Guest blog by Clare Anderson, Mas Project Coordinator, Women’s Resource and Development Agency
Who is MMHA’s new member WRDA?
The Women’s Resource and Development Agency (WRDA) has a vision of a fair and equal society where women are empowered and are a visible force for change and influence in all areas of life. The Mas project (Maternal Advocacy & Support), in partnership with eight women’s centres in the Belfast, Lisburn and Derry area, offer peer support to women who are experiencing perinatal mental health problems. The project also provides a platform for women to talk about their experiences in the healthcare system and identify service areas that could be improved or developed for pregnant and postnatal women in Northern Ireland. 
Working with and for women
To date, WRDA has talked to women across the eight Mas groups about their experiences and held an event with Mas advocates to map out a vision for change. They are planning a public event on 30 November 2021 to highlight some of the key service area improvements and invite decision-makers to hear directly from women with lived experience.
Some of the issues that women attending the Mas project have raised:
1. Continuity of care
Experiences spanned both staff and advice, where women felt that opportunities for early identification of perinatal mental health problems and support were missed. When women experienced poor communication, it impacted rapport-building and trust, which led to a reluctance to share concerns and worries.
2. Breastfeeding advice and support
Women felt that the feeding advice given was unsatisfactory, inconsistent and was further exacerbated by the pandemic due to a lack of family support. Many women felt pressured to breastfeed but found support lacking when they expressed interest.
Northern Ireland has the lowest rates of breastfeeding in the world. Data indicates a significant drop in breastfeeding at discharge, starting at 46% and dropping to 14% after just six months (2017). Public Health Agency data also highlights health inequalities associated with breastfeeding, with women from the most deprived areas found to have the lowest breastfeeding rates.
There are breastfeeding support groups in the community, in Sure Start centres for example, but they are only helpful if you know about them and at the right time. Receiving feeding support in the hospital was considered to be crucial. Many women reported spending their first hours as a mum in the hospital alone and stressed that their baby was not getting enough milk.
3. Miscarriage and bereavement
Women felt that there is a lack of acknowledgement of baby loss and did not feel supported following a loss. They also suggested that there needs to be greater community and public visibility of baby loss at all stages of gestation.
4. No Mother and Baby Unit (MBU) in Northern Ireland
Northern Ireland is still the only part of the UK without an MBU. Therefore, women in need of in-patient care must sadly be separated from their babies. The business case for an MBU in Northern Ireland is still under development and is very much needed to support women with the highest levels of need.
5. Knowing your Voluntary and Community Sector: signposting and support
The Mas project is pleased that specialist perinatal mental health services are currently being set up in Northern Ireland but are mindful of the strict criteria. Therefore, women who do not meet the threshold will primarily be supported by primary care. Some women were only offered medication and/or the counselling waiting list was too long.
It is therefore essential that communication and referral pathways are improved between healthcare professionals (GPs, health visitors, and midwives) and the voluntary and community sector. The women shared some examples of referrals, mainly by health visitors, but they felt broadly that healthcare professionals need to be more aware of provision outside of formal healthcare so that women can get the help they need when and where they need it.
Tom McEneaney from AWARE says:
“This is an exciting time in Northern Ireland for perinatal mental healthcare and it’s great to be part of the MAS project. Its presence in Northern Ireland is very welcomed and timely.
“The development of the perinatal peer support groups will be a great resource for parents struggling with perinatal mental health issues and alongside the implementation and rollout of the specialist perinatal mental health teams, this will bring much-needed support.
“The MAS project, combined with other Voluntary and Community Sector organisations, will be a great resource for the specialist teams to signpost clients to for support and for the MAS project to be part of the development of an integrated perinatal mental health pathway for all parents.
“The Maternal Mental health Alliance’s new ‘Make all care count’ campaign seeks for better perinatal mental health services for all across the stepped care model of prevention, early intervention and recovery. We look forward to our continued collaboration with WRDA and the MAS Project over the coming months and years ahead.”
The Mas Project’s wishlist for change includes:
- A Mother and Baby Unit in Northern Ireland
- Increased awareness of perinatal mental health leading to stigma reduction
- Training for all healthcare professionals working with women in the perinatal period
- Continuity of care: a concerted effort to see the same staff member where possible
- Acknowledgement of baby loss and grief following miscarriage, stillbirth and neonatal loss
- Localised leaflet so that healthcare professionals can refer to community/voluntary organisations to help women access support sooner
- Long-term funding for projects like Mas
- Increased counselling availability.
Next steps for the Mas project
Conversations have taken place with the Royal Maternity Hospital who informed us that Continuity of Care is being developed for Northern Ireland. We are also pleased to have joined the Maternity Liaison Committee and look forward to collaborating. In addition, we have liaised with multi-disciplinary teams in West Belfast in the hopes of bridging some of the gaps in care by providing an array of services from the GP surgeries. We look forward to the rollout of this service across Northern Ireland aimed at improving client satisfaction and well-being.
The WRDA is keen to work with others to support the progression of these changes. We are having a Mas public event online on Tuesday 30th November at 10am that will highlight the voice of women with lived experience. For further information, please contact Clare Anderson: firstname.lastname@example.org.