Perinatal Mental Health

Introduction

Perinatal mental health is the term used to describe the mental health of parents during pregnancy and up to two years after the birth of a child. This critical period, often referred to as the antenatal (before birth) and postnatal (after birth) stages, brings significant physical, emotional, and psychological changes. For many, this transition to parenthood is a time of profound emotional upheaval, involving both joyful and overwhelming experiences as parents adjust to new roles and responsibilities. Perinatal mental health issues can arise for the first time or pre-existing conditions can intensify during this period, affecting both mothers and fathers in distinct ways.

It is estimated that between 15% and 25% of women¹ and approximately 1 in 10 men experience mental health challenges during the perinatal period.² For mothers, perinatal mental health encompasses a range of diagnosable conditions that may arise during pregnancy or after birth, from postnatal anxiety or depression, obsessive-compulsive disorder, and post-traumatic stress disorder (PTSD), to more severe conditions such as postpartum psychosis, severe depressive illness, schizophrenia and bipolar illness. While maternal perinatal mental health issues are more widely studied, there is increasing awareness of paternal mental health challenges. Paternal perinatal depression and anxiety are the most recognised forms, with research showing that maternal and paternal mental health are often interdependent. For instance, maternal depression is one of the strongest predictors of paternal depression, and mothers whose partners are depressed are over 4 times more likely to experience worsened depressive symptoms within the first 6 months after childbirth.³

Parental mental health during this period is critical for the wellbeing of the child, as unresolved issues can have long-term consequences on child development. The first 1,001 days of life, from conception to the age of 2, are particularly crucial for brain development, with early experiences shaping a child’s physical, cognitive, and emotional growth. Healthy interactions between parents and their child during this time lay the foundations for emotional resilience, social skills, and academic success later in life. Conversely, untreated perinatal mental health issues can hinder bonding and attachment which can lead to consequences for the child’s physical, cognitive and emotional growth, potentially impacting them for the rest of their life and those of future generations.⁴

Childbirth and early parenthood are often idealised as a time of great joy and happiness, however, these periods are also marked by intense stress, sleep deprivation and adjustment to significant lifestyle changes. Mental health challenges during this time can cause profound distress and may interfere with a mother’s ability to care for her newborn or her other children, as well as her relationship with her partner. Societal and cultural expectations surrounding parenthood can add to this pressure, often resulting in parents feeling afraid or wary of seeking support. Fear of stigma, judgement, and concerns regarding potential intervention from social services may prevent parents from disclosing how they are feeling.⁵

Addressing perinatal mental health is essential not only for individual and family wellbeing but also for population health. Accessible and early intervention in perinatal mental health can mitigate potential negative outcomes, reduce health inequalities, and lessen long-term societal costs. Mental health problems during pregnancy and the postnatal period are a leading cause of maternal mortality, contributing to 15% of maternal deaths in pregnancy and the first 6 months postnatal.⁶ More than half of these maternal deaths involve women with a history of severe mental illness, with suicide being a significant cause.

The financial cost of perinatal mental health conditions in the UK is estimated at £8.1 billion for each 1-year cohort of births, with nearly three quarters (72%) of this cost associated with adverse impacts on the child rather than the mother.⁷ These costs include health and social care expenses, productivity losses, and additional educational and social service needs, all of which highlight the broader societal impact of untreated perinatal mental health issues.

Derbyshire’s focus on perinatal mental health forms part of a comprehensive approach to population health, addressing these challenges through prevention, early intervention, and accessible support for all families. By prioritising mental health throughout the parenthood journey, Derbyshire aims to create a supportive environment for families to feel able to seek and receive help when needed, to enable them to flourish.

Why is it important to Population Health?

Perinatal mental health is important to population health for many reasons:

Easily available and accessible perinatal mental health support for parents is critical right from the start of the parenthood journey. Early intervention to support families through pregnancy, birth and into childhood is vital not only to improve the outcomes for parents, but also to minimise the negative impacts on the unborn or developing baby/child.

The management of mental health during the perinatal period differs from at other times because of the nature of the life stage and the potential impact of any difficulties and treatments on the woman and her baby. Mental health problems in pregnancy and the postnatal period may often need more urgent intervention than they would at other times because of the potential effect on the baby and on the woman’s physical health and care, and her ability to function and care for her family.

