Inquiry into Perinatal Mental Health Services – Can Welsh Government improve them??

The Children, Young people and Education Committee recently undertook an inquiry to consider how Perinatal Mental Health Services are currently provided and how the Welsh Government can improve services for mothers, babies, fathers and families. The inquiry took place in Cardiff on May 18th.

PMH Cymru attended the event along with other organisations and families with a lived experience. We were recently sent an email from Rebecca Arnold, Rebecca wanted to share with us some of the questions that were asked for the inquiry.

Here we have some of the questions that have been answered by Rebecca

Exploring your experience of perinatal mental health problems, including the impact on you, your partner and the wider family.

 

Whether you felt supported by your healthcare professional to talk openly and
honestly about your feelings.

2011: I had with my husband prepared what I was going to say to my GP at my 6 week postpartum check-up. I went to the check up; I was asked about my stitches, my tummy was prodded, I waited to be asked ‘how are you feeling?’. I was not asked this question and I did not know how to begin to talk about how I was feeling. I went home and crumpled into ball of uncontrollable crying, unable to unfurl because the anxiety had made my internal organs feel as though they were knotted and I couldn’t stand straight.

The help you received from your healthcare professional (obstetrician, midwife, health visitor, GP); whether they recognised your symptoms and were able to provide accurate, timely information.

2011: My husband phoned my health visitor and told her that there was something seriously wrong with how I was feeling and behaving. The GP phoned back and my husband described how I had been and I was invited into the surgery. I completed the GAD7 and pHQ9 and was prescribed medication for my depression and anxiety. I had a review 2 weeks later and then quarterly appointments with my GP and that was it.

What they missed was what I now know to be symptoms of a more serious mental health illness. I hadn’t been asked about the smoke I could smell in my house as if my house were on fire, when it wasn’t. I hadn’t been able to tell them about each time I walked over the bridge over the A470 to my house, that I had graphic thoughts about jumping off that bridge and being killed by a vehicle. That each time I walked over the level crossing, I had disturbing graphical images of being obliterated by an oncoming train along with my baby. That on one day I stayed out and walked for 5 hours, because I could not cross the road to go back to my house, because I knew with certainty that myself and my baby would be knocked over and killed by a car driving at speed. That I stayed awake most nights, frightened that there would be a fire or the picture hanging up on my wall would fall off the wall and kill my baby. I would walk along the Taff Trail and I would duck as a bird of prey swooped down above my head to attack the baby I was carrying, accept there was no bird of prey. My anxiety was off the scale, I still do not know how I functioned without sleep, my days and nights were filled by an almost constant barrage of disgustingly graphic, morbid thoughts of myself or my baby dying in every way imaginable. I loved my baby so how could I begin to say any of this to anyone? I would have told a professional, except my health visitor only cared to tell me I should put my baby down more. I think the lactation consultant I visited had an inkling. The PHQ9 and GAD7 done with my GP did not capture these symptoms.

Only 6 years on and working as a Perinatal Support Coordinator have a learnt to name my symptoms and to have an idea of what perinatal illness I had. I envy those that have mental health support and drugs to stop what I was suffering.

2012: My husband sought support from the GP for depression and anxiety. 1 in 6 men who have a partner with PND develop depression themselves, he was one of these men.He completed the GAD7 and PHQ9 and was prescribed medication for depression and anxiety. That was it, with quarterly appointments. Five years on and he is still on this medication as he has not had any support to otherwise stop taking them

Whether you had timely and local access to specialist maternal mental health services; how long you waited to be referred and whether you sought any private treatment.

I was told I had postnatal depression and that was it.

Continuity of care across midwifery, obstetric and neonatal care.

2015: I was told I had to be consultant led because I had disclosed that I had PND in my booking in appointment with the midwife. I was devastated; I did not want my pregnancy to be medicalized in this way. I attended every appointment that I was given. At 28 weeks the midwife who I had a grumble to about being under consultant led care, told me that ‘there is a very good reason why you are under consultant led care with your mental health’. It still took until 38 weeks for the consultant or a midwife to ask me how I was feeling as they went through their questions. I was a little surprised at this stage 8.5 months on and didn’t really know how to express the prenatal anxiety I had been having, I started to work out my answer and they moved onto the next question. I didn’t get an opportunity to tell them how I had felt.

I was not asked by a midwife antenatally; even though I was hospitalised 7 days after the birth with and infection and breastfeeding was excruciatingly painful as my son had a tongue tie. I was asked by my health visitor as I had seen her off my own accord antenatally and I had asked her to look out for me and to support me if I were unwell.

Which services you were referred to (i.e. Mother and Baby Unit, specialised maternal
mental health therapist, general therapist, in-patient psychiatric unit, local peer group support) and your experience of them.

None

Any support you received to help with parent-infant attachment.

None

The impact of breastfeeding

Breastfeeding was my savior. It saved me, it saved the bond I had with my daughter and it saved me a second time round with my son. The thoughts in my head were incompatible with forming a good parent-infant attachment but through my physical action of breastfeeding my daughter and responding to her every cue and feeding her, I formed a good, strong attachment with her. I felt guilt for the thoughts I was having but I knew I was doing the best I could for her by breastfeeding her.

Sometimes I think perhaps not having the support from mental health services was a good thing. I didn’t know about the BFN’s Drugs in Breastmilk helpline and had I been prescribed drugs incompatible with breastfeeding and didn’t question this, I would have stopped breastfeeding and I think that this would have affected me for far longer than the perinatal mental health illness I had. I think about if I had given up breastfeeding and it makes me feel nauseous and on the verge of tears.

I trained as a breastfeeding peer supporter when my first child was just four months old. I was so grateful for the breastfeeding support I had from a lactation consultant that I was overwhelmed by the need to pass it on as I could never repay that support. Imagine, me being in the sorry state I was in with a perinatal mental health illness and volunteering each week to support mothers to breastfeed their babies, because these mothers were getting neither good or timely support from their paid healthcare professionals! I am now training to be a breastfeeding counselor and still support at a breastfeeding group on a weekly basis! Breastfeeding saved the bond I had with my children, it saved me and I am determine to save other women from developing or worsening a perinatal mental health illness as a result of choosing to stop breastfeeding from inadequate healthcare support.

My life has changed immeasurably from having a perinatal mental health illness. Six years ago, I was an Assistant Energy Manager for Cardiff Council. I dealt in CO2 footprints, installing renewable energy technologies and knew my energy meters inside and out. I now work as a Perinatal Support Coordinator for a National Charity, supporting mums from across South Wales who have or are at risk of developing a perinatal mental health illness.

Thank you for sharing this with us Rebecca x

For more information about PMH Cymru please visit www.pmhcymru.com

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