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NICE urges GPs to assess mental health of all pregnant and postnatal women

Article By: Melissa McAlees, News Editor

Pregnant women and new mothers should be given more support and guidance surrounding their mental health, according to a new report by The National Institute for Health and Care Excellence (NICE).

NICE is calling on GPs to assess the mental health of all pregnant and postnatal women, as some symptoms of mental illness - changes to appetite or sleeping patterns - can be masked by what is considered “normal” for individuals.

Dr Andrew Black, GP at Mortimer medical practice and deputy chair of the NICE indicator advisory committee, suggests the routine six-week postnatal appointment could provide an opportunity for new mothers to be asked about their mental health.

He said: “GPs play a vital role in helping vulnerable people to get the correct diagnosis and the support they need.

“These indicators, put forward by NICE, could help GPs to identify and support their patients who are most at risk. This can only be a good thing.”

NICE says that clinical commissioning groups (CCGs) should record how many women with a suspected mental health problem during pregnancy or the postnatal period receive a comprehensive mental health assessment, and if referred, how many of these women gain access to psychological services within six weeks.

Depression and anxiety are the most common mental health problems during pregnancy. Around one in eight women experience anxiety or depression whilst pregnant and up to one in five during the first year after childbirth.

The new guidance states that women should be asked about symptoms such as poor sleeping and eating at their six-week check.

During the first appointment with a midwife they should also be asked questions about mental health, such as how often in the past month have they been bothered by feeling down, depressed or hopeless.

Women should also be asked if they have lost interest in doing things they usually enjoy, if they are bothered by feeling nervous, anxious or worried and if they are able to sleep.

Commenting on the report findings, Janet Fyle, professional policy advisor at The Royal College of Midwives (RCM) said: “The RCM believes that midwives, GPs and other healthcare professionals should always place equal importance on a women’s mental and physical health, not only after birth, but throughout the entire pregnancy.

“We know that suicide is a leading cause of death in new mothers in the UK and up to 20 per-cent of women are affected by mental health problems at some point in pregnancy or the postnatal period – within the first year after birth.”

She added: “Midwives play a central role in promoting the emotional well-being of women and their babies and in ensuring that all women with mental health concerns get appropriate and timely care.

“This is why it’s vital that GPs and midwives work closely together so warning signs and symptoms are not missed. In addition, maternity services as a whole need to ensure they are bridging the gap between hospital and community based care. Unfortunately, at the moment the provision of these services is currently patchy at best and this is simply not good enough.”


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