women are routinely and compassionately asked about their mental health. I wonder if any healthcare professionals asked Sophie not just how the baby was but how she was. I wonder if the discussions about her baby’s feeding were had in a way that sought to reduce her anxiety. I wonder if she was given less attention because this was her third child, and her earlier experiences had been smoother—but I will never know. In the same way that many physical health complications are dealt with by multidisciplinary maternity services, the same should be true for mental health care. That means midwives, health visitors and others being trained to ask the right questions and assess the risks, and then psychological therapists, equivalent to those employed in talking therapies, integrated into maternity teams to support women’s care where necessary. They would understand the specific needs and risks of the perinatal period, and be able to intervene quickly where that is needed. Thirdly, I want to acknowledge the importance of community support for pregnant and new mums, as we have heard from other Members, and I recommend its expansion. There are fantastic voluntary groups providing some support, and in some places family support hubs are up and running, but often the postcode lottery kicks in again. We are a long way from the broader and more reliable provision that was established under the last Labour Government—notably the Sure Start model, which all the long-term evidence shows was so effective. As part of our national health mission to shift care from hospital to the community, we need to rebuild those community services, including for pregnant and new mums. We need them to be across the country and widely accessible, with clear maternal mental health guidance embedded in them. Finally, it is incumbent on all of us to keep building a society where everyone understands the mental health challenges in the perinatal period, including the suicide risk in the most serious cases. Crucially, we all need to learn to be good allies to people who are struggling. I think about that a lot in relation to Sophie. When Sophie sent me messages saying, “Feeling desperate today”, and, “I’m just not sure I have it in me to keep going”, did I do enough? Did I worry about her anxiety? Yes. Did I worry about her being depressed? Yes. Did I worry about suicidal thoughts? Honestly, yes. But did I think she might take her own life? No. I have struggled with the guilt that I did not somehow do something to stop it, but I also recognise how ignorant I was and how hard this is. I have had good conversations with Sophie’s dad about what needs to change. He is part of a group called Facing the Future—a support group for people who have lost family to suicide. One of his group members said: “I think what I’d like to see is a more proactive and visible campaign to target those who are at risk. Not just for those at risk, but for their families/friends/carers/loved-ones. Let people know that it’s okay not to be okay...Give people the knowledge and confidence to ask someone they are concerned about how they are feeling, to know what to look for and ask, and to know where to go for help.” That is absolutely right. There are some fantastic charities and campaigns out there. I know the Government are listening; I am particularly pleased that not just mental health, but suicide prevention are woven into our health mission, where moving from treatment to prevention is such an important focus more broadly. But there is more to do. I conclude by saying that I do not want Sophie’s life to be defined by her death. I want it to be defined by her first-class Cambridge degree, her talents as a writer and actress, her Foreign Office career, her friendships, her playful sense of humour, and the beautiful family that she began to raise. I talk about her death because I hope her experience can be a catalyst for change. While her story—every story like hers—and the wider statistics can seem bleak, the real story here is one of hope and potential. With the right support in place at this crucial and pressured time in women’s lives, they do surmount great mental health challenges and recover, often quickly and well—and their babies get off to a good start in life. The Government have embarked on transformative work to improve the country’s health, and better maternal mental health outcomes must be one test of our success.

Members should stand if they wish to speak. You have a very short amount of time.

11:15:00

It is a pleasure to serve under your chairmanship, Ms Furniss. I commend the hon. Member for Aylesbury (Laura Kyrke-Smith) for securing this hugely important debate and speaking so eloquently about her friend. As someone who has lost a close friend to suicide, I completely agree that they are not defined by their death, but by the impact they had during their life and the impact they had on other people. Suicide is the leading cause of death among women in the six weeks to 12 months after giving birth, and maternal mental health in Winchester and across the UK is in crisis. As the Lib Dem spokesperson for mental health, I am hearing more and more stories about this from individual women. Every year, 600,000 women give birth, and one in five of those women will experience a perinatal mental health condition. This is a completely neglected mental health crisis, on an extremely large scale. Polling from as recently as December 2024, commissioned by the campaign Delivering Better, representatives of which I am pleased are in the Public Gallery today, found that seven out of 10 women who have a negative birthing experience say that it has had a long-term impact on their mental health. A recurring theme is that women are not being listened to—that has been a theme in essentially every major maternity inquiry. Women are not listened to when they raise concerns pre, during and post labour, not listened to when they raise complaints with trusts about their care, and not listened to by successive Governments who have failed to treat this issue with the seriousness it demands. If this crisis is to be meaningfully addressed, far greater emphasis needs to be placed on the voices and experience of women and birthing people.