Impact on individual: Untreated perinatal mental health problems contribute significantly to maternal morbidity and mortality. Perinatal psychiatric disorders have been among the leading causes of maternal deaths for the past two decades, accounting for 15% of all maternal deaths during pregnancy and within the first 6 months postpartum.⁸ Tragically, over half of these maternal deaths involve women with a history of severe mental illness, and suicide is a leading cause among these deaths, underscoring the importance of early detection and treatment.

Impact on infant: We know the first 1,001 days of life are critical for brain development; healthy interactions between a baby and their parents during this vital period of time set the foundations for a baby’s cognitive, emotional and physical development.⁹ Babies are also incredibly vulnerable during this time. They do not have the language skills to advocate for themselves so carers must do so for them. Parents who are struggling with their own mental health during this time are less able to adequately do so and less able to be appropriately attuned to their infant’s needs, hindering attachment and bonding. Children of parents experiencing perinatal mental illness are at increased risk of prematurity and low birth weight, irritability and sleep problems in infancy, and behavioural problems and academic difficulties when they get to school.¹⁰

Impact on family: Perinatal mental health issues affect not only the parent and child but the wider family as well. There is a strong correlation between maternal and paternal depression during the perinatal period, and this shared mental health burden can strain relationships and family dynamics. Insecure or poor attachment between parents and children can lead to lifelong adverse physical and mental health outcomes.¹¹ Support for both parents during this period is essential for building healthy family relationships and reducing inter-generational impacts.

Economic and societal implications: The societal costs of perinatal mental health issues are substantial. In the UK, these conditions carry an estimated long-term cost of £8.1 billion for each annual cohort of births, with nearly three quarters (72%) of these costs due to the impact on the child rather than the mother.¹² For Derbyshire, this includes costs associated with pre-term births, infant deaths, special educational needs, academic challenges, and mental health issues such as depression, anxiety, and behavioural problems. In addition to health and social care expenses, the economic impact of lost productivity and ongoing social support needs, underscores the importance of effective, early perinatal mental health support.

The Derbyshire Population Health Approach

The Derbyshire Population Health Approach focuses on prevention, population health, evidence-informed practices, causes, and collaboration. It emphasises proactive measures to prevent health issues, tailors interventions to specific populations, incorporates evidence-informed practices, addresses underlying causes, and promotes collaboration for effective action.

When considering the topic of perinatal mental health within The Derbyshire Population Health Approach:

• Prevention

Ensuring positive outcomes for parents and infants starts well before conception and continues throughout the perinatal period. Proactive, preventive care strategies, such as health education, screenings, lifestyle support, and early interventions, play a critical role in promoting the health of parents and their children.

Preconception

Supporting healthy pregnancies begins with comprehensive care for individuals of reproductive age, regardless of gender, socioeconomic status, or age. Good preconception health can reduce the risk of complications, including birth defects, prematurity, and low birth weight. For individuals who may not actively prevent pregnancy, addressing health behaviours like smoking, alcohol consumption, or unmanaged physical and mental health conditions can help avoid complications from unplanned pregnancies. The Derbyshire Preconception toolkit offers practical resources for professionals working with groups at risk of unplanned pregnancies, those considering pregnancy, or those already expecting. This toolkit encourages open conversations about emotional and mental wellness and highlights the importance of accessing support early on.

Antenatal

Throughout pregnancy, Derbyshire Midwives routinely assess emotional wellbeing during antenatal and postnatal appointments, offering a vital opportunity to identify and address mental health concerns. A number of studies have shown that many women who have postnatal depression have symptoms of depression in pregnancy and therefore can be identified antenatally, these checks therefore offer opportunity for early intervention and reduction of longer term risks for mum and baby¹³. Identifying perinatal mental health challenges at this stage allows for timely support, reducing long-term risks to both mother and child¹⁴.

Midwives explore perinatal history, any previous mental health concerns and any new thoughts or feelings with each woman in their care. They utilise question-based assessments to identify any additional support or help required and can refer to additional specialist support. Any individuals flagged for additional support receive continued care from their Community Midwife, who may coordinate further resources if required.

