Almost 20,000 women a year living with mental health problems triggered by being pregnant or giving birth are being denied support by the NHS, the Guardian can reveal.
Furthermore, those who do receive mental health help for their trauma are having to wait up to 19 months to start treatment in some parts of England because specialist services are so overstretched.
The situation has been described as “an absolute scandal” and sparked warnings that “rationing” of such vital care could leave women who do not get it in a very vulnerable state and risk their children facing lifelong health problems and stop mothers bonding with their baby.
One in four mothers develop a mental health problem as a result of pregnancy or childbirth, for example, because she has experienced birth trauma or lost her baby. Common conditions include postnatal depression as well as anxiety, psychosis, post-traumatic stress disorder and obsessive compulsive disorder that emerge after the birth.
The widespread refusal of help and huge delays in accessing maternal mental health care has emerged in new NHS figures obtained by Dr Rosena Allin-Khan, Labour’s former shadow minister for mental health, in freedom of information requests to England’s 54 NHS mental health trusts.
Last year 11,507 women who sought care for such problems did not get any after they had been assessed, according to figures provided by 34 specialist trusts. But extrapolating those findings to the other 20 trusts that did not release data, despite their legal duty to do so, means that an estimated 18,953 mothers across England as a whole were denied care, Allin-Khan said.
“It is an absolute scandal that new mothers are facing long waits for mental health services and all too often end up being turned away. No mother should be left behind to suffer in silence,” Allin-Khan told the Guardian.
“We know all too well how important the first 1,000 days of a child’s life are. Failing to support new mothers during this crucial period will have an unfathomable human cost.”
During 2022-23 the Southern Health mental health trust did not provide treatment for 1,644 women seeking perinatal – or maternal – mental health care once it had assessed them. It “closed” their referral. In Essex 929 women were refused help, as were 924 in Kent and Medway.
However, only one of those who sought care from the Berkshire and Norfolk and Suffolk mental health trusts last year were denied it, according to those trusts’ figures.
Dr Alain Gregoire, the president of the Maternal Mental Health Alliance, said the “unacceptable” situation Allin-Khan had revealed was mainly due to most services trying in vain to meet demand despite having sometimes significant shortages of doctors, nurses and therapists.
“Staff are working absolutely flat-out but can’t deliver the amount of care they should be delivering. So they are having to make clinical decisions about who gets priority. No one is saying ‘don’t see this woman’. They just don’t have the capacity to do it.
“It is rationing of care at a clinical level because there just isn’t the capacity to deliver that care, largely because there aren’t enough staff.”
Maternal mental ill health is estimated to cost the NHS £1.2bn a year and society as a whole £8.1bn. Much of the NHS’s £1.2bn bill is care for children whose mothers struggled to form a close bond with them because of their maternity-related mental ill health.
The dire situation facing women struggling with such problems comes despite NHS England having created in recent years what it describes as a “world-leading programme” to expand the help available. It has set up a specialist team in every part of England and increased the number of places in mother and baby units, which treat the most seriously ill women as inpatients, for example those with postpartum psychosis.
NHS England did not respond when asked about the large number of women whose pleas for care are being rejected and the long waits that Allin-Khan uncovered or offer any explanation for them.
But Angela McConville, the chief executive of parenting charity NCT, said: “The lack of mental health support services for pregnant women and women in the postnatal period is now at a stage where we would consider them to be dangerously patchy and unreliable. Access … remains a postcode lottery.
“Services are inconsistent and poorly-resourced, with long wait times that are detrimental to the long-term health and wellbeing of new parents and their babies.”
That scarcity of NHS care means that the NCT is receiving more and more referrals for “women with increasingly complex mental health needs who cannot easily access NHS services” to the perinatal mental health services it runs itself, McConville added.
Warning signs of mental distress among pregnant women and mothers are more likely to be missed because of a recent fall in the number of specialist perinatal mental health midwives, she said.
Care delays also increase the risk of a woman taking her own life, experts warn.
A report from the annual confidential inquiry into maternal deaths published in October highlighted that “suicide is the leading direct cause of death between six weeks and 12 months after the end of pregnancy”.
An NHS spokesperson said: “Women across England are benefiting from specialist perinatal mental health support, with an estimated 51,000 new mums treated over the last year, up nearly 70% compared to three years ago, with every local health system now having access to a specialist community perinatal mental health team.”
