So much has happened since 2003, when in my third pregnancy I first started to experience signs of depression and anxiety in pregnancy. Back then, people didn’t talk about their mental health, or if they did they were ridiculed or chastised for it. They certainly didn’t speak of it during a time when society expected you to be ‘glowing’ and happy. Now, much more than a decade later, and the world has changed. But have we come far enough?
Since I started writing and sharing my story, I’ve spoken to hundreds of women who have told me that knowing they weren’t alone brought them such relief. Many of them said that being able to talk to their midwife or doctor knowing the National Institute for Health and Care Excellence had specific guidelines in place to make sure they were cared for, enabled – and empowered – them to feel held and supported. We also know now that fathers can suffer with poor mental health during the ante-natal period and beyond too, and more services are starting to appreciate this.
The peer support group I established at the local hospital, which ran for two years, provided a much needed outlet for people who were pregnant – and their families – to talk about how they felt. But this was unique in its time and it’s only now, as I write this in 2020, that we are starting to recognise the need for such support across the country. Many will argue it’s a ‘postcode lottery’ in terms of the quality or availability of care that a person may receive.
It matters that mental health services are recognising the need for perinatal mental health services for both mothers and fathers, and I applaud the efforts of local community mental health teams and people participation networks to ensure that the reach is far and wider than it used to be. But there is still much to be done.
We need to remember that maternal mental health is so much more than stress, depression and anxiety. We need to acknowledge that some of what people experience when they’re pregnant is normal, and not pathologise their fears and frustrations. Rather than viewing people as if they need “fixing”, speaking only of “treatment”, meet them where they are and ask them what they need. And whilst we can advocate that good mental health is possible, when people are struggling they need to know they haven’t failed, and that help is available.
We still need to see a higher standard of fair access to services, along with a rang of options (not just ‘CBT’ or medication) for people to get the help that they feel they need. The COVID-19 outbreak has highlighted inequalities in standards of health care that particularly affect Black women in pregnancy and childbirth, which still need to be understood and addressed. And there is still a stigma associated with talking about mental health, especially for those who are pregnant, in the way expectant mothers and fathers are treated by healthcare professionals.
So yes, we’ve come a long way. Even I have changed the way that I work and speak about mental health, making sure I work with people in a more trauma informed way – my experience is one of the reason I do the work I do today. But those pregnant in these times – and their families – still need the right help at the right time.
Copyright Delphi Ellis 2020 – updated 2021