The following sections highlight some of the areas in which GPs may need specific information and resources to support their clinical management of perinatal mental health problems.
Culturally sensitive care
Sadness post birth occurs in all countries but is not always considered an illness. Migrant women therefore may be unable to express their feelings and present more frequently with somatic symptoms. Unfamiliarity with healthcare pathways, lack of social support, economic hardship, cultural stigma and traumatic past experiences may pose a barrier to seeking help, in addition to language.
Perinatal mental health information in other languages:
Traumatic birth and complex neonatal cases
The risk of postnatal mental health problems increases if a woman experiences a traumatic birth or if there are serious health concerns for baby. Members of the Primary Care Team should assess needs and offer support as necessary at every contact.
Pregnancy loss and neonatal bereavement can put a substantial strain on the mental health of the mother and other members of the family, in addition to the related physical issues. Primary Care staff should treat a pregnancy loss at any gestational stage with respect and sensitivity. Women should be reassured that they can attend later if they do not feel ready to discuss in the early stages.
Termination for fetal anomaly
- Antenatal Results and Choices Charity offering non-directive information and support through antenatal testing and its consequences for fetal abnormality.
Miscarriage and stillbirth
Further learning for primary care staff
Substance misuse including alcohol
Mothers who misuse substances may feel reluctant to access help due to the associated stigma and concerns about the involvement of social services. Maternal substance misuse can harm a child's development both directly and indirectly, through its impact on parenting capacity. Supportive and coordinated care is recommended in order to minimize harm to the whole family.