Meeting of the Parliament (Hybrid) 29 March 2022
I am pleased to take part in this debate on perinatal mental health and I thank the committee for its report. I am told that having a baby can be the happiest period in someone’s life, but it can also be the most difficult. As those with lived experience know, mental health issues can come from anywhere during pregnancy. The impact can be serious on expectant mothers and those who have given birth.
Mothers who are pregnant or who have recently given birth can develop feelings of sadness and depression. Mothers can feel guilty and confused. Many mothers hope to feel the glow of pregnancy; they expect to look back fondly on that period of their life. Sadly, as Natalie Don said, that could not be further from the truth for many women and for the partners and families who support them.
In Scotland, perinatal mental health problems affect up to one in five new and expectant mothers. As we have heard, that covers a range of conditions, including mood disorders, depression, anxiety and psychosis. We know that, if they are left untreated, perinatal mental health issues can have long-lasting effects on women, which can impact their relationships with their baby and other family members. The impact can extend to a child’s cognitive and emotional development. In the very worst and most tragic cases, mental illness can lead to maternal suicide.
The Scottish Conservatives welcome the committee’s report and urge the Government to take forward its recommendations to address what the committee rightly identifies as fundamental gaps. The report makes 55 recommendations on subjects that include access to mother and baby units and workforce recruitment and retention. It covers birth trauma, baby loss units, stigma and, of course, the impact of inequalities. It is impossible to address all the recommendations today, but the report is fundamentally about looking at how the Government can work across settings to improve patient pathways.
Many women who suffer mental health problems following childbirth are scared to come forward. They fear that they will be judged or that their baby will be taken away. Removing stigma and ensuring that services are inclusive are vital steps that can have a huge preventative impact. It is crucial to educate professionals on the right questions to ask, so that they avoid inappropriate treatments and potential misunderstandings in the system. I therefore encourage the Scottish Government to bring forward its delayed raising awareness strategy as soon as possible.
I am concerned that the report highlights again systemic and endemic issues in recruitment and retention. When we talk of problems in our NHS, that is the dead end that—sadly—we repeatedly come to. Ministers must act now to break the roadblock and to boost training about and understanding of mental health in midwifery.
In its briefing, the Royal College of Midwives Scotland agrees with the committee that an
“appropriately trained and supported workforce”
is vital to delivering the care that women need. As the committee notes in its recommendations, it is not simply a matter of training and supporting existing staff; we also need to ensure that there are more staff—and, by that logic, fewer vacancies—in the system.
The RCM supports the recommendation that perinatal mental health training should be incorporated into training for all midwifery students. Staff also need to be empowered to engage in continuing professional development and to be able to do so with no negative impact on the delivery of patient care.
The pandemic has had a profound impact on all our lives, and it has pushed a lot of mental health services and support to an online environment. As Gillian Martin rightly identified, Covid has led to negative experiences. We know that the reduction in face-to-face contact has negatively impacted the mental health of expecting and new mothers. Not everyone is able to access online resources, and a lack of infrastructure and capacity can prevent some mothers from connecting digitally.
The committee heard evidence that some individuals have been unable to access GP appointments. That is why the Scottish Government must take urgent action to ensure that alternative routes are available for referrals into perinatal mental health services. I welcome the fact that the minister says that he is in listening mode, but on this, as on so much else, I hope that he can get into action mode quickly.
I understand that the issues are complex, but one statistic stands out: under the SNP, women are waiting more than the maximum of six weeks from referral to access services. Mothers who are seeking support can often encounter a postcode lottery, with inconsistencies in the accessibility of mother and baby units across different NHS board areas, as we heard.