The antenatal contact is a key part of the support provided by the Derbyshire Community Health Services 0-19 Health Visiting Service. Health Visitors use their experience and judgement in addition to relevant observational question based tools to assess the emotional health and wellbeing of the mother, and take appropriate action based on the results of those assessments, including referral to more specialist support as necessary. Health Visitors explain what support women and families will receive postnatally and discuss emotional health with them, including what to do if they feel low or anxious. Health visitors can utilise these visits to discuss any relevant area of support that may help the family.

In addition to their own assessments, Midwives and Health Visitors liaise together if any additional support needs are identified as part of a team approach to ensure the family is well supported.

Antenatal classes are offered to help support families to prepare for parenthood.

Postnatal

After birth, the Derbyshire Community Health Services 0-19 Health Visiting Service assumes a primary role in supporting families through the early years. This service is integral to the delivery of the early years elements of the Healthy Child Programme and provides emotional health & wellbeing support tailored to Derbyshire families. Health Visitors, all of whom receive specialist training in parent-infant mental health, continue to assess the emotional wellbeing of parents during each mandated contact, utilising question based observational tools. This applies to the mother but also the father if present during their visits.

Some parents identified as needing extra help can be offered additional set of emotional wellbeing visits from their Health Visitor. Information on additional support for all such as the “My Baby & Me” Emotional Health & Wellbeing groups and any feeding support required is offered providing them with further resources and peer support.

Additional support is provided to families who require more help through the Intensive Home Visiting Service, this is a specialist health visiting service offered by Derbyshire Family Health Service and includes more frequent contacts and a range of other public health interventions, all delivered within the service to increase continuity of care for the child and family.

During this time, infant feeding can have a complex relationship with, and impact on, mental health. The demands of breastfeeding can impact on maternal mental wellbeing, issues with breastfeeding can lead to feelings of guilt and inadequacy, feeding difficulties can lead to intense distress both for the infant and mother and unaddressed maternal mental health issues may result in the mother feeling unable to identify or achieve her own feeding goals.

In recognition of the importance of supporting families with their infant feeding choices.  Health Visitors support families to make informed decisions regarding how to feed their baby. They help families to identify their thoughts and feelings on the topic and share relevant information that can help with decision making. No-one is pressured to feed in a particular way. It is recognised that many different factors will affect decision making.

For those that do choose to breastfeed, Derbyshire Family Health Services are committed to supporting mothers do so, and helping them to sustain that choice. They are guided by the principles of UNICEF Baby Friendly Initiative and in February 2014, along with Derbyshire County Council Children’s Centres, Derbyshire Family Health Services were awarded full Baby Friendly accreditation. They undergo Baby Friendly re-accreditation every 3 years to ensure maintain the standards set by UNICEF. This means that across Derbyshire, breastfeeding is supported and protected.

Derbyshire’s 0-19 Service launched a public communications campaign in 2024 addressing the mental health challenges many parents experience during early parenthood. This campaign offers practical self-care tips and resources, including podcasts, and more details can be found on the Derbyshire Family Health Service’s Parent and Carer Mental Health webpages.

For individuals experiencing more complex mental health issues during or after pregnancy, the Derby & Derbyshire Perinatal Mental Health Service provides specialist care. This service comprises two community teams, one serving southern Derbyshire and the other the north, both offer assessment and treatment within the community provided by a multi-disciplinary team consisting of a consultant psychiatrist, community psychiatric nurses, occupational therapists, psychologists and a nursery nurse.

The Service also includes a self-contained, specialist inpatient facility, called ‘The Beeches’, based at the Royal Derby Hospital site for mothers who experience severe mental health illness without separating them from their baby. The Beeches can accommodate up to six mothers with their babies. Women can be admitted from 12 weeks of pregnancy up to 1 year after giving birth.

Women can access the Perinatal Mental Health Service through self-referral or professional referral, ensuring flexible pathways to care.

Parent Infant Relationship Support

Importantly, in addition to supporting the mental health and wellbeing of the parents, Health Visitors also hold in mind the experience of the baby and how that relationship is developing to support them with their bonding and attachment to their new baby. Babies are completely reliant on their caregivers; physical and mental wellbeing, social skills and cognitive and linguistic capabilities that develop in this period are heavily influenced by loving attachments formed between caregiver and baby. Health visitors are trained in supporting healthy parent-baby relationships though promoting an understanding of newborn babies’ communication through using the Newborn Behavioural Observation (NBO) tool. The NBO is a set of shared observations to help the practitioner and the parents together observe the baby’s behaviour. Since we know a newborn baby’s method of communicating is their behaviour, taking time to observe and understand these signs, movements and responses, means understanding what that baby is saying, who they are, what they like and what they dislike.

