Perinatal mental health (PMH) problems are those which occur during pregnancy or in the first year following the birth of a child.
In the UK, perinatal mental health difficulties affect up to one in five women and one in ten men during pregnancy and the first year after having a baby.
Many women have experienced birth trauma or loss or have a fear of childbirth. Early detection, referral and support can have lasting, positive outcomes and improved wellbeing.
The Lancashire and South Cumbria Reproductive Trauma Service has been set up to offer a variety of support and therapies to those who have experienced:
- Birth trauma
- A fear of childbirth (tokophobia)
- Perinatal loss – including:
- early miscarriage,
- recurrent miscarriage,
- neonatal death,
- termination of pregnancy for any reason,
- parent infant separation at birth.
This service recognises that fathers/birthing partners and co-parents play an integral role in the wellbeing of the woman. Any fathers/partners and co-parents of women accessing support from our service will be offered an assessment and signposted accordingly if appropriate.
The team of specialist health professionals include:
- Maternal mental health midwives
- Psychological therapists
- Mental health practitioners
- Peer support coordinators and volunteers with lived experience
What is offered?
The trained therapists will provide a range of psychological interventions and support which will be discussed with you to meet your personal needs. These may include psychological therapies, relaxation techniques, anxiety management or information to help you with your difficulties. They may be within a group or in a one-to-one setting.
Staff have a specialist skill set to allow them to deliver specialist assessment and evidence-based psychological interventions in line with NICE guidance including:
- Person centred and psychodynamic counselling
- Eye movement desensitisation reprocessing (EMDR)
- Cognitive behavioural therapy (CBT)
- Guided self-help
- Psychoeducational groups
The service has been co-produced with women (and men) with lived experience of reproductive trauma and/or loss to gain a better understanding of their needs.
Those that we have spoken to have suggested a number of ways the service should operate and we have done the following to make sure we act on these suggestions.
|You said||We plan to|
|You would like a mixture of venues that are sensitive to each person’s situation.||Use a wide variety of venues to meet service users in appropriate settings where they feel comfortable|
|The impacts of reproductive trauma can last for many years so there should be no time limit to access the service||Offer the support to anyone who has previously experienced reproductive trauma and who meets a level of need|
|You did not like having to retell your experiences at each appointment||Have systems in place so that anyone who is accessing the specialist mental health services can use the same assessment form and will not need to repeat their histories/issues.|
|Fathers and partners should also be supported||Undertake mental health assessments for fathers/partners of any woman who is receiving treatment and to signpost as appropriate. We also plan for fathers/partners to receive support from trained peer supporters.|
|You wanted opportunities to understand your experiences and to ask questions about what happened||Develop a debrief/listening service that is in line with service-user needs|
|You wanted language to be used that is inclusive of all family types important to you||Provide perinatal LGBTQ+ training to all staff and use inclusive language on forms and literature used within the service|
We also understand that talking to people who have experienced something similar is often really helpful. Our peer support coordinators will match up women/fathers/partners and co-parents with an appropriate peer support volunteer to provide additional support.
Referral to the service
The best person to speak to if you feel you need some support is your health care professional such as GP, health visitor or midwife. They will discuss your difficulties with you and may recommend this service to you or an appropriate alternative. If you are referred to the Lancashire and South Cumbria Reproductive Trauma Service, a member of the team will contact you to arrange an initial consultation.
What happens then?
Upon referral, a discussion will be had at the weekly referrals meeting to determine whether it would be appropriate to offer an assessment with a member of the team. Following assessment a further team discussion will be had to determine which input would be most appropriate to provide care and treatment to each individual, based on their presenting difficulties.