My Blog

It is great to see many media posts today for Mental Health Awareness week. I shall be playing my part by running two one-day workshops to professionals in St. Helier, Jersey.

Over the last few weeks, I have had the privilege of presenting at a number of events and hope that some of the content may be of use to you in the perinatal world.

On Thursday 21^st April I was at Leeds for a study day organised by the British Journal of Midwifery. It was very well attended and the Leeds South Village hotel did a great job looking after us. I shared my story of perinatal mental illness and recovery along with the types of needs that expectant and new families have told me that they would like from healthcare professionals.

We heard from Caroline Carr who described the service provided by a Mother and Baby specialist unit, specifically at the Brockington Centre in Stafford. We continue to be short of them (MBU) in the UK. The economic review in 2014 showed where the huge gaps are in the UK. Wales has no unit at all – please pass on the details here to campaign and lobby for one.

I was surprised that a midwife who has worked for many years in Liverpool was unaware of the one in Manchester that would cover her patients. If you work with expectant and new families do you know where your nearest unit is? If not, here is the link to them.

MBUs can literally be life-saving!

We also heard from Dr Lih-Mei Liao who spoke to us about Post Traumatic Stress Disorder following childbirth. Details on this subject can be found here.

The chair for the event was Amanda Burleigh, an award winning midwife. She was telling me about her research around delayed cord clamping and its benefits. This was a new area for me and I was interested in what she told me.

 The next event was in London – a bi-annual conference now – for ‘Improving the Quality of Perinatal Mental Health Services’ organised by Healthcare Conferences UK. An added excitement was that it was held on the first Global Maternal Mental Health Day. It was wonderful to know that as we were presenting, so were many other people across the world. Look at their website (pictured) for all the reasons why this is so important.

After my presentation, we heard from a passionate consultant perinatal psychiatrist Dr Nisha Shah, who talked to us about identifying women in distress. She emphasised the need to reduce the stigma associated with these illnesses and to make real improvements we need both education and legislation to work alongside. She encouraged us to connect with our local commissioners. She is part of a perinatal service that has an excellent community service which has links with MBU; integration of CAMHS and adult services; has psychiatry and psychotherapy; PLE roles being explored; joint obstetric clinic and a father’s group.

Professor Louise Howard took us through the NICE guideline for postnatal mental health, CG 192. A great summary of these are in this BMJ article.  I recommend that you take a look at both documents.

The bottom line

• Do not offer valproate for acute or long term treatment of mental health problems in women of childbearing potential
• Assess women with a known or suspected mental health problem who are referred in pregnancy or the postnatal period for treatment within two weeks of referral; provide psychological interventions within one month of initial assessment
• At a pregnant woman’s first contact with services, ask about any past or present severe mental illness, previous or current treatment, and any severe postpartum mental illness in a first degree relative
• Refer all women who have, are suspected to have, or have a history of severe mental illness to a secondary mental health service (preferably a specialist perinatal mental health service) for assessment and treatment

We had a photograph of the delegates and some speakers to mark the event globally!

Dr Jane Hanley spoke about the importance of listening and understanding different cultural needs. Take a look at her book.

I am pleased that increasingly, we are looking at the broader implications of perinatal mental health beyond postnatal depression. One of these areas concerns infant mental health and the effects of prenatal stress, anxiety and depression on the developing fetus and the child. It reminds us of yet another reason why we must help pregnant women to look after their mental health as well as their physical health. Lauren Capron, a researcher from Imperial College London, eloquently shared some of the research around this. Have a look at www.beginbeforebirth.org

Next we listened to Mark Williams who highlighted the need to be aware of the father in the perinatal period as their mental health can be affected too, e.g. PTSD from the birth, depression leading to substance/alcohol abuse.

Sadly Anne Prendergast was unwell so I was able to cite the PSS Parent and Baby Wellness Service in Liverpool as good practice.

Finally we heard about the ‘Findings from suicide in perinatal mental health: 15 year findings from a UK national inquiry’ from Dr Hind Khalifeh from King’s College London.

It was great to conclude the day by asking delegates to take the information and consider what they can Apply, Change and Teach. I thoroughly enjoyed the day with enthusiastic delegates, great speakers, venue and organisation. Watch this space for another one later in the year!

My next trip was a long drive down to Gillingham in Kent. I stayed at the Premier Inn and had one of the tastiest breakfasts ever! It set the tone for an excellent day – it may have been the hottest day of the year so far, yet for all of us involved in ‘BirthChoices16’, we didn’t notice it!

I have spoken at a number of events this year organised by Midwifery Student Societies. This one was by CCSU MidSoc. I was thrilled to meet Professor Lesley Page, President of the Royal College of Midwives, who chaired the day. We have been connected on Social Media for a long while and never met until now. What a warm, endearing and inspiring lady! I was so impressed with every speaker and learned much as the day progressed.

