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Maternal and Infant Mental Wellbeing

Maternal and Infant Mental Wellbeing. Ann Kerr, Team Head NHS Health Scotland. How the work got started How the work was carried out What the recommendations are Next steps. Content. Refreshing the Maternity Services Framework. 2001 Last Maternity Services Framework

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Maternal and Infant Mental Wellbeing

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  1. Maternal and Infant Mental Wellbeing Ann Kerr, Team Head NHS Health Scotland

  2. How the work got started How the work was carried out What the recommendations are Next steps Content

  3. Refreshing the Maternity Services Framework 2001 Last Maternity Services Framework 2009 Maternity Services Action Group (MSAG) commenced revision Health inequalities and health improvement identified as key gaps MSAG workshop focus on health improvement Decision to focus on maternal and infant mental wellbeing 2010-2011 Short life working group 2011 recommendations to MSAG

  4. Working group Role and remit agreed with MSAG Membership: British Psychological Society Consultant midwives Health Promotion Managers Group Health Scotland National Childbirth Trust NHS Education for Scotland Mental Health Improvement Specialists Group Royal College of Obstetrics & Gynaecology Scottish Government

  5. Initial brief review of systematic reviews and current work Logic model Review of reviews Development of recommendations Process

  6. Definitions Context: Dyad Recommendations

  7. Recommendations cont • There should be coherence and consistency between the Parent Education Curriculum and the wellbeing components of the Curriculum for Excellence. • Parent Education and relevant parts of the Curriculum for Excellence should be integrated into Scottish Government’s wider parenting strategy • The partnership that developed the new Parent Education Curriculum (HS, NES and HIS) should ensure that its implementation and effectiveness, in terms of short and medium term outcomes, is robustly evaluated.

  8. Recommendations cont 4. The use of equipment that allows physical or face to face contact between mother and infant (such as soft baby carriers, and parent facing buggies) should be promoted. 5. Pre conceptual care should be provided by sexual health staff, general practice, maternity care and specialist mental healthcare providers in order to improve their identification and care for women who are planning a pregnancy and are at particular risk of poor mental health related outcomes.

  9. Recommendations cont 6. All interactions between antenatal service providers and pregnant women should be used to promote mental wellbeing using strengths and asset based approaches, as well as to assess risk and need. 7. Staff providing postnatal care should be suitably skilled to be able to identify and respond to signs of mental health problems, and appropriate systems and pathways should be in place to allow appropriate referral where necessary.

  10. Recommendations cont 8. Postnatal social support (which might include peer support) is anecdotally very important but this is not yet reflected in highly processed evidence. There is evidence, however, that new mothers most at risk of poor outcomes do not access group based support. 9. Interdisciplinary training in maternal and infant mental health and wellbeing should be available for all staff providing maternity care, including managers, and should incorporate shared definitions and guidance, and focus on the important contribution of maternity care to promoting and maintaining maternal and infant mental wellbeing. This should include maternal and infant attachment.

  11. Recommendations cont 10. Effective assessment using the GIRFEC practice model should be integral to maternity care practice 11. Continuity of carer(s) and the development of trusting relationships should be provided for all women and ensured for the safe care of women with complex health and social care

  12. Recommendations cont 12. The way in which a woman is supported during labour and childbirth is central to how the woman feels about her childbirth experience and can have significant implications for her postnatal mental well-being.  Staff providing intrapartum care should be suitably skilled to identify and respond to women’s needs during labour and to provide continuous positive care that enables women to feel engaged and to have a sense of control.  All women should be given the opportunity to spend quiet private time with their baby and enabled to have skin to skin contact with their baby if they choose as soon as possible after the birth.

  13. Recommendations cont 13. New technologies (e.g. texting, social media) should be used as mechanisms for improving continuity of care and ongoing postnatal support.

  14. Next steps • MSAG endorsed recommendations and wrote to all relevant agencies for action • Merger of MSAG and the implementation group for the new Maternity Care Framework • Maternity care and public health special interest group • Parenting Strategy • Antenatal access HEAT target • Dissemination of evidence reviews and recommendations

  15. Contacts: www.healthscotland.com ann.kerr1@nhs.net jill.muirie@nhs.net

  16. Any questions?

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