Four years ago, I lost my brilliant friend Sophie, who took her own life after the birth of her third child. Her little daughter was just 10 weeks old at the time. Sophie’s death remains a huge sadness in my life, and for her family – some of whom will be in Parliament today to watch me introduce a Bill in her memory.
The shock of it still sits with me. I didn’t know – and many of us don’t – that suicide is the leading cause of death for a woman in the period from 6 weeks to a year after giving birth.
While Sophie’s death is a particularly serious example, I also didn’t know about the scale and normality of mental illness at that time in a woman’s life. One in four women experience some sort of mental health difficulties during pregnancy or after giving birth. It could be anything from depression to anxiety, to obsessive-compulsive disorder or post-traumatic stress following a particularly difficult birth. It can be completely debilitating for so many mums and their families.
The London School of Economics and the Centre for Mental Health estimate that untreated perinatal mental illness costs this country over £8 billion a year – largely through the long-term impact on the child’s health, education, and future productivity. Recent data from the MBRRACE-UK report highlights that mental health-related issues continue to be the leading cause of deaths occurring between six weeks and one year after pregnancy, accounting for over a third of maternal deaths during this period.
The Postcode Lottery
In theory, women are asked about their mental health early in pregnancy. NICE guidance specifies that questions about depression and anxiety should form part of a woman’s first contact with health professionals during pregnancy, including the booking appointment.
But in practice, women’s experiences vary enormously. Some women are asked a few hurried questions between blood pressure checks. Others are not asked at all. Some GPs and midwives have the training and time to offer support; others are stretched far beyond capacity. Some are almost afraid to ask the right questions, because they don’t trust that a referral to specialist support would actually work.
The result is a postcode lottery, where a pregnant woman’s access to mental health support can depend on the NHS Trust they happen to fall under. But it’s also a lottery that a woman is more likely to lose if they are Black, Asian, young, experiencing domestic violence, or experiencing poverty. As in so many areas of healthcare, pre-existing inequalities drive poorer outcomes.
That is why this Bill matters: because every woman, regardless of age, ethnicity, background or postcode, deserves the same standard of care and the same chance to be mentally well at this time in their life.
What My Bill Would Do
My Bill sets out a clear, practical framework to make maternal mental health assessment routine, consistent, and compassionate. It has four core pillars.
First, every pregnant woman should have a structured, evidence-based and compassionate mental health assessment. While mental health check-ins must continue after the birth of a baby too, the evidence shows that outcomes are better when interventions happen sooner. So that is why I focus my Bill on improving support in the antenatal period first and foremost. This assessment would form part of routine antenatal care. It would use validated tools and be delivered through trauma-informed conversations, not tick-box exercises.
Second, GPs, midwives, obstetricians, health visitors and community mental health practitioners all need the knowledge and confidence to ask the right questions, to do so compassionately, and to recognise when something isn’t right. This Bill calls for a national training standard, endorsed by NICE and the Royal Colleges. Importantly, this training must equip professionals to recognise and respond to the specific needs of women from diverse backgrounds.
Third, clear referral pathways into perinatal mental health services are vital, ensuring women can access the right support at the right intensity, at the right time. The Maternal Mental Health Alliance recommends that a specialist perinatal mental health midwife is embedded in every maternity service. There are also fantastic voluntary services out there – such as PANDAS – and yet many women are not made aware of them through their routine antenatal care, and should be.
Fourth, NHS England and Integrated Care Boards would be responsible for ensuring that local maternity systems introduce the single, standardised assessment process, and capture data through the Maternity Services Data Set, allowing outcomes to be tracked.
Building on Progress
We are not starting from scratch. The Government has set out its determination to reorient our health system away from treatment towards prevention, and away from hospitals towards the community. Ensuring that pregnant and new mums are mentally well is one of the ultimate acts of prevention, setting them and their children up for a healthy, productive future.
On mental health specifically, the Government has matched its commitment with action. In the last year, an additional 6,700 mental health professionals have been recruited. £120 million is being invested in 85 dedicated mental health emergency departments, ensuring that those in crisis can get help quickly. And we are rolling out Best Start Family Hubs – a transformative initiative that will provide families with a single route into support services, including mental health.
My Bill builds on these commitments, focusing mental health support at the very start of motherhood, when women need it most.
I know resources are tight across the NHS – and I know there are particularly acute challenges in many of our mental health and maternity services, including the national shortage of midwives currently. But I also know how transformative the relatively modest measures in this Bill could be for the women at the heart of the Bill and for our society. It could have made a difference for Sophie – and it still could make a difference for the many women who are struggling with their mental health now, or will do in future.
Why every pregnant and new mum deserves mental health support – My bill for change
