Pregnant women at risk of mental health issues will receive extra support after tragic deaths of mother and four-day old daughter

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Pregnant women at risk of mental health problems will receive extra support after the tragic deaths of a new mother Charlotte Bevan (pictured) and her four-day-old daughter

Pregnant women at risk of mental health problems will receive extra support after the tragic deaths of a new mother and her four-day-old daughter. 

The National Institute for Health and Care Excellence (Nice) says women who experience or are at risk of mental health problems should receive extra support at every stage of their pregnancy, and after their baby is born. 

Nice’s 'wide-ranging' updated guideline comes two weeks after Charlotte Bevan, 30, went missing from a maternity hospital in Bristol with her four-day-old daughter at 9pm on December 2.

Search teams found the body of Ms Bevan, who is believed to have suffered from depression and schizophrenia, on the Avon Gorge on December 3, and her daughter Zaani Tiana the following day. 

Around 12 per cent of women experience depression and 13 per cent suffer anxiety at some point during and after pregnancy, with many experiencing both.

One in five women is affected by depression and anxiety in the first year after childbirth. There is an increased risk of psychosis in the weeks after childbirth.

Women may also experience disorders such as obsessive-compulsive disorder, post-traumatic stress disorder, tokophobia - an extreme fear of childbirth - and eating disorders.

The update will help doctors, nurses, health visitors and midwives identify mental health problems in mothers and mothers-to-be.

It also offers guidance on the most appropriate drugs or other treatments to safely offer mother and child.

Women who have had mental health problems will be advised what help should be available to them if they are planning to have a baby.

The guidance states women and their partners who have experienced a traumatic event such as a very difficult birth should be offered extra support.

There are also clear recommendations about what should be offered to mothers who have suffered a miscarriage or whose baby is still-born.

Search teams found the body of Ms Bevan, who is believed to have suffered from depression and schizophrenia, on the Avon Gorge (pictured) on December 3, and her daughter Zaani Tiana the following day

'Mental health problems during and after pregnancy are common,' said Nice Centre for Clinical Practice director Professor Mark Baker.

'More than one in 10 women will experience depression at some point during their pregnancy. This increases to one in five women during the first year after giving birth.

'During pregnancy and the postnatal period, women may also experience other mental health problems. Giving women the right treatment at the right time can have a profound effect - not just for the mother, but her family too. The effect of getting this right can last for years.

'The guidance makes a number of new and updated recommendations, covering not only treatments, but also in providing women who are newly diagnosed or with a history of mental health problems with the information and support they need before they become pregnant.'

Ms Bevan, pictured on hospital CCTV, went missing from a maternity hospital in Bristol with her four-day-old daughter Zaani Tiana at 9pm on December 2

Nice says the guidelines have been updated thanks to more information becoming available on using drugs to treat mental health problems during pregnancy, and on stopping medication.

More is also known about detecting mental health problems in mothers and pregnant women.

Professor Stephen Pilling, Professor of Clinical Psychology and Clinical Effectiveness at UCL and facilitator of the group that developed the guideline, said: 'Having a baby is a time of huge change and any woman can find herself needing help. This updated guideline is about spotting what is not normal for each woman and making sure she gets the right treatment.

'Women with a history of mental health problems are at risk of relapse when they become pregnant, especially if they stop taking their medication.

'Drugs often have an important role in treating antenatal and postnatal mental health problems, but they are not always suitable and so we have again emphasised the need for rapid access to effective psychological interventions.

'It is critically important that a woman is able to make an informed decision about treatment and she is helped to weigh up the risks and benefits of stopping, starting or changing any treatment she is offered or currently receiving.'

Mother-of-two Maria Bavette, co-founder of Maternal OCD, experienced postpartum obsessive compulsive disorder and helped to develop the new Nice recommendations.

'Being pregnant and/or a new mum can often be challenging, with a perinatal mental health problem it can be incredibly difficult,' she said.

'I believe this guideline will help to de-stigmatise mental health problems during the perinatal period and encourage all healthcare professionals at every point of contact with a mum to talk about their mental health as well as their physical health.

'Mothers especially need looking after so they can in turn care for themselves and their baby - this guideline sets out which treatments are recommended for mild, moderate to severe maternal mental health problems and needs to be utilised by all healthcare professionals.'

The updated guideline makes recommendations for the recognition, care and treatment of mental health problems in women during pregnancy and the postnatal period.

It also includes the care of women with an existing mental health problem who are planning a pregnancy, and the organisation of mental health services.

Rachael Dobson, co-founder and chief executive of Pandas (Pre and Postnatal Depression Advice and Support), said the guideline highlighted the importance of individualised care for women.

'I welcome these new guidelines as an aid to assisting doctors, midwives, health visitors and nurses identify mental health illnesses in pregnant women and mothers, which will allow the illnesses to be treated and supported earlier thus helping to lower the impact both on women and the wider family unit,' she added.

The guideline are available on the Nice website from today. 

Dr Patrick O’Brien, spokesman for the Royal College of Obstetricians and Gynaecologists, said: 'We welcome these revised guidelines on antenatal and postnatal mental health. They come at a time when perinatal health services are in the spotlight.

'Many women experience low mood following childbirth; however, this is normal and should pass. However, women who have pre-existing mental health conditions, or who develop a more serious mental health condition antenatally or postnatally need specialist attention and care. Mental illness makes a significant contribution to maternal deaths and therefore it is vital these women receive the right support at the right time by the right professional.

'We cannot over-emphasise the importance of early identification and reaching women pre-conceptually, especially because women with pre-existing mental health disorders are at a greater risk. Healthcare professionals need to ensure that these women receive the best possible care.

'There is also a need to consider the training and support needs of professionals in order to develop better services for women. They need to be aware that this group of vulnerable women may not want to tell anyone about their condition and, if this is the case, they need to know the correct care pathways to follow.

'An integrated care plan should be developed for a woman with a mental health problem in pregnancy and the postnatal periods that sets out the treatment options and the roles of all healthcare professionals.'