Keeping Mothers in Mind: Perinatal Mental Health and the Role of the Midwife

Jayne Cardwell, Gail Anderson*

*Corresponding author for this work

Research output: Contribution to conferencePosterpeer-review


The term perinatal mental health (PMH) encompasses all maternal mental health complexities experienced during pregnancy and/or the first year following birth, including depression, anxiety and psychosis-related disorders. In the UK, around 1 in 5 women develop PMH problems, with almost half having no access to appropriate care. PMH problems are a major public health issue with considerable social and economic costs to society. If left untreated, they can have a devastating impact on women and their families, including avoidable suffering; damage to family relationships; compromised emotional, social and cognitive development of the child; and serious maternal injury or suicide. The vulnerability of women who suffer from PMH problems is therefore far-reaching. This poster aims to demonstrate the role of specialist PMH midwives (SPMHMs), alongside all midwives, in mental health promotion, as well as the prevention, early detection and management of PMH problems.
The SPMHM role evolved as a result of the increasing prominence of PMH problems, and the subsequent need for more specialist services. SPMHMs are expert midwives and local leaders in PMH, driving efforts to ensure that women with PMH problems receive high quality woman and family-centred care, with the overall aim of reducing health inequalities. This is achieved through developing local multi-agency PMH care pathways; working collaboratively and coordinating care with other PMH specialists and maternity teams; in addition to providing crucial links with obstetric and midwifery teams, GPs, social services, health visitors, mental health services and voluntary sector organisations. Another significant function of the SPMHM is the education, training and support of midwives in relation to PMH. This enables midwives to be more effective in mental health promotion, as well as the early identification and appropriate referral of at-risk women or those already experiencing mental health problems, in order to help prevent or minimise the impact.

Although the Royal College of Midwives recommends that every maternity trust has a SPMHM and has provided standards to ensure quality of care, service provision cross the UK is inconsistent and falls short of this recommendation. SPMHMs work most effectively within or alongside specialist PMH multidisciplinary teams which operate in the community/and or mother and baby units. Not all SPMHMs, however are formally linked with these specialist teams and the teams themselves do not exist across every health trust. These challenges in practice undermine the consistency, quality and coordination of care that the SPMHM aims to provide.
There are, however, many examples of the effectiveness of the SPMHM role. In NHS Grampian, the appointment of a SPMHM has seen a 53% increase in PMH referrals due to improved staff awareness, improved communication and collaboration between multi-agency teams, and numerous examples of good practice which have earned the SPMHM multiple awards.
All midwives have a significant role to play in promoting positive mental health in addition to prevention, early detection and appropriate referral. Where appointed, SPMHMs are a critical part of multi-agency PMH pathways, having a crucial role in improving the quality and coordination of care, as well as integrating maternal and mental health services. They are most effective when formally linked with specialist multidisciplinary PMH teams. These are important considerations for parts of the UK deficient in specialist PMH services, such as Northern Ireland.
Original languageEnglish
Publication statusPublished - 30 Nov 0005
EventAll Ireland Annual Midwifery Conference: ‘Midwifery – adaptable and responsive during a crisis’ - online, Ireland
Duration: 05 Nov 202005 Nov 2020


ConferenceAll Ireland Annual Midwifery Conference
Internet address


  • Perinatal Mental Health, Midwifery, Public Health.


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