All new mothers should be screened for depression and anxiety in the weeks after giving birth, according to the National Institute for Health and Care Excellence (NICE).
The NHS advisory body says that GPs should routinely assess the psychological state of all new mothers to prevent potentially serious conditions going undiagnosed.
NICE said that women who have just given birth and are displaying signs of mental health disorders, such as such as sleep disruption and changes to appetite, are too often dismissed by hospital staff because their symptoms can also be “considered normal.”
In the year immediately after child birth, up to one in five mothers suffer anxiety or depression. However, a recent NHS report has highlighted large discrepancies in the quality of treatment these women receive.
Furthermore, new mothers are also at risk of panic and generalised anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder. Less of a risk, but still a concern, is postpartum psychosis, which affects between one and two in every 1,000 women who have given birth.
At present, women are given a physical check-up by their GPs around six weeks after giving birth. NICE wants this routine six-week check-up to be broadened to include proactive checks for signs of mental illness.
Moreover, NICE wants pregnant mothers to be asked about the state of their mental health when they have their first midwife appointment at around the eight to 10 weeks pregnant mark.
At this check-up, expectant mothers should be asked questions about their mental health, such as how often have they been bothered by feeling down, depressed or hopeless since they’ve been pregnant.
NICE has also called for Clinical Commissioning Groups (CCGs) to record the number of women with suspected mental health disorders pre- or post-pregnancy who receive a comprehensive mental health assessment. In addition, NICE wants CCGs to also record how many of these women are able to access psychological support within 6 weeks of giving birth.
Women who already have a mental health disorder prior to getting pregnant may see their condition worsen as their pregnancy progresses. Changes in their bodies, such as weight gain, can cause or exacerbate eating disorders.
Professor Daniel Keenan, associate medical director at Manchester University Hospitals and chairman of the NICE Indicator Advisory Committee, said: “Giving women the right treatment at the right time can have a profound effect, not just for the mother but her family too.
“Symptoms of mental health problems can be masked during pregnancy, and the post-natal period.
“We recommend that clinicians ensure new mothers are asked about their mental health so that these symptoms are not overlooked and women are not left so suffer in silence.”
All of NICE’s recommendations are under consultation as part of its draft indicator menu, which aims to help GPs and CCGs by identifying areas of care that could be improved.
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