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17 December 2014

UK: Guidance on antenatal and postnatal mental health problems

New guidance from the National Institute for Health and Care Excellence (NICE) recommends more support for women suffering from a fear of childbirth and those who have experienced a traumatic birth or miscarriage.

The updated NICE guidance, released on 17 December, states that women who suffer form tokophobia (an extreme fear of childbirth) and those who have experienced a traumatic birth, stillbirth or miscarriage should be offered extra support. The guidance covers a wide range of mental health problems in the antenatal and postnatal period, and states:

• Women with tokophobia should be offered the opportunity to discuss their fears with a specialist healthcare professional, and references recent guidance that states requests for planned caesarean sections should be respected
• Extra support and advice should also be offered for women who have had a traumatic birth, stillbirth or miscarriage, and healthcare professionals should also take in to account the impact on a woman’s partner.

While there is growing awareness and recognition of mental health problems in pregnancy and the postnatal period, NICE acknowledges that under-diagnosis and under-treatment remains a problem, and that many women feel unable to disclose information because of stigma and fears that their baby may be taken in to care. A survey from the Royal College of Midwives found that 60% of midwives feel they do not have enough time and resources to support women’s mental health needs in the postnatal period.

Clare Murphy, Director of External Affairs at BPAS, said:

“It is deeply troubling when we see women who feel they cannot continue with a pregnancy because they suffer from tokophobia or because of a traumatic experience of childbirth in the past.

“Access to specialist support will of course be important in addressing the needs of women suffering from tokophobia or birth trauma, but we know it is also vital that women are offered support and choice around how they give birth, whether that is deciding to give birth at home, ensuring they have access to effective pain relief or planning an elective caesarean section. Supporting women’s choices around their care enables women to feel more involved and empowered during pregnancy and labour, and can help to prevent further distress or trauma.”

New guidance on support for pregnancy mental health. BPAS press release, 17 December 2014