Maternal mental health during a pandemic: A rapid evidence review of Covid-19’s impact

We call on the Department of Health and Social Care in England, and the equivalent bodies in the devolved nations, to conduct an immediate assessment of the level of need for perinatal mental health services in light of the impact of the pandemic. Previous assumptions will need to be updated to reflect higher levels of need as a consequence of the crisis. This is essential to get the right services and workforce in the right places as soon as possible.

We are calling on the UK Government and devolved assemblies to guarantee a minimum high standard of mental health care and support for pregnant women and mothers of young infants. We want to ensure that perinatal mental health staff numbers are maintained, and where staff redeployment proves necessary in a crisis, mental health services must be maintained.

NHS Digital and equivalent bodies in each of the devolved nations should collect and publish routine data on the mental and physical health of women during the perinatal period. This should include data on the uptake of perinatal mental health services, on deaths from all causes, and on hospital admissions. Data must include robust monitoring across equality groups to identify inequalities in prevalence, experience and outcomes.

The NHS in all four nations needs to address the disparity in maternal mental health outcomes caused by the crisis, and by longer-term issues, for women of colour. In England, this should be included within the Advancing Mental Health Equalities strategy and the Patient and Carer Race Equality Framework.

We are calling on those funding and conducting research across the UK to prioritise understanding the longer-term emotional and psychological impacts of the pandemic on young families. This might include research with women with existing mental health difficulties, and groups that have been particularly affected by the pandemic. We need to hear from particularly vulnerable groups of women, and groups whose voices are seldom heard. We recommend research on the impact of women’s mental wellbeing on their partners and infants, and research on partners’ mental wellbeing and the impact this can have on women.

Where face-to-face services have been replaced by remote services, we must understand how they work and whether there is an impact on quality, choice, patient satisfaction and most of all whether they help people deal with their mental health issues. We are calling on the NHS to fund new research, to ensure those women who do not have access to digital technology get the support they need, and to make sure digital options are not a way to save money at the expense of face-to-face consultations and therapies.

NHS organisations commissioning mental health services must recognise and value the role of voluntary and community organisations in meeting women’s mental health needs during the perinatal period. We are recommending that funding should extend beyond short-term support for projects and initiatives, to provide organisations working in communities with stable long-term support and help with core costs and adaptations during crises.

NHS employers in all parts of the UK and in every organisation must support the mental health and emotional wellbeing of staff working with women and families during the perinatal period, recognising the risk of exhaustion, anxiety, depression and post-traumatic stress disorder (PTSD) created during the pandemic.