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Raising awareness of women’s mental health before, during and after pregnancy

Research by Professor Susan Ayers focuses on women's psychological wellbeing and mental health during pregnancy and after birth

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Depression and anxiety affect nearly one in five women during pregnancy and after birth, with potentially very serious consequences for mothers, babies and families. Research by City academics including Professor Susan Ayers has had a significant impact and helped raise awareness of women’s mental health before, during and after pregnancy.

Leading the Centre for Maternal and Child Health Research at City, which includes more than thirty academics, research staff and doctoral students, Professor Ayers is a trained health psychologist and cognitive behaviour therapist. Having obtained her PhD from St George’s, University of London, she worked at St George's and later at Brighton and Sussex Medical School before joining City in 2012.

Professor Ayers’ research focuses on women's psychological wellbeing and mental health during pregnancy and after birth, particularly anxiety and post-traumatic stress disorder (PTSD). Her research examines the prevalence, causes, screening and treatment of anxiety in pregnant and postnatal women, while also considering the impact of mental health on the mother, baby and family relationships.

In a recent study, Professor Ayers and colleagues from Brighton and Sussex Medical School and the Royal College of General Practitioners (RCGP) highlighted that although GPs and others working in primary care, including midwives and health visitors, are likely to be the first point of contact for women with these problems, there is a serious shortage of community-based services to which women can be referred for treatment. GPs often do not have timely access to appropriate psychological treatments and use several strategies to mitigate this shortfall.

Looking more closely at the factors which prevent many women seeking help for postnatal depression in the UK, another study involving the RCGP found that stigma and fear of being seen as a ‘bad mother’ meant many women did not mention psychological problems despite regular contact with health services. Other factors also included difficulty in recognising that there is a problem and negative previous experiences with healthcare professionals.

As a result, Professor Ayers and colleagues suggest that psychological care, including screening and treatment, should be a routine part of all maternity care. Better information for women and their partners and continuity of care will also improve psychological care and wellbeing during pregnancy and after birth.

Other research by Professor Ayers and colleagues has focused on the importance of events during pregnancy and birth on women's psychological wellbeing and mental health, showing that women can develop PTSD in response to complications and events in pregnancy and birth. Professor Ayers’ research has shown women are particularly vulnerable if they are depressed during pregnancy, frightened of birth or have complications, negative experiences or poor support during birth. A review of research conducted by Professor Ayers and her team showed that PTSD as a result of events during pregnancy and birth could affect up to 28,000 women in the UK each year, confirming that perinatal PTSD is common enough to be a significant health concern that warrants routine screening and treatment.

In 2015, Professor Ayers contributed to the All-Party Parliamentary Group 1,001 Critical Days’ report, Building Great Britons. The report highlighted the importance of the first 1,001 days of a child's life from conception to age two, with authors warning of the potentially enormous economic cost of these cycles of deprivation unless tackling them was made a priority for our politicians and health and social care professionals. An economic report estimated that the total long-term cost of perinatal mental health problems is £8.1 billion for every annual cohort of women giving birth, with 72 per cent of this cost being due to long-term consequences on the child, highlighting the importance addressing such issues. The All-Party Parliamentary report contributed to the Government committing £290 million in funding for perinatal mental health services in 2016.

Professor Ayers’ research has had a major impact on changing policy, raising awareness, educating healthcare professionals and enabling mothers to recognise the risks, signs and symptoms, leading to healthier mothers and babies.

www.city.ac.uk/susan-ayers

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