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OCT 24/2014

New NICE guidance: the need for specialist mental health midwives

One of the key areas in which the NHS is aiming to improve its standard of services at the moment is in the provision of better-quality care for people with mental illnesses, due to growing recognition and understanding of their medical needs.

Within this field, new mothers are recognised as a demographic who may be in particular need of specialist support. This point has been underlined in the last few weeks following the publication of new guidance on antenatal and postnatal mental health issues from an influential industry body.

As such, the creation of these new guidelines from the National Institute for Health and Care Excellence (NICE) has once again reignited debate over the need for new midwifery jobs to be created to ensure the needs of this vulnerable group are being properly met.

The new NICE guidance
The updated draft guidance from NICE - the independent body responsible for driving improvement and excellence in the health and social care system - represents the first major overhaul of best practice on this issue since 2007.

Since this time, understanding of the best ways of detecting, treating and medicating patients in this category has evolved considerably, making the issuing of new advice a vital step.

Under the new guidance, all women of present and future childbearing potential with mental health issues will be spoken to about how pregnancy and childbirth can affect this condition, while discussions will also take place about the pros and cons of possible treatment options.

New insights into the benefit/risk profile of specific pharmaceutical interventions will help to guide therapy decisions in a better direction, with special considerations to mothers with severe mental illnesses, or those whose children die before or shortly after their birth.

Professor Mark Baker, director of NICE's centre for clinical practice, said: "Having a baby is a time of huge change and any woman can find herself needing help. This updated draft guideline is about spotting what is not normal for each individual woman and ensuring she receives the treatment that is right for her."

The need for specialist mental health midwives
This new guidance has been welcomed by the healthcare sector, while also reinvigorating calls for more midwives with specialist mental health training to be recruited.

Antenatal and postnatal depression is not an uncommon issue - indeed, official data suggests that more than one in ten women will experience depression at some point during their pregnancy, increasing to one in five during the first year after giving birth. There is also a high risk of anxiety, obsessive compulsive and post-traumatic stress disorders.

The Royal College of Midwives (RCM), meanwhile, has published research suggesting that almost 60 per cent of women experienced feeling down or depressed after giving birth, which it described as evidence of the pressing need for more midwives in England.

Jane Munro, quality and audit development advisor at the RCM, said the new NICE guidance contained "a lot of positives", while adding: "We have been campaigning for more resources, particularly an increase in the number of midwives so that they can give women suffering from mental health problems the attention and support they need."

The government has previously demonstrated its recognition of this fact, with Health Education England unveiling plans last year to ensure there is enough training in perinatal mental health to guarantee the availability of specialist staff for all birthing units in the country by 2017.

Moreover, as of the end of last year, there were over 1,300 more midwives working in the NHS than was the case in 2010, with a record 5,000 in training.

It is hoped that these and other measures will help to ensure that British mothers with mental health issues will be able to get the care they need in the near future.

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