31 August 2022

Postpartum Psychosis & Covid-19: Update

As the coronavirus pandemic continues, we know that pregnant women and new mothers have questions about what will happen to their care and how they should access services.

Action on Postpartum Psychosis (APP) has compiled information for: pregnant women with a history of postpartum psychosis / bipolar; women and families in crisis or who are developing psychosis; and for those recovering from PP at this time.

This is a fast-moving situation. Health trusts/boards across England, Wales, Scotland, and Northern Ireland are continuing to make changes to their services. We will update this guide as information becomes available.

(i.e. those who have had a previous PP or who have a bipolar diagnosis):

You can find APP’s insider guide: ‘Planning pregnancy: a guide for women at high risk of Postpartum Psychosis’ here & APP’s resources on bipolar disorder and pregnancy here. You can take part in a trial of a new interactive workbook to support women through pregnancy by emailing us here.

1. What will happen to my antenatal psychiatric appointments or preconception advice appointments?

  • In England, Scotland & Wales, there are plans in place for routine home visits and out-patient appointments to continue, but some appointments will be done by telephone or video call. We will add information from Northern Ireland when we have it.
  • Perinatal Psychiatrists say that birth planning for women at high risk of PP will in some cases be offered remotely but will still be thorough and comprehensive.

2. How do I get medication during this crisis?

  • In England, Scotland and Wales, medication plans for pregnancy and the postnatal period should be made with perinatal psychiatrists in advance to ensure there is plenty of time to get prescriptions filled. Talk to your GP, Specialist Perinatal Mental Health Team, or Perinatal Psychiatrist, to ensure plans are in place.
  • Women who are remaining on Lithium throughout pregnancy will continue to need the same degree of medical vigilance. Antenatal care is still “open for business” and obstetrics/ maternity and perinatal mental health will work collaboratively to ensure the safest possible antenatal care remains uninterrupted.
  • In Scotland, medication prescribing remains with GPs on recommendation of mental health services. We will add information from Northern Ireland when we have it.
  • You can phone your GP prescriptions line / psychiatric services and they can send prescriptions directly to your local pharmacy for collection. Some pharmacies are operating a delivery service for those who are shielding or self isolating.

3. What impact does Covid-19 have on pregnancy, foetal development or risk of postnatal illness?

  • Our best knowledge to date is that Covid-19 doesn’t seem to cause problems with pregnancy, and it is believed that having CV-19 is unlikely to impact on your baby’s development. Most pregnant women who develop the illness will experience mild or moderate cold or flu-like symptoms. Pregnant women with other health conditions (e.g heart disease, or if you usually are advised to have a flu jab) should be extra cautious as they may be more unwell than other women. It may be possible for you to pass coronavirus to your baby before they are born. But when this has happened, the babies have got better. There’s no evidence coronavirus causes miscarriage or affects how your baby develops in pregnancy.
  • Pregnant women have been placed in the ‘moderate risk group’ as a precautionary measure as not enough is yet known about the virus. This means you should follow guidance on hand-washing and social distancing. You can access up to date government guidance here.
  • You should still attend appointments and scans, unless advised not to.
  • You should still seek help if you are worried about your physical or mental health.
  • Maintaining contact with friends and family, and being active, can be very important to maintaining good mental health during pregnancy, so consider how to stay connected, and what you can do, within government guidelines.
  • The Royal College of Midwives and The Royal College of Obstetricians and Gynaecologists have produced some excellent guidance for health professionals and women, which is being regularly updated here and here. You can access the Royal College of Psychiatrists advice here.
  • We do not yet know whether stresses related to the crisis will impact on women’s chance of developing maternal mental illness. We know that managing anxiety and stress in pregnancy and the postnatal period is important. You can find excellent advice from Mind about managing anxiety and isolation here and from the Mental Health Foundation here.

APP are here for you. If you are a pregnant women with previous experience of PP or bipolar, you can talk to an APP peer supporter by visiting our forum or registering for email or video support here. APP also has a number of Facebook groups (e.g. a book club, an activities & wellbeing group, various volunteer groups) you can join. You can watch videos from our peers and clinical experts here. 

Women and families in crisis or developing symptoms

You can find APP’s general resources about symptoms of postpartum psychosis here and getting help here. You can find more information on common early symptoms here. You can find APP information guides about PP for women and partners here. If you are a partner, you can also join our Partner’s Facebook group for information, signposting and support from other partners who have ‘been there’.

