New mums affected by any kind of mental health problem need specialist help and support which factors in pregnancy, birth, and baby. Conditions like antenatal or postnatal depression/anxiety, postpartum psychosis, and postnatal PTSD (birth trauma) need effective and timely treatment from professionals who fully understand them, or the consequences can be devastating and even fatal. Currently, in the UK this specialist care is only available in certain areas. It is a postcode lottery.
There was no perinatal mental health service where I lived, when I became pregnant in 2013. I had a diagnosis of bipolar disorder and was at high risk of becoming severely unwell as a new mum, but no one kept a trained eye on me during pregnancy or even after the birth. The community mental health team and maternity services were not co-ordinated and I was left, falling through the gaps.
My son’s birth had been extremely traumatic, an emergency c-section with numerous complications, but no one spoke to me about how I might feel afterwards. I was just completely numb, shut down. The lights were on but no one was home. I began to experience flashbacks to the labour and birth: it was like being in a time machine I had no control over. I had intrusive thoughts, videos playing in my mind of someone torturing my baby. I became so anxious all the time. It was like there was a life-threatening emergency, if only I could work out what that emergency was. I felt out of control and terrified. I didn’t know what was happening to me. Neither my midwife nor health visitor were trained to recognise that I had PTSD and needed urgent help.
And so, because there was no perinatal mental health service where I lived, things escalated. Visions of harming myself became a determination to take my own life. I believed that I was a toxic influence on everyone around me, but most of all on my baby and that I was selfish to stick around. I spent a night wandering alone around town. I stood for hours on a bridge, staring at the river. Soon afterwards, I spoke to my GP, who failed to recognise the danger I was in. We ended up going to A&E, with my baby boy sleeping in his car seat. The doctor there, a lovely man who looked and sounded very much like the actor Michael Caine, agreed with my husband that I needed to go to an inpatient psychiatric mother and baby unit (MBU), where I could be safe, get specialist help, and remain with my baby.
But, because there was no perinatal mental health service where I lived, there was no MBU in my area, and the process of referral to another one was ridiculously protracted and complex. We were shunted on to my community psychiatrist, then to the home treatment team. Everyone agreed that I needed to go to an MBU: they just didn’t have the power to send me there. Meanwhile my poor husband was run ragged trying to keep me safe and look after the baby. Eventually we did get admitted to an MBU in Winchester. I shudder to think how close we came to a very different outcome.
The MBU was 50 miles from home. Many women have to travel much further, uprooted from their families and support systems. There was a lady at Winchester with me who lived in Cardiff, where her other three small children were at home without their mummy, too far away to visit. Other women are admitted to general psychiatric wards, separated from their babies for months at a time. The care at the MBU was excellent, and I was able to begin to make sense of what had happened and to bond with my baby. He’s four now. We’re best friends.
And all this is why I am now a champion for the Everyone’s Business campaign, calling for every family in the UK to have access to consistently good perinatal mental health care. The campaign has just released some new maps which show how patchy the current provision is, but also how it is improving. Good perinatal mental health care saves lives, and gives the next generation the best possible start. Please check your local area on the map, and have a look at the Everyone’s Business website for ways you can support the campaign, so that every family can access the help they may need.