Additionally, a Specialist Health Visitor in Parent and Infant Mental Health is available to offer guidance and support, ensuring that any identified needs are promptly addressed.

The Derby & Derbyshire Safeguarding Children Partnership prioritises infant safety, developing resources to support any professional working with new families. The Keeping Babies Safe observational tool, supports practitioners to have those early conversations with families about their relationship and parenting of the baby, helps them consider the lived experience of the baby and identify any areas where a family would benefit from additional support.

Baby loss

The Maternal Mental Health Service provides specialist support for women who have experienced baby loss and have associated mental health concerns around the loss of the baby or other concerns such as trauma related to birth, anxiety around pregnancy or tokophobia (fear of childbirth). There is also specialist support for women with neonatal loss or trauma.  

Additional support

Derbyshire Maternity and Neonatal Voices is an independent NHS committee made up of volunteers, parents, midwives & health care providers, representatives from local charities. and community groups. We listen to feedback and experiences of maternity and neonatal services and work together to improve maternity and neonatal care in Derbyshire.

The Derby & Derbyshire Perinatal Mental Health Partnership Group, established in January 2022, unites local partners to improve care for those experiencing mild to moderate perinatal mental health issues. This partnership promotes system-wide collaboration to drive improvements in perinatal services, ensuring that Derbyshire families receive coordinated, high-quality support.

• Population

Perinatal mental health issues can affect all demographic groups, but certain populations face significantly higher risks and additional barriers to accessing care. This section considers disparities in vulnerability, service access, and support, which highlights the importance of addressing health inequalities to achieve equitable perinatal mental health outcomes.

Some of the specific populations that are considered to be at a higher risk of experiencing perinatal distress are highlighted below:

• Previous mental health conditions: Women with a history of mental health challenges, particularly those with severe pre-existing disorders, are at increased risk of experiencing mental health deterioration after childbirth.¹⁵ The perinatal period can amplify previous vulnerabilities, necessitating targeted, proactive support for those with known histories of mental illness.
• Pregnancy following perinatal loss: Experiencing a loss in pregnancy or of a baby has a profound effect on parents and may contribute to intense psychological distress including grief, PTSD, anxiety and depression. The subsequent pregnancy may also be perceived as more stressful due to the fear of recurrent loss.¹⁶
• Childhood abuse or trauma: Experiences of childhood trauma, particularly sexual abuse, are linked to a heightened risk of perinatal mental health issues. Pregnancy and the transition to parenting can be highly triggering for these individuals, often resurfacing unresolved trauma and requiring specialised mental health support.¹⁷
• Domestic or gender-based violence: Women who have experienced domestic, emotional, psychological, or sexual violence are at greater risk of developing perinatal mental health issues. Supportive interventions must be trauma-informed to effectively address the unique challenges faced by these individuals.
• Socioeconomic disadvantage: Living in poverty, insecure housing, or unstable employment conditions can create chronic stress, which is further intensified during pregnancy and the perinatal period. These stressors are linked to both increased risk of mental health issues and reduced access to consistent care, amplifying health disparities. Additionally, those experiencing social isolation or limited family support may struggle more with mental health issues and are less likely to seek help when needed.
• Unplanned or unwanted pregnancy: Unplanned pregnancies can pose additional psychological challenges, particularly for those without adequate emotional or financial resources. Such circumstances may elevate the risk of anxiety and depression, making it essential to ensure these individuals have access to supportive resources.
• Uncertain migration status: Migrants, especially those with uncertain or temporary status, often face unique barriers, including limited social support networks, language barriers, and fear of discrimination. These factors can prevent them from seeking necessary perinatal mental health care.

Health inequalities and service access

People experiencing socioeconomic disadvantage are also more likely to encounter health inequalities, as they are often less likely to have their mental health issues recognised or treated within the healthcare system.¹⁸ These barriers contribute to a disproportionate burden of perinatal mental health conditions among disadvantaged groups, perpetuating cycles of poor health and limited access to resources.