I thank the hon. Member for giving way and thank my hon. Friend the Member for Aylesbury (Laura Kyrke-Smith) for securing the debate. Does the hon. Member agree that, given the scale of the problem and the barriers to new parents and new mothers asking for help, it is important that this Government focus on pre-emptive support, in case people are struggling with their mental health? We should assume that having a child will affect women’s mental health, and that assumption would force the Government to take a proactive approach to supporting women in that time.

I completely agree with the hon. Member and thank her for her important intervention. For years, we have been calling for better community healthcare. We know the demographics who are at high risk of mental health issues: not only women who are within a year of giving birth, but a whole load of other people, such as military veterans and farmers. Those groups of people need proactive help before they reach crisis point. It is more cost-effective to treat them earlier, rather than to pick up the pieces once they are in a crisis. The Government recently announced that they will drop women’s health targets to avoid overspending, but it is clear that women’s health, including maternity care, has been deprioritised for too long. I urge them to reconsider.

11:18:00

I thank my hon. Friend the Member for Aylesbury (Laura Kyrke-Smith) for securing the debate—I am so sorry about her friend Sophie. Maternity services in this country are in a dire state. In Nottinghamshire, this has been exacerbated by the fact that we have had the largest maternity scandal in NHS history. We have seen at first hand how women have suffered from some of the worst care and treatment imaginable; in many, if not most, cases they were left with little or no support and support was lacking or sparse. I had a traumatic pregnancy and a traumatic birth. My son was born in the first week of the first lockdown. Despite having an emergency C-section due to not having been listened to, I was sent home in less than 24 hours. I was left alone and abandoned by the health services. The mental health situation that I faced does not go away—it never leaves you—but I am one of the lucky ones. I do not wish to say much more, other than that maternal mental health provision will be fixed only when we fix our maternity services, and our maternity services start by supporting women before they are even pregnant. To get to the point where women do not go home feeling that they have done something wrong, that their situation is all their fault, and that they are useless and not capable of being a mother, we have to fix our system for how we care for women and babies.

11:20:00

It is a pleasure to serve under your chairship, Ms Furniss. I thank my hon. Friend the Member for Aylesbury (Laura Kyrke-Smith) for securing this crucial debate, and I am truly sorry to hear of her loss. For too long, mothers’ mental health has been dismissed. Women raising concerns are belittled and told they have “baby blues” when they are battling post-natal depression or even PTSD. This is personal for me. After my son’s birth I requested a debrief—a simple conversation to process my own experience. My son turns three this year and I am still waiting. For doctors and midwives, it might be their thousandth birth, but for the mother it can be traumatic, particularly if it is her first. Reports by the Care Quality Commission show that one in three mothers are denied pain relief, with some told to “suck it up” when they ask for help. That is misogyny, not medicine. As a member of the Women and Equalities Committee I am proud to have played a part in highlighting some of the medical misogyny that women experience with the publication of our most recent report. I thank my hon. Friend the Member for Aylesbury for referring to post-partum psychosis, a severe but treatable illness that affects over 1,200 mothers a year. I am also proud that Amy Rothwell of Bolton Maternity Voices Partnership is working with Royal Bolton hospital to ensure that patient feedback drives real improvements. I urge the Minister to make maternal mental health in Bolton and around the country a priority. No mother should feel ignored or alone, and we really need urgent change.

