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Depression In Pregnancy Being Missed

Aug 24, 2007
A health watchdog has said that GPs and midwives need to do more to spot the signs of depression in pregnant women and new mothers. The National Institute for health and Clinical Excellence (NICE) has also said that women with anxiety or eating disorders also to be identified.

The guidance was welcomed by mental health experts as one in seven women experience a mental health disorder at some point in pregnancy or after the birth. Currently only around 30% are being diagnosed with mental health issues during or after pregnancy. The mental health problems that pregnant women and new women are at risk of include depression, anxiety, eating disorders and severe mental health conditions such as schizophrenia and bipolar disorder.

Dr Steve Pilling, a consultant clinical psychologist who worked on the guidance by NICE said that there was "very significant under-recognition" of mental health issues in pregnancy. NICE has advised that healthcare staff dealing with pregnant women or new mothers ask three questions during ante or postnatal checks:

- Have you felt down, depressed or hopeless during the last month?
- Have you been bothered by having little interest or pleasure in doing things?
- Is this something you feel you need or want help with?

The NICE guidance goes on to say that women needing psychological treatment should normally be seen within one month and no longer than three months after an initial assessment.

Treatment for women with such problems may include counselling or anti-depressants, with the health worker explaining how medication may affect breastfeeding. Those who worked on the guidance have stressed the importance of using it to identify women who may be scared to ask for help for fear as being labelled as a "bad mother" or having their children taken away from them. They have also warned that leaving mental illness untreated could have consequences for both mother and child, including poor educational performance for the child and anxiety.

Dr Gillian Leng, who led the team which compiled the guidance, said: "This is not just about helping women get through the 'baby blues' - we are looking at all types of mental health disorders and distinguishing the ups and downs of everyday life for more serious conditions."

Fiona Shaw, a patient who also helped draft the guidelines, told how she was admitted to a mental health unit after the birth of her second daughter. She was not eating and was self-harming but had been told by her doctor to either take anti-depressants and stop breastfeeding or just "grin and bear it". She added: "Many women are concerned they will not be listened to if they come forward, or that they will be judged, or that their condition is not serious enough to warrant help from a healthcare professional."

Paul Farmer, chief executive of mental health charity Mind, said: "We welcome these guidelines, which look to be a very promising start. The challenge, as always, will be ensuring that they are implemented. Parents deserve the very best support at the start of their child's life. The resources to make these excellent guidelines a reality must be available, otherwise they risk becoming little more than a wish-list."
About the Author
Guide to Pregnancy explores the issue of pregnancy from the very beginning until the baby is born. It explores issues concerning pregnant mothers and offers guidance and advice on a number of related topics. For more information please visit http://www.guide-to-pregnancy.com
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