Why Aren’t More Mum and Baby Units Accredited by the Royal College of Psychiatrists Perinatal Quality Network (PQN)?

When a woman becomes a mother, she enters a profound period of transformation. The journey through pregnancy, birth, and the postpartum period involves significant emotional, physical, and psychological changes. For many, this period can be overwhelming, particularly for those dealing with mental health challenges such as postpartum depression or anxiety. Despite the growing recognition of the importance of mental health during and after pregnancy, many maternity and baby units still lack accreditation from the Royal College of Psychiatrists’ Perinatal Quality Network (PQN). This raises the question: Why aren’t more mum and baby units accredited by the PQN, given the critical role they play in supporting new mothers’ mental health? In this article, we will explore the reasons why this accreditation is not more widespread, the importance of antenatal and postpartum care, and what can be done to improve the availability and quality of mental health support for new mothers. We will also discuss how improving access to antenatal care, mental health services, and postnatal recovery support can positively impact both mothers and their babies.

What is the Royal College of Psychiatrists’ Perinatal Quality Network (PQN)?

The PQN was established to improve the quality of care for women who experience mental health issues during pregnancy and the postpartum period. The network aims to set standards for care and to ensure that services are providing the necessary support for mothers and their babies. The accreditation is a mark of quality that identifies services that meet specific standards of mental health care. This includes mental health assessments, intervention, and treatment for women who are struggling with issues such as postnatal depression, anxiety, and psychosis.

The Link Between Antenatal and Postnatal Care

Anticipating the mental health needs of mothers before childbirth is vital. Antenatal care, which encompasses regular appointments, check-ups, and screenings, is often focused on physical health. However, mental health screenings should be a standard part of antenatal care as well. Addressing mental health concerns early in pregnancy can help prevent or mitigate issues that could arise later, during the postpartum period. However, the integration of mental health services into antenatal care varies greatly across regions and health systems. Some areas offer comprehensive antenatal care that includes mental health support, while others may neglect this aspect, leaving mothers to face mental health challenges without adequate resources. By offering mental health screenings and support during antenatal appointments, healthcare professionals can ensure that new mothers are better equipped to handle the challenges of childbirth and the postpartum period.

The Need for Antenatal Support: Addressing Mental Health in Pregnancy

Antenatal support goes beyond routine check-ups. It involves a holistic approach to caring for expectant mothers, addressing their physical, emotional, and mental well-being. Pregnancy care should include discussions about antenatal vitamins, yoga for pregnancy, and support groups for mental health. Yet, there remains a gap between the care offered and the support needed, especially when it comes to addressing mental health. Prenatal yoga and other relaxation techniques during pregnancy, such as antenatal massage, have been shown to reduce stress and anxiety for expectant mothers. These practices, combined with appropriate psychological support, can help prepare mothers for the challenges they will face after childbirth. Despite the well-established benefits of prenatal care and antenatal support, these services are not always adequately funded or readily accessible.

Why Aren’t More Units Accredited by the PQN?

The lack of widespread accreditation among mum and baby units can be attributed to several key factors:

1. Resource Constraints: Accreditation by the PQN requires resources, both in terms of funding and staffing. Many hospitals and maternity units may struggle to allocate the necessary budget for mental health services or may not have enough trained mental health professionals to meet the PQN standards. Given the pressures on healthcare systems, some hospitals may not prioritize this accreditation, even though it’s clear that postnatal mental health is crucial.
2. Awareness and Understanding of Perinatal Mental Health: Despite the growing awareness of perinatal mental health issues, many healthcare providers are still not fully aware of the importance of integrating mental health services into maternity care. There is often a lack of training for antenatal staff in recognizing the signs of mental health problems during pregnancy and postpartum. This knowledge gap means that mothers who experience mental health challenges may not receive the timely interventions and support they need.
3. Stigma Around Mental Health: Even though attitudes toward mental health have improved in recent years, there remains a certain stigma attached to seeking mental health care. This stigma can deter women from speaking openly about their struggles during pregnancy and the early stages of motherhood. In turn, healthcare systems may be less likely to address this issue comprehensively. This cultural barrier can also prevent mums from seeking help when they need it, which exacerbates the problem of untreated mental health conditions.
4. Insufficient Policy Focus: Mental health services for new mothers may not always be a priority for policymakers, especially in times of financial strain. The lack of government investment in perinatal mental health services can leave many units without the resources to become PQN-accredited. Without a clear policy framework that mandates mental health care during the perinatal period, progress is slow.
5. Geographical Disparities: There are significant regional disparities in access to PQN-accredited care. While some areas have made great strides in integrating mental health services into maternal care, others are left behind. These disparities may be linked to the level of funding available, the presence of trained mental health professionals, and the prioritization of maternal mental health services within specific healthcare systems.

The Role of Antenatal Care in Supporting Postpartum Recovery

Antenatal care has the potential to play a pivotal role in supporting postpartum recovery by preparing mothers for the physical and emotional challenges of motherhood. Antenatal classes and check-ups should cover not only the expected physical changes but also address emotional well-being and mental health. This could include discussions about the benefits of relaxation during pregnancy, how to access mental health support, and the importance of self-care during the postpartum period. Moreover, antenatal education about the early signs of postpartum depression and anxiety can equip new mothers with the knowledge to seek help before their condition worsens. Understanding that mental health is a vital part of pregnancy care can reduce the stigma surrounding mental health issues and empower mothers to seek support without shame or fear.

Improving the Accessibility of Accredited Care

While the lack of PQN accreditation in mum and baby units is concerning, there are steps that can be taken to address this issue:

1. Increasing Funding for Mental Health Services: Governments and healthcare providers should allocate more resources to maternal mental health services. This includes funding for training staff, increasing access to therapy and counselling services, and ensuring that mum and baby units have the necessary resources to obtain PQN accreditation.
2. Raising Awareness Among Healthcare Providers: Healthcare providers need more training on the importance of addressing mental health during pregnancy and after childbirth. Integrating mental health screenings and support into routine antenatal care can ensure that mothers receive the support they need as soon as possible.
3. Encouraging Public Health Campaigns: Public health campaigns can help reduce stigma and raise awareness of mental health issues surrounding pregnancy and the postpartum period. These campaigns can also highlight the importance of seeking help early, which can lead to better outcomes for both mothers and their babies.
4. Expanding Access to Mental Health Services: It is crucial to ensure that mental health services are accessible to all mothers, regardless of geographical location or socioeconomic status. This can be achieved by increasing the availability of local antenatal clinics, offering more accessible antenatal education, and expanding the availability of prenatal and postpartum mental health services.

Prioritising Mental Health in Antenatal and Postpartum Care

The integration of mental health services into antenatal care and the accreditation of mum and baby units by the PQN are crucial steps toward improving the overall well-being of mothers and babies. The lack of widespread PQN accreditation is a complex issue with multiple contributing factors, but it is not insurmountable. By increasing awareness, providing more funding, and prioritising mental health in pregnancy care, we can ensure that all new mothers receive the support they need during this transformative and often challenging period.