There is increasing awareness of perinatal mental health as a public health issue. The Government is keen for midwives to further develop their role in public health. Midwives need to be adequately prepared to take on a more developed role in perinatal mental health if practice improvements are to be made. I am aware that death from psychiatric causes has been the leading cause of maternal death for the last few years. Although the most recent Confidential Enquiry into Maternal and Child Health indicated that this is no longer a leading cause, mental health problems before and after childbirth have a significant impact on the health of women, family relationships and children’s subsequent development. I believe that midwives need to be able to detect women with current mental health problems and those at high risk of a serious mental illness following delivery, in order to improve the care and support offered to them throughout their contact with maternity services. One of the most serious areas where we see ongoing harm is in adult mental health. Recent research shows that a large proportion of adult mental health problems can be laid at the door of early childhood. We need to consider the likely future effects of not breaking the cycle while these people are young. The ACE Study estimates that 54 per cent of current depression and 58 percent of suicide attempts in women can be attributed to adverse childhood experiences, which also correlate with later high levels of alcohol and drug consumption. In order to screen systematically and sensitively, and to enable them to refer on appropriately, I feel that midwives need to understand why they are asking questions about mental health; how to encourage women to disclose past and current problems; what the risks of recurrence and relapse are; and what services are available in their area of practice.
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I feel very strongly that having post graduate qualifications
References: Felitti V & Anda RF (2008) ‘The relationship of adverse childhood experiences to adult health, wellbeing, social function and healthcare’ in R Lanius & E Vermetten (Eds) The Hidden effects of unresolved trauma.134Epidemic: The Impact of Early Life Trauma on Health and Disease, Cambridge University Press, Mary Ross-Davie, Sandra Elliott, Anindita Sarkar, Lucinda Green British Journal of Midwifery 14(6): 330 - 334 (Jun 2006) National Institute for Health and Clinical Excellence. 2007. Antenatal and postnatal mental health: clinical management and service guidance. NICE clinical guideline 45. London: NICE. Oates M. 2001. Perinatal maternal mental health services. Recommendations for provision of services for childbearing women. London: Royal College of Psychiatrists Cathy Rowan1 RM, PGCEA, MA. Christine McCourt2 BA, PhD. Debra Bick3 RM, BA, MedSc, PhD. (2010) Evidence based Midwifery:Volume 8 (2010) » issue 3 » Provision of perinatal mental health services in two English strategic health authorities: views and perspectives of the multi-professional team.. 6|Page