Northern Ireland Mother and Baby Unit news welcome, but we need funding, a timeline and interim measures to save lives

News today that Belfast Trust is the preferred site for Northern Ireland’s first Mother and Baby Unit (MBU) is welcome, but we need ring-fenced funding, a firm timeline, and interim measures to save lives and prevent life-long trauma, national charity Action on Postpartum Psychosis (APP) said.

Northern Ireland is the only part of the UK without an MBU, a specialist inpatient mental health treatment centre where mothers can be admitted with their babies for care and treatment. Instead, mums are admitted to acute psychiatric wards for non-specialist treatment, separating them from their babies.

APP estimates that around 100 women a year will require hospital admission for severe mental illness in the year after birth, including about 30 with postpartum psychosis, a severe and life-threatening mental illness that can develop suddenly. Suicide is the leading cause of maternal death in Northern Ireland.

Dr Jess Heron, Chief Executive of Action on Postpartum Psychosis said:

“It’s been 15 years since Michelle O’Neil and the Stormont Health Committee agreed that Northern Ireland needs a Mother and Baby Unit. We are delighted that we are today seeing real plans for this to progress. However, with no Assembly sitting, we still have no guarantee of funding and there is no timeline.

“It’s incredibly good news that Belfast Trust has been chosen as the preferred site for an MBU - Belfast has well-developed perinatal mental health services, as well as excellent transport links. So we’re pleased their next step is to put together a business plan, but it still, in reality, could be many years until a facility opens. Years when women continue to be separated from their babies for treatment by non-specialists; where they don’t receive appropriate physical care in the weeks after giving birth; where they miss out on vital bonding with the baby; and where families struggle to provide care for babies. Years in which women continue to be traumatised or die by suicide because they aren’t getting the care and treatment they need.

“We’re cautious about calling for interim measures, as there is always a risk that what should be short-term solutions become long-term, or even permanent. But there needs to be a plan while we wait; we know there are women dying, and being needlessly traumatised, in non-specialist units.

“There are places such as Exeter where interim units have been just that – not ideal, but a safe and appropriate space where mums can be with their babies while they recover from severe postpartum mental illness while a permanent unit is built.

“We have cross-party agreement that an MBU is essential, but with no Stormont executive, there is little MLAs can do – we need dedicated funding and we need firm deadlines so that this facility in Belfast can be built and opened as soon as possible.”

NI women who have experienced postpartum psychosis and admission in general inpatient units have also welcomed the news, but say something has to be done immediately to stop mums being separated from their babies when they require admission.

Tara Maguire was admitted to the Bluestone acute psychiatric ward at Craigavon Area Hospital in 2021 when she developed postpartum psychosis after the birth of her daughter Maisie. Tara said:

‘‘For me, the hospital was awful. It was like a prison ward. There were bars on the windows and no bathroom doors, just shower curtains. I remember not being able to sleep, they wouldn’t let me have my phone to look at photos of Maisie, and there was no privacy. I didn’t know where I was so was very quick to try to express milk wherever I felt the need, including in public areas. It was all they had to offer me because being at home was too dangerous and there was no Mother and Baby Unit.

“I have to live with this for the rest of my life. If it was handled correctly, I could have gone to a Mother and Baby Unit. I’ve had quite a lot of therapy about it. I am a success story, but I have a lot of demons and a lot of trauma that could have been avoided.”

Action on Postpartum Psychosis has been campaigning with other charities and organisations for an MBU in Northern Ireland. In October 2022 we worked with the Maternal Advocacy Project (Mas) to present an open letter to then Health Minister Robin Swann, signed by 40 mental health and parenting organisations, calling for an MBU, as well as a public petition with almost 7,000 signatures.

Clare Anderson, Mas Project Coordinator said:

“This announcement is a positive development, but we need to know it’s going ahead. From speaking to women, we know of the damaging impact of separation of mum and baby in the perinatal period.

“We would be keen to hear more about the timescales and what is going to be put in place in the meantime for mums and babies as it is going to take a long- time for the completion of an MBU.”

For more information or to speak to a an APP representative, contact Liz Morrison on 07711 558 296, liz.morrison@me.com

Anyone affected by postpartum psychosis, now or many years ago, can access support from APP, including an NI Peer Support Group for mothers who have experienced it at any time. Email app@app-network.org for more information. For more information on postpartum psychosis and support available go to www.app-network.org

Background

Northern Ireland is the only part of the United Kingdom that doesn’t have a Mother and Baby Unit (MBU), which provides specialist inpatient care for mums experiencing severe postnatal illness and their babies. Instead, mothers are admitted to general acute psychiatric wards for non-specialist treatment, separating them from babies.

An MBU provides specialist care for both mum and baby. Mental health teams with specialist training are able to provide the best care, for example: prescribing drugs that are suitable for use in the perinatal period; supporting the mother-infant relationship and the development of parenting skills; providing adequate postpartum physical care and appropriate facilities (such as nappy changing, milk fridges, play areas, safe places for older siblings to visit).

One in 5 women will experience mental health problems during pregnancy or after birth. Around 1000 women each year in Northern Ireland will develop a severe postnatal illness. This can include postpartum psychosis, severe depression and anxiety, and obsessive compulsive disorder. Between 84 and 122 will need admission to hospital. Suicide is the leading cause of maternal death, but with the right care is almost always preventable.

Postpartum mental health problems, in particular postpartum psychosis, can come on and escalate very quickly. This is not rare. The charity, Action on Postpartum Psychosis, who have recently set up a peer support group for women in NI who have experienced PP, estimates that 35 women in NI will develop the illness each year. While women with bipolar disorder are more likely to develop postpartum psychosis, 50% of cases are ‘out of the blue’, to women who have experienced no previous mental health problems.

The risk was highlighted at the 2022 inquest into the tragic death of Orlaith Quinn, who took her own life on a maternity ward while experiencing postpartum psychosis. The Coroner called for an MBU in NI.

According to the Confidential ENquiries into Maternal Deaths, suicide was the leading cause of maternal death in the first year after birth in the UK.

Acknowledgement

APP’s NI MBU campaign is supported by a grant from Rosa’s Voices from the Frontline fund.