Support for ethnic minority populations

In addition to groups that experience an increased risk of developing perinatal mental health concerns, there is a general lack of recognition of poor mental health and its signs and symptoms during and after pregnancy and birth. When considering perinatal mental health care, this is particularly the case for women of ethnic minority background, who face a variety of barriers which prevents them from accessing appropriate perinatal mental health care.¹⁹ Concerns such as a lack of awareness about mental ill health, cultural expectations, ongoing stigma, culturally insensitive and fragmented health services and interactions with culturally incompetent and dismissive health providers, all impact on ethnic minority women’s ability to receive adequate perinatal mental health support in the UK.²⁰

Addressing Fathers’ mental health needs

Fathers and partners also experience significant psychological distress during the perinatal period but may struggle with acknowledging their own needs, often feeling that doing so detracts from their partner’s wellbeing. Many fathers hesitate to seek support, both due to societal expectations and fears of stigma.²¹

Local initiatives

Action to address the issue of health inequalities across the Derbyshire workforce is underway through the launch of Quality Conversations training.  This is available to anyone working in the health, social care, and community, voluntary and social enterprise sector in Derby and Derbyshire. The training specifically focuses on understanding health inequalities and how they impact across Derby and Derbyshire, and learning how to effectively help and support those facing or experiencing health inequalities, to overcome these barriers.

In Derby and Derbyshire, all fathers receive access to DadPad through their health visiting service, offering resources and guidance on mental health during early parenthood. The DadPad is best utilised as early as possible during pregnancy, around birth and beyond, and provides guidance for babies and children up to the age of 2. It’s particularly useful to have during paternity leave. The DadPad aims to:

• Help fathers develop the necessary mindset and practical skills to care for their baby.
• Support fathers to quickly get to grips with their new responsibilities.
• Reduce anxiety and help develop fathers’ confidence.
• Give fathers the tools to provide the best support for their baby and their baby’s mother.

Additionally, the voluntary sector provides further support through various initiatives aimed at addressing the mental health needs of fathers and partners (Derby & Derbyshire Emotional Health and Wellbeing Website).

Talking Therapies services (which used to be known as Improving Access to Psychological Therapies – IAPT services) are psychological therapy services tailored to people’s needs and include talking therapies, group approaches, couples therapy and self-help support for people who experience anxiety and depression. There are four providers of Talking Therapies in Derbyshire and they all fast track referrals received from pregnant or new mothers.

Maternal mental health service

Parents who have experienced bereavement or trauma during pregnancy are now able to receive specialist support from Derbyshire Maternal Mental Health Service.

Here in Derbyshire, a recognition of barriers to specific ethnic and socioeconomic groups receiving the mental health support they need around the time of having a baby, has resulted in the creation of perinatal outreach workers, who specifically work to try to reach out into communities to increase awareness and access to perinatal support.

• Evidence

Mental health challenges during pregnancy and the postnatal period are a significant concern, requiring immediate and effective intervention to improve outcomes for mothers, fathers/partners and their babies. These challenges can have far-reaching impacts, affecting maternal well-being, child development, and family dynamics. Early identification and support are critical to mitigating these effects.

NICE guidance emphasises the importance of providing timely mental health support for women during the perinatal period.²² This is particularly critical for those with pre-existing mental health conditions, such as severe depression, psychosis, schizophrenia, bipolar disorder, or schizoaffective disorder. For these individuals, proactive care starting in the preconception period and continuing through pregnancy and the postnatal period is strongly recommended. Research consistently shows that without adequate support, the risk of relapse or deterioration in mental health is significantly heightened. Clear pathways to ensure timely access to good quality perinatal mental health care have been set out in national guidance.²³ The NHS Long Term Plan (2019)²⁴ set additional goals for expanding and developing specialist perinatal mental health services by 2023/24, these goals are set out below:

• Increase access to evidence-based care for women with moderate to severe perinatal mental health difficulties and a personality disorder diagnosis, extending care from preconception to 24 months after birth.
• Expand access to evidence-based psychological therapies, including parent-infant, couple, co-parenting and family interventions.
• Fathers/partners of women accessing specialist perinatal mental health services offered an evidence-based assessment for their mental health and signposting to support as required.
• Maternal mental health services (MMHS) will integrate maternity, reproductive health and psychological therapy for women experiencing mental health difficulties directly arising from, or related to, the maternity experience.²⁵

The importance of universal support is also highlighted in national policy.²⁶ While targeted interventions for women with diagnosed conditions are vital, emotional and mental health support should be offered to all families during this time. This is crucial to address issues such as stress, anxiety, or mild depression that may otherwise go unnoticed but still impact maternal and child outcomes.

