Perinatal Mental Health Midwife

Application for Temporary perinatal wellness midwife There is increasing aw areness of perinatal psychogenic wellness as a public health cater. The Government is keen for midwives to but develop their aim in public health. Midwives deprivation to be adequately prepared to take on a more developed role in perinatal intellectual health if utilize amelioratements are to be made. I am aware that death from psychiatric clears has been the placeing cause of maternal death for the last few years.Although the most re centime hidden Enquiry into Maternal and Child health indicated that this is no longer a leading cause, genial health problems before and after childbirth get hold of a signifi messt impact on the health of women, family sexual congressships and childrens incidental development. I believe that midwives need to be able to detect women with current psychical health problems and those at eminent risk of a solid intellectual unsoundness chase delivery, in orde r to improve the carry off and support offered to them throughout their contact with maternity runs.One of the most dangerous areas where we see ongoing harm is in adult mental health. young research shows that a large proportion of adult mental health problems can be laid at the door of early childhood. We need to consider the likely future make of not breaking the cycle per second while these people are young. The ACE Study estimates that 54 per cent of current effect and 58 percent of suicide attempts in women can be attributed to adverse childhood downs, which also correlate with later high levels of alcohol and drug consumption.In order to examine systematic completelyy and sensitively, and to enable them to refer on set asidely, I tincture that midwives need to understand wherefore they are asking questions around mental health how to encourage women to interrupt past and current problems what the risks of recurrence and relapse are and what services are availabl e in their area of practice. 1 scalawag I feel very strongly that having domiciliate graduate qualifications and experience like my deliver in counselling and different approaches to psych early(a)apy are essential attributes for this post.The facts about childbirth and mental indisposition are startling (reference, Oates M 2001) nearly one in ten women will develop postnatal depression after delivery. After psychosis (puerperal) postnatal develop will women 500 in one Suicide is one of the leading causes of maternal death in the UK. A woman is 20 times more likely to be admitted to a psychiatric hospital in the two weeks after delivery than at any time in the two years before or after. Despite this, talking about and confronting the issue of mental illness during m separatehood or the postnatal period still poses challenges for healthassist professionals.Motherhood is affluent with emotive expectation. This contributes to a large number of cases of perinatal mental illness g oing undiagnosed. This can prevail serious consequences including poor bonding mingled with mother and baby reduced quality of life for the mother, baby and puzzle prolonged disability caused by living with an untreated serious mental illness and potential risk to the health and safety of the mother, baby or other family member, either through neglect or harm payable to illness.As a midwife with 20 yrs of clinical practice and with almost experience as a service user, I was pivotal in setting up the current bereavement service and come been charge women and their families at West Middlesex Hospital since June 2009. I also have experience of providing supportive psychotherapy to a diverse range of clients with differing pathologies in a firsthand care and private setting since 1999. In my Role as Midwifery Matters facilitator (2007-2009) South East Strategic Health Authority, I regularly travelled across the patch, giving presentations to multi professional audiences.I am c ocksure in designing, producing and presenting a 2Page range of presentations, including role play, origin point, interpersonal workshops and formal lecture format. I have experience in writing academic papers (published) and information leaflets, guidelines and information posters. I am a naturally creative person who enjoys implementing evidence based practice change at a strategical and operational level. I am very excited about the opportunity to be potentially abstruse with designing an E-learning package.Whilst works with other experts in this industry I have gained some knowledge in the process of elearning development. I think that ordinary antenatal and postnatal care present an excellent opportunity to screen the mental health of pregnant women and women with a new baby. To do this efficaciously however, requires running(a) more collaboratively across different professions to meet the inescapably of our patients. Having the post of a specialist midwife in mental he alth could pull up stakes me to provide focused care to pregnant women with mental illness. This could include co-morbid substance & alcohol misuse problems.I envisage the role as working closely with a perinatal psychiatry team at W. M. U. H and as an important point of liaison between the other midwives, especially safeguarding and case loading midwives, obstetricians, health visitors, child and family social services, obstetricians in the hospital, and mental health services. A useful means to achieve partnership working would be for the S. M. M. H to attend the weekly midwifery team impact. Here, all midwifery community and labour ward teams meet to discuss the caseload and modify the antenatal progress notes.This provides a valuable opportunity for potential referrals to be discussed, both with the specialist mental health midwife and the perinatal lead psychiatrist/obstetrician. Many women will prefer and only require superfluous support and advice from a midwife with spe cialist expertise, rather than see a psychiatrist. However, some pregnant women will need to see a perinatal psychiatrist for expert advice, for example, if having severe mental illness, or to discuss medications in pregnancy or breastfeeding. 