Perinatal mental health: the role of social inequalities and domestic abuse on maternal outcomes

Perinatal mental health conditions, commonly defined as depression, anxiety disorders, and postpartum psychosis/bi-polar disorder, occur during pregnancy or in the first year following the birth of a child, and can affect up to 27% of new and expectant mums. They are one of the leading causes of maternal death in pregnancy and in the first year after giving birth. Despite the UK government’s commitment to improving perinatal mental health services, as documented in the NHS Long Term Plan (2019), maternal mortality in the UK, unrelated to covid, has increased in recent years. This study will explore the impact of multiple adversity (defined here as social inequalities, socio-demographic factors, maternal interactions with social services in childhood, and domestic abuse) on maternal mortality and morbidity outcomes for women with perinatal mental health conditions in Northern Ireland (NI). Maternal morbidity outcomes include mental health medication use and hospital admissions. The second phase of the study will assess the effect of perinatal mental health conditions on child outcomes.

This study has policy implications due to concerns about rising maternal mortality, and the significant and long-lasting effects of mental health conditions on the woman, the child, and the wider family. Previous studies have shown that NI has higher rates of maternal anti-depressant use compared to other Western European countries, and that women living in the most deprived areas in NI have double the rate of antidepressant prescriptions compared to women living in the least deprived areas. However, there has been little research on the effects of perinatal mental health conditions and multiple adversity, and how these impact on maternal mortality and maternal morbidity outcomes. This study will address this gap in the literature so that early effective support and interventions can be implemented to reduce maternal mortality and morbidity outcomes.