Perinatal peer support is an evidenced based intervention shown to provide support for families during this time. Peer support links new parents with trained peers who have lived experience of perinatal mental health difficulties. Peer support has been shown to reduce social isolation, improve self-esteem, and enhance parenting confidence, particularly in mothers. These benefits align with the principles of person-centred care, addressing not only clinical needs but also emotional and social well-being.²⁷

Evidence on infant feeding and mental health

There continues to be gaps in evidence and provision which results in persistent inequity and which requires continued effort to address;

• Access to perinatal mental health services, including peer support, remains inconsistent and varies across the country.²⁸
• As described, many women experiencing mild to moderate mental health issues during pregnancy or after birth may not seek help, resulting in unmet needs.
• Similarly, fathers and partners often seek to minimise or hide their distress due to a variety of factors including stigma, also resulting in unmet need.

• Causes

Perinatal mental health challenges arise from a complex interplay of individual, social, and environmental factors. Understanding these underlying causes is essential to addressing barriers to treatment and supporting comprehensive interventions.

Fear of judgement

Many women are reluctant to disclose their mental health struggles due to stigma. Societal pressures around the time of having a baby and expectations of being a ‘perfect mother’ can lead to women feeling that they will be judged as unfit if they reveal how they are really feeling, and have concerns about their baby being removed from their care. These fears can delay mothers from seeking timely help, exacerbating their condition further.

Practical barriers also play a role. The demands of caring for a newborn can leave mothers with little time to focus on their own well-being, further delaying the acceptance and pursuit of treatment. This is compounded by a lack of awareness of why they feel this way, or what support might help them, leaving many feeling isolated and unsupported. Research indicates that approximately half of all cases of perinatal depression and anxiety go undetected, with many failing to receive evidence-based treatment.

As described above, to specifically promote open discussion of mental health around the time of having a baby, Derbyshire’s 0-19 Service launched a public communications campaign addressing the mental health challenges many parents experience during early parenthood. This campaign offers practical self-care tips and resources, including podcasts, and more details can be found on the Derbyshire Family Health Service’s Parent and Carer Mental Health webpages.

History of mental health illness

As described previously, women with a history of depression or antenatal depression are at a higher risk of developing postnatal depression. Bipolar disorder is strongly associated with postnatal psychosis. However, 50% of women who develop postnatal psychosis have no prior history of mental illness. Women in Derbyshire who are already under the support of the Community Mental Health Service are referred to the Specialist Perinatal Mental Health Service if they become pregnant.

Social and economic determinants

Social and economic factors are significant contributors to perinatal mental health problems. Poverty, unemployment, and financial instability create a heightened sense of stress, increasing the risk of depression and anxiety. Women in these circumstances may face additional barriers to accessing care, such as the cost of treatment, lack of childcare, or limited transport options.

Migration and low social support are also critical risk factors. Women who have migrated may face language barriers, cultural stigma, and isolation from family or community networks, all of which heighten their vulnerability. Similarly, those with limited social support - whether from partners, friends, or family - are at an increased risk of developing mental health issues during pregnancy and the postnatal period. This is particularly relevant within Derbyshire given the rural nature of the County; families may feel that they are geographically isolated from support systems. Public transport can be infrequent or difficult to access with young children. Access to services is inevitably more difficult given these challenges.

Environmental and traumatic risk factors

Exposure to violence - whether domestic, sexual, or gender-based - represents a major risk factor for perinatal mental health challenges. Women living in emergency or conflict situations, or those who have experienced trauma such as natural disasters, are particularly vulnerable. These situations compound stress and can lead to long-term mental health issues, including post-traumatic stress disorder (PTSD).

Bereavement, such as miscarriage, stillbirth, or neonatal death, significantly increases the likelihood of mental health problems for both parents. The loss of a child can lead to profound grief and trauma, making professional support essential during and after such experiences.

