Mental Health and Wellbeing in Maternity Contexts
With Sophie and Theo, Sociology & Mental Health Specialist
Key Takeaways
- About one in five women experience a mental health problem during pregnancy or in the first year after birth — more common than gestational diabetes, yet still under-identified in many settings.
- It is one of the most significant complications of the perinatal period.
- The WHO defines mental health as a state of wellbeing in which individuals realise their potential, cope with normal stresses, and contribute to their community.
- In midwifery it reminds us that mental health is about functioning and flourishing — not just absence of illness.
- The continuum places mental health on a spectrum from thriving to crisis.
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Full Transcript
Sophie: This episode is about mental health and wellbeing in maternity contexts. I'm Sophie, and joining me is Theo, our Sociology and Mental Health Specialist. Theo, how common are mental health problems in the perinatal period?
Theo: About one in five women experience a mental health problem during pregnancy or in the first year after birth — more common than gestational diabetes, yet still under-identified in many settings. It is one of the most significant complications of the perinatal period.
Sophie: How does the WHO define mental health and how does that apply in midwifery?
Theo: The WHO defines mental health as a state of wellbeing in which individuals realise their potential, cope with normal stresses, and contribute to their community. In midwifery it reminds us that mental health is about functioning and flourishing — not just absence of illness.
Sophie: What is the mental health continuum and why is it useful?
What are the different types of mental health and wellbeing in maternity contexts?
Theo: The continuum places mental health on a spectrum from thriving to crisis. It normalises the idea that everyone moves along it at different times — reducing stigma and helping midwives engage without implying something is fundamentally wrong with the woman.
Sophie: What are the most common perinatal mental health conditions midwives encounter?
Theo: Anxiety and depression are most prevalent, occurring during pregnancy and postnatally. Post-traumatic stress following birth trauma is significant. Postnatal psychosis is rare but a psychiatric emergency. Tokophobia — profound fear of childbirth — is increasingly recognised.
Sophie: How does perinatal mental illness affect the baby as well as the mother?
Theo: Untreated perinatal mental illness affects attachment, breastfeeding, infant development, and long-term child mental health. Maternal anxiety during pregnancy has physiological effects via cortisol and altered uteroplacental blood flow.
Why is mental health and wellbeing in maternity contexts important in midwifery practice?
Sophie: What screening tools do midwives use and how should they be applied?
Theo: The Whooley questions are the standard UK screening tool — two questions about low mood and loss of interest. PHQ-9 and GAD-7 are used for deeper assessment. Screening is only useful if followed by a genuine, compassionate response — not box-ticking.
Sophie: The follow-through piece is really important. Thank you, Theo.
Theo: Disclosure takes courage. If a midwife responds with genuine care and action it can be the turning point. If the response is dismissive, a woman may never disclose again. That is the weight of those moments.