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Update on recent petition about better services for women with PND

February 27th, 2009

Dr Petra

You may remember a few months ago there was a petition to the UK government to improve services and support for women with postnatal depression and their partners.

The government have now responded to this petition with the following statement (also available here):

Thursday 26 February 2009
Post-natal – epetition response

We received a petition asking:

“We the undersigned petition the Prime Minister to arrange for more and higher standard of services for women and their families affected by post natal illness.”

Details of Petition:

“Currently services in the UK provided by the NHS are not up to the guidlines submitted by NICE. We believe the following basic principals should be put in place to help women and their families who are deeply affected by PNI to recover siwftly and fully: * A dedicated HV from each area in the UK to follow up any refferals from GP * Support groups on an informal basis to take the pressure off mums who may be suffering confidence with the opportunity to incorporate a buddy system. * Funds made for community groups to be set up with the support of a HV/CPN or other trained proffesional. * Faster follow up counselling than is currently available. * Shorter waiting lists for CBT and other therapies * A specifically trained individual on PNI to operate in each PCT * Correspondence for all mums with HV until the child reaches the age of 5 * More funding for charities supporting women and their families suffering PNI * Dedicated support for the father and families affetcted by the mother suffering PNI.”

The Government’s response

The Department of Health fully recognises that postnatal depression (PND) has a devastating effect not only on a woman following the birth of her child but also on her whole family.

The Maternity Standard of the National Service Framework (NSF) for Children, Young People and Maternity Services sets standards for maternity care, including the early identification of and better support for women at the highest risk of developing postnatal depression. It is important for women to be provided with a postnatal care service that identifies their needs and responds in a structured and systematic way, and the NSF addresses this for both pre and postnatal mental health.

The 2007 strategy document Maternity Matters: Choice, access and continuity of care in a safe service builds on the maternity standard. It outlines how women should receive coordinated postnatal care, delivered according to relevant guidelines and in an agreed pathway of care, encompassing both medical and social needs of women and their babies, including those requiring perinatal mental health services or neonatal intensive care. Maternity Matters also outlines the roles that service providers and commissioners will have in the provision of woman-focused, family-centred maternity services, incorporating the need to commission high quality, equitable, integrated maternity services as part of maternity, neonatal and perinatal mental health networks, according to local need.

It is also quite clear that maternity services should be designed, reviewed and improved through a programme of consultation with users, and with a full range of choices of postnatal care. In particular, Maternity Matters advocates that all professionals involved in the care of women immediately following childbirth need to be able to distinguish normal emotional and psychological changes from significant mental health problems, and to refer women for support according to their needs.

The Department of Health has proposed extending the current duration of community postnatal care. This is because current research suggests that the routine midwife discharge at ten to fourteen days and routine discharge from maternity care at six to eight weeks is too short for a full assessment of health needs, and does not identify those women who may have post-delivery health problems, which need longer term care.

The Department has therefore recommended that midwifery-led services be provided for the mother and her baby for at least a month after birth or discharge from hospital, and up to three months longer depending on individual need. The whole emphasis is on having better multi-professional working in order to meet the complex needs of women and their families. We expect midwives and health visitors to work closely together at this important time in both the mother’s and baby’s life.

This is good news, although we all have to keep the pressure on to ensure these promises are kept and that services provided are of a high standard. You can do your bit by feeding back to your health visitor, GP, practice nurse or PCT if you have a positive or negative experience after having your baby – particularly if you are struggling with PND.

As well as the support groups mentioned in my previous blog (see above), I’ve also had the following group – Perinatal Illness UK recommended. In particular you may find their reading list and messageboards helpful if you are coping with PND or know someone who is affected.

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