Mother and baby units are vital for recovery from postpartum psychosis

Hollyoaks fans will no doubt be following the soap’s big Christmas stories on Channel 4 this month, including Liberty’s experience of the devastating effects of postpartum psychosis (or PP). This important storyline will help to raise awareness of what PP is – and what it isn’t – amongst the general public. 

But as the show opens the doors to this much-needed conversation, one thing I am keen to highlight is the need for more mother and baby units. These specialist units are essential to the safe and effective treatment of new mums who develop this illness.

For those who don’t know, postpartum psychosis is a severe and frightening form of postnatal mental illness that develops in the days after a mother has given birth. It affects one to two women in every 1000 births – that’s around 1,400 women each year in the UK, and 140,000 women globally. 

PP symptoms include severe confusion, delusions, hallucinations, elation, anxiety, rapid mood changes and unusual behavior. Women with a pre-existing bipolar disorder are at risk of postpartum psychosis, but around half of cases occur completely out of the blue to new mums with no psychiatric history. With the right treatment, women recover from the illness, but it can take many months.

Because PP can become severe so quickly, urgent inpatient treatment is needed. The problem is this: there are not enough specialist MBUs for those who need them. Over the past decade, our charity has been campaigning for more Mother and Baby beds, and we’ve seen a large increase and improvement in the specialist services in England. Women in Wales and Northern Ireland do not yet have access unless they travel to England – although a unit is being planned for South Wales. 

Women in all four of the UK nations are often faced with either moving many miles from home to access specialist care or being admitted to a general psychiatric ward. As women can expect hospital treatment to last 8 to 12 weeks, and sometimes many months, this distance can be an enormous pressure on new families.

As we work to support women and families recovering from the illness, we hear daily about the value of MBUs, and unfortunately, about the trauma experienced when mothers are unable to access such specialist care.  

General psychiatric wards are of course geared up to treat bipolar and psychosis, along with a whole range of other mental health conditions. But they are far from an ideal environment for new mums for many reasons.

Research conducted by our charity shows that mothers who have access to a mother and baby unit have higher levels of satisfaction with their care. They feel safer and more confident in the knowledge of the staff, and are closer to recovery by the time they leave care. They have a shorter time to full recovery and feel more confident with their baby when discharged from care.

We know also that there are fewer deaths by suicide in women who access MBUs, compared to those who are separated from their baby for care in a general ward. In the UK, suicide is the leading cause of new mothers dying. We must do more to address the fact that families are torn apart by this very treatable illness. 

Any new mother reading this can, I’m sure, imagine the feeling of being separated from their newborn. It would be a difficult experience under any circumstances – for both the baby and the parents. For mums with PP, enforced separation can amplify fears and frightening beliefs. It can delay recovery and cause long term trauma. Missing out on critical early bonding, and key developmental milestones, can have a significant impact on the relationship between mother and child, as well as the mothers’ self esteem and confidence.

Some dads or partners do try to take their newborn into general psychiatric wards so that mum can spend time bonding with their child. But these wards are treating so many different kinds of mental health problems and do not offer the same kind of privacy or support that MBUs do – they can be quite daunting environments to bring a baby into. Added to that, there are no specialist facilities – places to change nappies, make up feeds, toys, outdoor space or baby sensory rooms – no other new mothers to relate to - and no specialist staff.  

MBU’s are set up to safely care for mums and babies. Staff have additional training in perinatal mental health – in the care needs of pregnant and postnatal women, in the differences in symptoms, treatments needed, in supporting babies, bonding and parenting. MBU teams include lots of different health professionals within the team, including midwives, health visitors, psychologists, and nursery nurses, to support both the physical and emotional needs of the developing family unit.

Therefore, the consequences of a lack of MBU beds is significant. Mums remain unwell for longer than needed, missing precious time with their baby; mums feel traumatised by not having their postnatal needs considered and from the separation from their baby. Mums often leave hospital before they are fully recovered in order to be reunited with their baby – only to struggle further at home.  

Where an MBU is not available, the burden of care with the new baby often falls on partners, other family members, or social services. Where partnerships break down, single mums who were unable to access an MBU place may find themselves fighting legal battles for access to their children.  

Our failure to provide consistent standards of care across all four nations has both short term and lifelong consequences for women. For every time we don’t get it right the impact on a person’s life can be immeasurable and inter-generational.  

Our network of recovered, strong, loving mums, who share their stories and help other families through this terrifying illness is testament to the fact that there is hope. But there is such a short window of time in which to get it right. MBUs are not a luxury, but a life-saving necessity. We need commissioners, policymakers and budget holders to recognise this and to make sure that these specialist facilities are available to all who need them wherever they live in the UK.

Dr Jess Heron is CEO for the national charity, Action on Postpartum Psychosis and a senior research fellow in perinatal psychiatry at Birmingham University.

If you or a family member has been affected by postpartum psychosis and you’d like to access further information and support, click here

You can speak to someone from the Samaritans for free over the phone, in confidence, on 116 123 (UK and ROI), email jo@samaritans.org, or visit the Samaritans website to find details of your nearest branch.

If you are based in the USA, and you or someone you know needs mental health assistance right now, call National Suicide Prevention Helpline on 1-800-273-TALK (8255). The helpline is a free, confidential crisis hotline that is available to everyone 24 hours a day, seven days a week.