1. If I develop symptoms of PP, how will assessment happen?

  • If you believe you are developing symptoms of postpartum psychosis (or your partner, family members is) you need to act urgently via the normal routes: telephone your GP, maternity services, or 111. If you believe you or someone in your household is in imminent danger, call 999. Services are still here for you. Urgent home visits are still being completed, but may also include phone & video call contact.
  • Every acute mental health trust in England has a 24/7 crisis line number who can direct you to appropriate services. You can find your local one here – input your postcode in the helplines section.
  • In Scotland, A&E mental health presentations are being diverted directly to mental health sites. Crisis/Out of Hours staff will work in assessment centres with extra resources, seeing people from A&E and other urgent referrals.

2. Are Mother & Baby Units staying open?

  • In England and Scotland MBUs will remain open and are doing an enormous amount of work to minimise any risk of infection on inpatient units. There are no units in Wales; women requiring MBU admission will be offered the opportunity of a bed in England. In Northern Ireland, postnatal women with PP are admitted to General Adult Psychiatric Units for care.

3. How are MBU’s managing coronavirus?

  • MBUs are following general NHS inpatient guidance on barrier nursing and staff will be using personal protection equipment (PPE) for patients with coronavirus symptoms. MBUs have set up isolation areas to care for women separately. To date there have been very few cases of coronavirus in MBUs.
  • Visitor advice varies between units. Some units have restricted visits to one named family member per patient, with specific time slots. Please contact the MBU for more specific advice. For a full list of MBUs in England click here  or here for all UK units.
  • NHS England guidance on visiting during the coronavirus crisis can be found here, and, for Scotland, here.
  • Patients will be supported to use FaceTime and telephone video calling more. Peer Support, including that delivered by APP, will be available via video call, and in some areas, peer supporters are still visiting the unit.

During recovery

You can find APP’s resources on recovery here.

1. How will I get medication? How will I be monitored and supported during recovery?

Urgent home visits will continue. Some routine appointments will happen via video call.

2. How can I manage my anxiety, depression, isolation during recovery while we are socially distancing?

UK wide, online resources and peer support will be incredibly important for recovering women. There is already a wide range of online resources and more are being produced each day. The links below contains further resources, recommended reading, recovery modules, and support.

APP provide support, information and a lived experience community for women & families recovering from PP. You can talk to others on our forum or get in touch to talk to a trained peer supporter via text or email. We have a variety of Facebook groups you can join and zoom activities you can get involved in.

NHS mental health services are open & here for you during this time. Contact them if you need extra help.

3. Social distancing and isolation mean my usual family support, and especially grandparents, are not available. Where can we find help?

NHS services will continue to provide outreach support during recovery via telephone, video and face to face as needed. Do ask for support if you need it.

The support that friends and family are able to provide will depend on your own situation and theirs. As someone recovering from a severe mental illness, a ‘carer’ in a non-vulnerable group can visit to provide support.

APP will continue our national peer support services throughout the outbreak. Our Forum is available for you to talk to other women and partners.

We offer one to one peer support for anyone in the UK, where you are paired with an APP coordinator with lived experience, or a volunteer peer supporter. We can give this one to one peer support via messaging, email, or video call. APP also have trained partner and grandparent peer supporters. If you would like to access this support or join our lived experience community, email us here. We have a variety of Facebook groups and social media activities you can get involved in.

Resources for partners are available here, and you can join our partner’s Facebook page for more information, signposting and support.

Action on Postpartum Psychosis

Connect with APP via Facebook, Twitter, Instagram and follow the news on our website to find out more about what APP can offer.

Links and more information/support:

For a list of England’s community teams go to: https://nhswebbeds.co.uk/community-team/list

For a list of Mother & Baby Units go to: https://nhswebbeds.co.uk

APP offer support for those affected by postpartum psychosis (personally, or at risk of PP, due to bipolar disorder. For telephone, email or Facebook support for postnatal depression and anxiety, see: https://www.pandasfoundation.org.uk/

For general advice about managing mental health, isolation and anxiety visit:

For advice specific to perinatal mental health during Coronavirus visit:

For more advice about Coronavirus:

 

Help with a research survey
We are working with colleagues at the National Centre for Mental Health to understand better the impact COVID-19 is having on people with mental health conditions. To find out more about how to participate in the NCMH COVID-19 survey click here