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New study provides recommendations to health services and government on how to help pregnant women and new mothers with psychological and emotional difficulties.

By Mr Shamim Quadir(Senior Communications Officer), Published

One in five women will experience psychological or emotional difficulties during pregnancy and the first year after birth, which are collectively known as the ‘perinatal’ period. These difficulties include anxiety, depression, post traumatic stress disorder (PTSD), and stress-related conditions. Research has shown that only about half of women with perinatal mental health problems are identified by health services and even fewer receive treatment.

Launched today, as part of Maternal Mental Health Awareness Week, the MATRIx study website and recommendations for practice and policy provide guidance to prevent women from falling through gaps in services.

Led by Prof Susan Ayers, at City, University of London, the MATRIx (Perinatal Mental Health Assessment and TReatment: An Evidence Synthesis and Conceptual Framework of Barriers and Facilitators to Implementation) study was carried out by initially reviewing the evidence from existing research studies to understand why it has been difficult put perinatal mental health care into place. This has been published in The Lancet Psychiatry and provides recommendations for implementing perinatal mental health care. Secondly, evidence was reviewed to identify why it is difficult for women to access perinatal mental health care. This included scrutinising the evidence relating to all the factors that prevent women being able to get the care and treatment they need. This paper is currently under review.

The study authors then worked with a group of women, health professionals (such as GPs, midwives), and health service managers to discuss the synthesised findings of the evidence review.  This led to the development of frameworks that provide a clear overview of factors that help or prevent women getting care and treatment. The frameworks identified 39 factors that help women access services, and 70 factors that prevent access.

Taking into consideration the quality of the evidence they had collected, and the relevance to the NHS the authors finally developed recommendations for health service practice and policy.

These were split into recommendations for women and families, health professionals, service managers, commissioners and policy makers and can be viewed on the MATRIx website. As an example, here is  a breakdown of the recommendations for service managers:

Service managers - Workforce

  • Provide sufficient workers to meet women’s needs. Use a workforce planning tool.
  • Provide high quality training on perinatal mental health for all people working within a service.
  • Make sure to recruit staff with positive interest and attitude towards providing high quality care to women. Ensure diversity where possible.

Service managers - Workplace culture and practices

  • Encourage team working within and across services. Implement multidisciplinary meetings, co-location, joint working, sharing knowledge, and approachability.
  • Develop clear & easily accessible guidelines on where to refer women to depending on their need. Development of one referral form that can be uploaded and amended, discussed at multidisciplinary team meetings.
  • Employ someone in a liaison role who has access to all systems to bridge the gap between different services.

Service managers - Service provision

  • Provide of care that meets women’s needs – flexible, easy to access and includes childcare.
  • Provide continuity of care across the care pathway.
  • Break down language barriers by recruiting interpreters.
  • Ensure that chosen assessment tools are easy to understand.

Watch the animation about the purpose of the MATRIx study on the project website.

Watch the presentation of the findings by MATRIx project lead, Dr Rebecca Webb.

Watch the presentation of the recommendations by Dr Webb.

Watch the Q & A with co-authors of the study, Professor Susan Ayers, Centre for Maternal and Child Health at City, University of London and Dr Judy Shakespeare, Clinical Champion for Perinatal Mental Health at the RCGP.

Commenting on the study finding, Dr Webb said:

The findings from the MATRIx study highlight the need for continued policy support and funding for perinatal mental health services, which means health professionals and organisations can deliver women-centred flexible care, provided by well trained, knowledgeable and empathetic health professionals

Find out more

An additional dissemination event, where study authors share the results with policy makers and practitioners is being held on 16th June at 2pm. Please sign up on Eventbrite here.

Visit the MATRIx project website.

Visit the Centre for Child and Maternal Health at City, University of London


The MATRIx study was funded through the National Institute for Health and Care Research (NIHR) Health Services Delivery and Research Programme (NIHR 128068).