Quality statement 10: Maternal health – mental wellbeing

Quality statement

Women who have transient psychological symptoms ('baby blues') that have not resolved at 10–14 days after the birth should be assessed for mental health problems.

Rationale

Women experience emotional changes in the immediate postnatal period which usually resolve within 10–14 days after the birth. Women who are still feeling low in mood, anxious, experiencing negative thoughts or lacking interest in their baby at 10–14 days after the birth may be at increased risk of mental health problems. These women should receive an assessment of their mental wellbeing.

Quality measures

Structure

Evidence of local arrangements for women in whom transient psychological symptoms ('baby blues') have not resolved at 10–14 days after the birth to have an assessment for mental health problems.

Data source: Local data collection.

Process

Proportion of women in whom transient psychological symptoms ('baby blues') have not resolved at 10–14 days after the birth who are assessed for mental health problems.

Numerator – the number of women in whom transient psychological symptoms ('baby blues') have not resolved at 10–14 days after the birth who are assessed for mental health problems.

Denominator – the number of women in whom transient psychological symptoms ('baby blues') have not resolved at 10–14 days after the birth.

Data source: Local data collection.

Outcome

Incidence of postnatal mental health problems.

Data source: Local data collection.

What the quality statement means for different audiences

Service providers ensure that systems are in place for women in whom transient psychological symptoms ('baby blues') have not resolved at 10–14 days after the birth to have an assessment for mental health problems.

Healthcare practitioners ensure that women in whom transient psychological symptoms ('baby blues') have not resolved at 10–14 days after the birth are assessed for mental health problems.

Commissioners ensure that they commission services with local arrangements for women in whom transient psychological symptoms ('baby blues') have not resolved at 10–14 days after the birth to have an assessment for mental health problems.

Women in whom 'baby blues' have not resolved at 10–14 days after the birth are assessed for mental health problems.

Source guidance

Postnatal care up to 8 weeks after birth (2015) NICE guideline CG37, recommendation 1.2.24 and 1.2.25

Definitions of terms used in this quality statement

Transient psychological symptoms ('baby blues')

Examples of symptoms of unresolved baby blues include tearfulness, feelings of anxiety and low mood.

[NICE's guideline on postnatal care up to 8 weeks after birth, recommendation 1.2.25]

Assessment for mental health problems

Assessment and diagnosis of a suspected mental health problem in the postnatal period should include:

  • History of any mental health problem including in pregnancy or the postnatal period.

  • Physical wellbeing (including weight, smoking, nutrition and activity level) and history of any physical health problem.

  • Alcohol and drug misuse.

  • The woman's experience of pregnancy and any problems experienced by her, the fetus or baby.

  • The other-baby relationship.

  • Any past or present treatment for a mental health problem, and response to any treatment.

  • Social networks and quality of interpersonal relationships.

  • Living conditions and social isolation.

  • Family history (first-degree relative) of mental health problems.

  • Domestic violence and abuse, sexual abuse, trauma or childhood maltreatment.

  • Housing, employment, economic and immigration status.

  • Responsibilities as a carer for other children and young people or other adults.

[Adapted from NICE's guideline on antenatal and postnatal mental health, recommendation 1.6.1]

Equality and diversity considerations

Communication between women (and their families) and members of the maternity team is a key aspect of this statement. Relevant adjustments will need to be in place for anyone who has communication difficulties, and for those who don't speak or read English.