Urgent need for an NI Mother and Baby Unit under the Spotlight: APP says funding is urgent to save lives

Media release: 3rd June 2025
For immediate release

Today’s BBC Spotlight investigation into perinatal mental health care in Northern Ireland shows just how urgently a Mother and Baby Unit (MBU) is needed to save lives and prevent life-long trauma, national charity Action on Postpartum Psychosis (APP) says.

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.

While APP welcomed the announcement more than six months ago that Belfast Trust will take forward plans for NI’s first MBU, we are concerned that we still haven’t seen ring-fenced funding, a firm timeline, and interim measures.

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

“Tonight we heard from mums and their families who urgently need better mental health care. It’s a story APP hears all the time from the mums who attend our postpartum psychosis Northern Ireland peer support group who, like Shelley, have been separated from their babies and admitted to psychiatric inpatient wards for treatment.

“And too often we hear the stories of tragedy, with lives lost - a story we all heard tonight from Siobhan Graham about her daughter Orlaith Quinn.

“We’ve waited 16 years since Michelle O’Neil and the Stormont Health Committee agreed that Northern Ireland needs a Mother and Baby Unit, but only now are we seeing real plans for this to progress. And we keep waiting. We have a site chosen, but there still isn’t a business plan. The Minister has told the Assembly he hopes to greenlight it this calendar year, but we need a commitment that this will happen. 

“We are concerned that in reality, it could be many years until an MBU 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 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.

“Spotlight visited the Exeter MBU which is a great example not just of how an MBU supports recovery while keeping mum and baby together, but is also an example of how an interim unit has 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.”

For more information or to arrange an interview contact Liz Morrison on 07711 558 296, liz.morrison@me.com / Lucy Nichol on 07771 967 032, lucy@app-network.org

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 run 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 Enquiry into Maternal Deaths, suicide was the leading cause of maternal death in the first year after birth in the UK.

Facts about postpartum psychosis

• Episodes of severe mental illness, such as mania or psychosis, follow 1-2 in 1,000 deliveries.
• In Northern Ireland, around 35 women a year experience postpartum psychosis.
• An average-sized maternity unit would see 8-10 cases of rapid-onset psychosis following childbirth in a year. Around 1,400 cases occur each year in the UK.
• Postpartum Psychosis is a devastating illness for mothers and families.
• It strikes at a time when families are full of expectation. Mothers feel loss, guilt, and responsibility for missing out on the early months of motherhood. Fathers become responsible for a newborn or are separated from their families. They do not know if their partners will fully recover.
• Postpartum Psychosis can occur in women from all social classes, occupations, and educational backgrounds. Often, it occurs 'out of the blue' to women without any previous psychiatric history.
• The stakes are high if the illness is not identified sufficiently early, or is poorly managed, both in terms of maternal outcome (including risk of suicide) and child outcome (including rare and tragic cases of infanticide).
• According to The Confidential Enquiries into Maternal and Child Health (MBRRACE-UK https://www.npeu.ox.ac.uk/mbrrace-uk), suicide is the leading cause of maternal deaths. Half of these suicides occur in mothers suffering the acute onset of psychotic illness. Completed suicides are the tip of the iceberg in terms of ‘near miss’ events occurring to women who develop Postpartum Psychosis.
• Postpartum Psychosis is eminently treatable, but services must respond quickly and appropriately to these psychiatric emergencies. Episodes have a rapid onset, usually within days of delivery, and may escalate to full-blown psychosis quickly - within hours or days.
• Although episodes of Postpartum Psychosis are among the most severe illnesses seen in clinical practice, Postpartum Psychosis also has one of the best prognoses.
• Acute symptoms are similar to those of bipolar disorder and may include: extreme elation or euphoria, rapid mood changes, or depressed mood; the rapid onset of unusual beliefs; visual and auditory hallucinations; extreme confusion; and behaviour can be very bizarre. Episodes can be very frightening for women and their families.
• The causes of Postpartum Psychosis are unknown, but the dramatic hormonal and biological changes that occur at childbirth are thought to be involved. There is some evidence of a genetic component to the illness and of a link with bipolar disorder. One in 4 women with a history of bipolar disorder experience Postpartum Psychosis following childbirth.
• The majority of women are substantially recovered within a few months, but full recovery and coming to terms with the illness may take 12 months or longer.
• Recovery is a difficult and lengthy process. Factors that contribute to these difficulties include: limited availability of information about Postpartum Psychosis and recovery; isolation caused by lack of visible others who have experienced the illness; poor awareness in the general public and media; the stigma associated with experiencing mental illness - particularly at this time when women have high hopes of new motherhood; difficulties coming to terms with behaviour during the illness; limited availability of specialist psychological and practical support following admission to facilitate coming to terms with the episode, looking after a baby, rebuilding relationships, and mothering confidence.
• Misguided portrayals in the media can contribute to mothers' feelings of isolation and to difficulties in discussing their experiences with other mothers. Often, when women or their partners search the internet for information about their illness, alarmist stories about mothers harming their babies are the first they encounter.
• Postpartum Psychosis is not simply a more severe form of postnatal depression. In fact, many mothers with Postpartum Psychosis do not experience any symptoms of depression at all; rather, they experience extreme elation, spirituality, confusion, and quickly lose contact with reality. The majority of women, therefore, are unable to seek help for themselves, and others must obtain help for them.