The first lady was Rebecca Schiller from the charity Birthrights on ‘Why women’s rights in childbirth really matter’: www.birthrights.org.uk for full information.

Sarah Gregson, a consultant midwife, shared some enlightening examples of maternal choice in the developing world. She also told us about Kangawraps that are sold on line with all profits going to maternal and child health charities in low income countries.

I confess that I did not know what ‘Supporting the Choice to VBAC’ meant in the title of the following talk by Stephanie Mansell. I soon did – Vaginal Birth After Caesarean’. She beautifully described her clinic where she supports, provides information and helping women to clarify what is really important to them. Stephanie is now using the term BAC (birth after caesarean) as it may help them feel at peace with their choice.

There were a variety of stalls including cakes and a raffle in addition to sources of information. These included SiMBA (Simpson’s Memory Box Appeal). Look at their website to find out how they support families with the loss of a baby. There was information on Hypnobirthing by www.kghypnobirthing.com; CMV virus that is a leading cause of birth defects in the UK and affects 2 to 3 babies every day and Dianne Garland who is an international waterbirth lecturer. Next to me was a stand by www.aims.org.uk .

I was the first speaker after the morning break and spoke about the choices for people contemplating another pregnancy after a perinatal mental illness. I couldn’t resist taking a selfie as there was so much happening with the event on Twitter!

Our next education came from Jenny Davidson, whose T-shirt had the slogan ‘breech geek’! She described the choices when your birth is breech. I only know a little information about this complication; Jenny shared ways that began to remove some of the fear and panic that often surrounds this. Her PhD will be published later in 2016.

The more the day progressed, the more I felt like I could have been a midwife! The next session was an eye-opener. Jenny Smith spoke about ‘The Jentle Midwifery Scheme and the ‘natural’ caesarean’. Her philosophy is adopting a holistic approach with the women and full collaboration in her care between midwives, obstetricians, anaesthetists, neonatologists, including doulas and complimentary therapists. Looking at how some simple procedures in a caesarean section can be changed to involve the mother more, e.g. immediate skin to skin, was amazing. Perhaps this approach could help prevent some of the aspects of failure that some women feel following a typically medical approached caesarean.

The day continued to be positive with the arrival and performance by Mark Harris, a former midwife who now helps to prepare men for the birth of their children by truly being ‘present’ and meeting the needs of his partner/wife as she labours. What a dynamic, lovely man! I have seen his postings on social media and up to now, had never heard him. Mark also spoke about the differences in the male and female brain and how that can cause disconnection. Using humour and his personal stories, he shared ways that we can help men prepare and be the best they are able to at the very special occasion of birth.

It was with regret that I had to leave before the final speakers as I had a 4 hour drive up to Wakefield. I missed Beverley Beech from www.aims.org.uk speaking about ‘why women choose to free-birth and how to support their choices’. She was followed by Theresa Caton about ‘Choices in the Irish Maternity System’. I do hope that I can be part of an Irish Midwives Association event soon.

I was thrilled to be part of an incredible, well-organised day that filled me with optimism for midwifery in the future built on the legacy of those before them. Also a tinge of sadness that I only had the opportunity to give birth once. It’s such a special and unique time and I applaud those who work tirelessly to ensure that it is. Professor Page commented that she noticed that I have a deep respect for midwives – I do.

I then had a chuckle at myself. As I had a 4 hour drive ahead of me, I decided to change out of my dress into comfy jeans. I continue to be troubled with a shoulder impingement and have limited movement in my left arm, I got stuck half in and out of my dress! Thank goodness a couple of the ladies from the CMV Action stand came in to the ladies room where I was attempting to change and were able to rescue me!

From Kent, I spent Saturday evening driving up to Cedar Court Hotel at Wakefield, managing to narrowly avoid the thunderstorms! I joined the Yorkshire and Humberside regional conference of The Samaritans. Sunday morning was spent speaking from a platform as opposed to wearing my dressing gown and pottering around to Steve Wright’s Sunday love songs on Radio 2!

It is always a humbling experience to speak to these groups of people who give of their time to ‘be there’ for others. I hope that my story and experiences help them to help others.  It was interesting to listen to two ladies from on Open Prison describe their role in listening to other inmates. They play a vital role in reducing suicide and supporting other inmates, especially at most vulnerable times. It was impressive hearing how the experience and training had helped their own development too. We concluded with a refreshing mindfulness session – I could quiet easily have nodded off!

Then it was home on the M62 again in high temperatures. I missed the sunshine outside all weekend yet had the honour to be inside with warm audiences and drove home with appreciation and passion for life. I also felt a sense of achievement and contentment knowing that I had learned some new information that I could share.

Remember to follow some of the links to increase your knowledge too. Whom will you share them with as your part of Mental Health Awareness Week?

Elaine