3PageThe referrals could be women with a annals of mental illness during childbirth or pre breathing mental illness who are now pregnant. However, quite often at booking or routine antenatal checks, midwives may pick up new aggression psychological distress in pregnant women who have no story of mental illness. Women may at first feel more fain to disclose things to a midwife rather than a psychiatrist or doctor. This may include apprehension or fear centred on the imminent delivery itself, increased general anxieties about coping, depression or other psychological symptoms.The National plant for Health and Clinical Excellence guidelines (2007) on antenatal and postnatal mental health have sought to finish this, suggesting that at a woma ns first contact with primary care, at her booking visit and postnatally (usually at four to six weeks and tercet to four months), healthcare professionals (including midwives, obstetricians, health visitors and general practitioners) should routinely ask the following two screening questions to identify possible depression During the past month, have you often been bothered by feeling down, depressed or dim?During the past month, have you often been bothered by having little elicit or pleasure in doing things? A third question should be considered if the woman answers yes to either of the initial questions Is this something you feel you need or take help with? As a specialist mental health midwife, I would want to scope the current service and rapidly undertake a gap analysis to work towards providing equal access to perinatal mental health services. I could provide consultation and advice with the knowledge and skills that I already have and from which I accrue whilst undertak ing my MSc in Psychodynamic approaches to psychological Health.I could perhaps investigate the possibility of providing a link to the topical anaesthetic mother and baby unit. 4Page In This role I could also act as a useful resource for other staff and support other midwives with their clients. They can be involved at an early stage in antenatal care and assist with supervise women who may be developing or at risk of mental illness in childbirth. They can link up between material and mental healthcare and can work in partnership with pregnant women to develop care plans for their individual needs.Having this post would give me the opportunity to hopefully address the stigma around mental illness and childbirth and improve screening and detection of women who need further specialist help at long last improving clinical outcomes and quality of life for new mothers and their families and long precondition financial benefits to the Trust and the N. H. S. A study of provision of p erinatal mental health services has already been undertaken in two English strategic health authorities views and perspectives of the multiprofessional team.Reports and policy recommendations have highlighted the need for early detection, appropriate referral and management. (Rowan1, McCourt 2 & Bick 3 (2010) This study has reported the in-depth views of relevant healthcare professionals on the extent to which perinatal mental health services are meeting policy and practice guidance. Their views highlight that although there have been developments in service provision, gaps persist particularly with respect to appropriate ongoing identification of needs and appropriate follow-up of women. Real challenges for the maternity ervices persist in relation to complex boundary issues that impacts on opportunities to support effective continuity of care and funding issues. Additionally, examples of good practice may still depend on the initiative and commitment of individual professionals, r ather than the support of the organisation, including dedicated resources. besides research is required to ascertain the extent to which resource issues and the drive to racetrack NHS healthcare budgets are limiting appropriate service provision for women with perinatal mental health needs. 5Page There is always a need to elicit the views of the women who use the service.I would approach this by Iinking with our existing Maternity Service Liason comittee and carrying out appropriate patient satisfaction surveys and audit. References Felitti V & Anda RF (2008) The relationship of adverse childhood experiences to adult health, wellbeing, social help and healthcare in R Lanius & E Vermetten (Eds) The Hidden effects of unresolved trauma. 134Epidemic The Impact of Early Life Trauma on Health and Disease, Cambridge University Press, Mary Ross-Davie, Sandra Elliott, Anindita Sarkar, Lucinda Green British Journal of Midwifery 14(6) 330 334 (Jun 2006) National Institute for Health and Cl inical Excellence. 007. Antenatal and postnatal mental health clinical management and service guidance. NICE clinical guideline 45. capital of the United Kingdom NICE. Oates M. 2001. perinatal maternal mental health services. Recommendations for provision of services for childbearing women. London Royal College of Psychiatrists Cathy Rowan1 RM, PGCEA, MA. Christine McCourt2 BA, PhD. Debra Bick3 RM, BA, MedSc, PhD. (2010) Evidence based MidwiferyVolume 8 (2010) issue 3 Provision of perinatal mental health services in two English strategic health authorities views and perspectives of the multi-professional team.. 6Page