11:22:00

It is a pleasure to serve under your chairship, Ms Furniss. I am so grateful to my hon. Friend the Member for Aylesbury (Laura Kyrke-Smith) for securing this debate, for raising a number of important issues and for making such a powerful and moving contribution. I was very saddened to hear of the utterly heartbreaking circumstances of her friend’s passing. I offer my sincere condolences to her and to Sophie’s family and loved ones. I am also thankful to all Members for their contributions, the sheer number of which, in such a short Westminster Hall debate, illustrates the importance of this issue. The Government take this matter extremely seriously, which is why are placing a renewed focus on mental health and suicide prevention, including for women during the perinatal period. The figures show that the challenges are sobering, and many of the issues raised today are symptomatic of an NHS that is simply not addressing needs. Perinatal mental illness affects over a quarter of new and expectant mothers and covers a wide range of conditions. Research shows that in the UK around one in three women experience traumatic births, and one in 20 women every year develop post-traumatic stress disorder after giving birth. Between 2021 and 2023, 26 women died from mental health-related causes within the six weeks following pregnancy. Over a third of maternal deaths occurring between six weeks and one year after the end of pregnancy are from suicide, drugs, alcohol or other mental health-related causes. It is unacceptable that so many women are not receiving the maternal mental health care they need, and we are determined to change that. That is why NHS England’s three-year delivery plan for maternity and neonatal services commits to offering all women a personalised care and support plan, considering physical health, mental health and social complexities, with an updated risk assessment at every contact. Ten years ago, fewer than 15% of localities provided specialist perinatal mental health services for women with complex or severe conditions at the full level recommended in National Institute for Health and Care Excellence guidance, and more than 40% provided no service at all. Today, specialist perinatal mental health services are available in all 42 integrated care systems across England. Those services are available for women with or at risk of mental health conditions who are planning a pregnancy, are pregnant or have a baby up to two years old. That care includes increased access to evidence-based psychological therapies. A record 62,723 women were reported to have accessed community perinatal mental health services and maternal mental health services in the 12 months to the end of November 2024. Women can be referred to services by any healthcare professional, including midwives, health visitors, GPs, hospital-based teams, mental health services and social workers. Self-referrals are accepted by some services. GPs also now deliver six to eight-week post-natal consultations that include a focus on perinatal mental health. The services are provided by multidisciplinary teams to cover every aspect of women’s health, often including a psychiatrist, nurses, mental health social workers, occupational health workers, health visitors, peer support workers and nursery nurses. The specialist perinatal mental health community workforce has almost doubled in the last five years. Furthermore, 165 mother and baby unit beds have been commissioned, 153 of which are currently operational. Mother and baby units provide in-patient care to women who experience severe mental health difficulties during and after pregnancy. When a mother goes through the heartbreak of losing her baby, we must do everything we can to support her through bereavement. Many trusts have specialist bereavement midwives who are trained to care for and support parents and families who have suffered the loss of their baby. All trusts in England are signed up to the national bereavement care pathway, which covers a range of circumstances of baby loss, with the aim of offering every bereaved parent the high-quality, safe and sensitive care that they deserve. In October, the Government extended the baby loss certificate service to help mums and dads who go through the nightmare of a pregnancy loss. In addition, health visiting teams are well placed to provide mental health support to new parents. They can offer assessment at each contact, appropriate interventions and referrals when necessary. Some areas have health visitors who specialise in perinatal mental health to strengthen provision for families who need it. However, service provision can and must be made stronger. That is why we are working with partners to improve the current health visiting services, including by looking at how we can best improve support for parental mental health, and by ensuring that it is sustainable for an overstretched workforce. This Government want every child to have the very best start in life. Last month, we announced £126 million of funding until 2026 through the family hubs and Start for Life programme. That will provide a raft of support for families with babies, from pregnancy up to the age of two. It includes funding for bespoke support for parents and carers with perinatal mental health difficulties, and for parents-infant relationships. This Government are committed to tackling suicide, which is one of the biggest killers in this country. My hon. Friend the Member for Aylesbury makes a very good point about building awareness and good allyship in order to reduce suicide risk. The suicide prevention strategy targets pregnant women and new mothers as a priority group for additional support, so that fewer loved ones will go through the heartbreak of losing a friend or relative to suicide. More than 100 measures have been outlined in the strategy, aimed at saving lives, providing early intervention and supporting anyone going through the trauma of a crisis. The Voluntary, Community and Social Enterprise Health and Wellbeing Alliance, managed by the Department of Health and Social Care, NHS England and the UK Health Security Agency, has sponsored a project, led by the Tommy’s and Sands Maternity Consortium, which explores experiences of perinatal suicide and self-harm and their risk factors. We have allocated funding to 79 organisations up and down the country from our £10 million suicide prevention fund over the two years to March 2025. Those organisations, many of which are grassroots and community-led, are delivering a broad and diverse range of activity that will prevent suicide and help save lives. I have taken careful note of the four proposals that my hon. Friend the Member for Aylesbury set out clearly in her speech, and I will work with my officials to give them the detailed consideration that they deserve. Although it takes huge courage to speak out about such painful matters in public, I have always thought that that is a vital part of our public discourse, which is enriched when we bring our experiences to these debates. I again pay tribute to my hon. Friend and all hon. Members who have taken part in this debate. Question put and agreed to.

11:30:00