Implications for intervention

Addressing these causes requires a multifaceted approach that incorporates:

• Reducing stigma through public awareness campaigns and promoting open discussions around perinatal mental health.
• Expanding access to affordable and culturally competent mental health services, particularly for marginalised groups, such as migrants and low-income families.
• Integrating trauma-informed care into perinatal services to support women who have experienced violence or bereavement.
• Providing flexible, family-centred care models that account for time constraints and the care giving responsibilities of mothers.
• Ensuring appropriate, quality and timely emotional and mental health support is offered to all families around the time of having a baby.

By understanding and addressing these underlying factors, policies and interventions can be better tailored to the diverse needs of women and families, ensuring more timely and effective care.

• Collaboration

Collaboration amongst all organisations, professionals, sectors and stakeholders involved with new families is vital to ensure effective, timely perinatal mental health support. The involvement and inclusion of those receiving care is vital to put them at the heart of designing care to deliver their needs. The diverse needs of women, their babies, and families during the perinatal period has been clearly outlined above. To ensure services are integrated, accessible, and aligned with the needs of the families of Derbyshire, collaboration is essential.

The nature of perinatal mental health supporting the mental health needs of mothers, fathers, partners, the unborn or new infant as well as taking into consideration the mental health impacts on the wider family unit, inevitably means that collaboration across sector, organisations and professionals is vital.

Working in strong collaboration has a huge range of benefits. It means that the physical, emotional, and social aspects of health can be considered in an integrated manner. Efficiencies can be realised through reducing duplication and ensuring that services are delivered where they are most needed. Inequity and barriers can be tackled through developing diverse networks to access hard to reach groups and communities. Finally, combining expertise and resources together can create interventions with greater reach and effectiveness.

Existing partnerships in Derbyshire

The East Midlands Perinatal Mental Health Provider Collaborative is a partnership to deliver high quality care for pregnant women and new mothers with serious mental illnesses who require admission to a Mother and Baby Unit, and to ensure seamless support between Mother and Baby Units and community perinatal mental health teams. The collaborative, which launched in October 2023 and is led by Derbyshire Healthcare NHS Foundation Trust, ensures that experts by experience are integral to both the planning, development and delivery of inpatient services at the region’s two Mother and Baby Units. The collaborative partners include community perinatal service providers, so there will be an opportunity to bring together decision-making on inpatient services from providers across the whole pathway, and work closely with community teams to connect services and improve quality.

Derbyshire Perinatal Mental Health Services hold an annual Stakeholder Event to bring partners and stakeholders together to share ideas, evaluate and help shape the future of the Service.

Derby & Derbyshire Perinatal Mental Health Partnership

The purpose of the group is to improve universal mild to moderate perinatal mental health support in Derby and Derbyshire, including fathers and co-parents. In Derby, this will be driven through the Family Hub governance arrangements, in Derbyshire through the Integrated Care System.

Key aim of the group:

• Develop a shared understanding of the existing and planned systemwide universal, primary, and secondary perinatal mental health support pathway across Derby and Derbyshire.
• In response to identified needs, improve the universal perinatal support provided by improving workforce capability, supporting workforce capacity, or enhancing existing services.

Derbyshire Maternity and Neonatal Voices Partnership

Derbyshire Maternity and Neonatal Voices Partnership (MNVP) is an independent NHS working group, led by people with experience of local maternity and neonatal services. They work with parents, health care professionals, commissioners and charities to help shape and improve local maternity and neonatal services.

A key role of the MNVP is to provide opportunities for all service users to share their experiences and for MNVP to listen to what they are telling us needs to change. However, its function is more than simply to listen; it is a way of discussing challenges across Derby and Derbyshire and finding ways to overcome them through co-produced work with a shared goal of improving maternity and neonatal care.

Wider Voluntary and Community Sector

There is a huge network of community and voluntary organisations offering support for families around the time of having a baby. From pregnancy support, mum and baby groups and dads groups, the role that community support plays is invaluable. Communities are able to search for support local to them through the Derby & Derbyshire Emotional Wellbeing Support website and the Rethink Mental Health Support map, amongst many other more local community directories.

Collaboration is essential to addressing the multifaceted challenges of perinatal mental health. By leveraging partnerships across healthcare, social care, community organisations, and other sectors, stakeholders can ensure that interventions are holistic, equitable, and sustainable. Strengthening existing networks and embracing innovative approaches to collective action will be key to improving outcomes for mothers, babies, and families.

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Latest Derbyshire Data

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Deliveries to Women from Ethnic Minority Groups

Domestic Abuse

Family stress or dysfunction