ABSTRACT
The background to mental health and midwifery 161 Defining mental health and mental health promotion 163 Factors affecting mental health 165 Vulnerable groups 165 Factors that may affect maternal mental health 167 Attitudes and mental health 168 The effects of mental health loss 168 The role of the midwife 169 Summary of key points 172 References 172 Further reading 175 Website 175
Mental health and mental ill-health have become a central aspect of care within midwifery in recent years, especially with the recent data from the sixth report Why Mothers Die (Lewis and Drife 2004) indicating that mental ill-health is now the leading cause of death in a pregnant or postpartum woman. Midwives, as the lead professionals for most of the care provided by maternity services in the UK, need to have a greater awareness of mental health and its impact on a woman’s health, which extends beyond just knowledge of the ‘baby blues’, postnatal depression and puerperal psychosis. They need to develop skills in mental health promotion as well as skills to assess and refer women accordingly. However, mental health, and in particular mental ill-health, suffers from prejudicial and stigmatizing attitudes (Crisp et al. 2000, Royal College of Psychiatrists (RCOP) 2000). Add to that the taboo nature of maternal suicides and the need to move emotional care beyond a superficial level and difficulties arise. Midwives, similar to everyone else, have their own personal constructs, attitudes, and ethical and moral judgements about mental health, which can and will impact on this area of care. This chapter explores these issues and examines the effects that mental health loss has on the relationship of the woman and her partner and their baby, and identifies the role of the midwife in mental health promotion, screening for mental ill-health and supporting women when they become mentally unwell.
