Postnatal mental illness

The National Childbirth Trust (NCT) has published The hidden half: bringing postnatal mental illness out of hiding.

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Image source: http://www.nct.org.uk

The Hidden Half campaign surveyed 1,000 women who had recently had a baby and found that half had a mental health or emotional problem postnatally or during pregnancy. Of these, nearly half hadn’t had their problem identified by a health professional and hadn’t received any help or treatment. Many of these new mothers said they were too embarrassed or afraid of judgement to seek help.

The document can be downloaded here

Additional link: RCGP press release

Better Beginnings: Improving health for pregnancy

Being healthy is the best start to pregnancy for a woman and child | NIHR

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Image source: NIHR

Preparing for pregnancy can focus attention on health, such as eating a healthy balanced diet or losing excess weight, as well as avoiding risks from smoking, alcohol and drug use. Ensuring the best care for long-term physical and mental health conditions is important for a healthy pregnancy, as well as addressing complex social needs.

Getting the best start in life for children is a UK policy priority, focused on preventing problems and early intervention to improve outcomes. NIHR research evidence into modifiable factors to influence health before, during and after pregnancy is growing and helping to inform policy and practice.

This themed review brings together NIHR research on different aspects of health before, during and after pregnancy. It features:

  • 46 published studies
  • 28 ongoing studies or interim results
  • Questions for clinicians, commissioners, public health professionals and others

Read the full overview here

Read the full report here

Postpartum Haemorrhage, Prevention and Management (Green-top Guideline No. 52)

This guideline provides information about the prevention and management of postpartum haemorrhage (PPH). This is the second edition of this guideline, which was published in 2009 under the same title | RCOG

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Image source: RCOP

PPH is the most common form of major obstetric haemorrhage. The traditional definition of primary PPH is the loss of 500 ml or more of blood from the genital tract within 24 hours of the birth of a baby. PPH can be minor (500–1000 ml) or major (more than 1000 ml). Major could be divided to moderate (1000–2000 ml) or severe (more than 2000 ml). The recommendations in this guideline apply to women experiencing primary PPH of 500 ml or more.

Read the full guidelines here

Postpartum depression: Clinical Pearls

Untreated postpartum depression is common affects the health of the woman, infant, and family | Now@NEJM

AS0000057FE21 Baby, bonding with mother

Image source: Anthea Sieveking – Wellcome Images // CC BY-NC-ND 4.0

Pregnant women should receive information about the signs and symptoms of postpartum depression and its effects. Treatment depends on the severity of symptoms and the level of functional impairment and can include social support, psychological therapy, and pharmacotherapy (generally an SSRI as first-line treatment). A new Clinical Practice article explains further.

Read the full article here

Preventing postnatal maternal mental health problems using a psychoeducational intervention

Ride, J. et al. (2016) BMJ Open.6:e012086

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Objectives: Postnatal maternal mental health problems, including depression and anxiety, entail a significant burden globally, and finding cost-effective preventive solutions is a public policy priority. This paper presents a cost-effectiveness analysis of the intervention, What Were We Thinking (WWWT), for the prevention of postnatal maternal mental health problems.

Conclusions: The results suggest that, although WWWT shows promise as a preventive intervention for postnatal maternal mental health problems, further research is required to reduce the uncertainty over its cost-effectiveness as there were no statistically significant differences in costs or outcomes.

Read the full abstract and article here

Working together to prevent maternal mortality

Royal College of Physicians and Surgeons of Glasgow / Royal College of Obstetricians and Gynaecologists, June 2016

It’s better to ask: working together to prevent maternal mortality

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image source: rcpsg.ac.uk/

The RCPSG and the RCOG have produced an animated video to help doctors assess unwell pregnant or postpartum women, which aims to help reduce the number of maternal deaths in the UK. It is accompanied by a poster, which highlights the main causes of maternal death and provides midwives and doctors with advice for assessing pregnant and postpartum women who are feeling unwell.

More information available from the Royal College of Midwives here