Perinatal Mental Health Podcast 1 Transcript

Episode 1 – Laura Bridle
The role of specialist midwives and getting the right perinatal mental health support

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Podcast transcript

The perinatal mental health team at Transformation Partners in Health and Care (TPHC) have created a series of podcasts that focus on perinatal mental health. The perinatal period is usually defined as the time between conceiving a baby and 1 to 2 years after giving birth. We know that during this time around one in every five women will experience mental health problems which may begin in pregnancy, during pregnancy or in the postnatal period.

Perinatal mental health is different for everyone, and people can be affected in many ways. It can often be difficult to recognise the worsening symptoms in the busy days of parenthood. Getting the right help, support and guidance is vital, but we know that sometimes it can be hard to know where to find it and how to access it. We understand the importance of beginning and continuing conversations around perinatal mental health by raising awareness of the impact that perinatal mental health problems can have for women, birthing people and their families, and also showing the effect that the right care can have.

We hope that we will be able to reach more people, challenge perceptions and change attitudes towards accessing help. In this episode, we are going to focus on the role that specialist midwives play in supporting women to get the right perinatal mental health support for their needs. And we are delighted to welcome Laura Bridle, a specialist midwife. Alongside me is also Chelsea.

Chelsea is the mother of two young girls, a military wife, has worked as a midwife for three years and now works as a lived experience practitioner for Transformation Partners in Health and Care. And me, Meghan Mathieson, Strategic Communications Manager at TPHC and the mother of a little girl born during the peak of the COVID-19 pandemic. As you listen to our chat today, you may feel you identify and relate to what we are discussing and want to find support.

We encourage you to use our website to find support that is local to you. TPHC is not a crisis service, and so in the first instance, we would encourage you to contact your GP, midwife or local services to support you. So welcome to Laura. Thank you so much for joining us. I think it would be great if we could start with hearing a little bit about you and how you came to be a specialist midwife.

Thanks, Meghan for inviting me and Chelsea. So I’m Laura. I’m a midwife and I’ve been qualified for 13 years now. I worked as a caseload midwife, so I got to follow women and birthing people from their first pregnancy appointment all the way till about one-month post-birth. I did that the first five and a half years and I worked abroad for a little bit and then came back and finished my Masters and went into becoming a specialist mental health midwife working for an NHS trust in London.

And I did that for five years and loved it and have now moved over to the new maternal mental health service and where I work across a larger spectrum of areas covering South London.

Thanks, Laura. Wow. You’ve not done anything at all really in those years, have you? It’s amazing. And I think thanks for explaining the different roles and we’ll go a bit more into them because I think most people listening when we think of Midwife, we just think of the one you meet in the hospital that delivers your baby or did your antenatal care.

But as we continue, we know that midwives are best placed to support women and birthing people through these journeys, and we’ve now moved them into specialist mental health roles. So if you could, could you just tell us a little bit about the difference between the maternal mental health midwife and the perinatal mental health midwife? Yeah, of course.

So I’ll start with perinatal mental health because that role has been around a lot longer. So mental health midwife, there should be one in every single trust and that midwife is there to support women and birthing people, but also staff help facilitate training because it’s odd, you know when midwives go into the training, they go to university for three years and there might be a day or two on mental health, but there’s not really that much discussion on it, even though we know from reports and from speaking to women that actually mental health has a huge impact, not just only in pregnancy, but post birth and then your learning after learning to look after

this new baby. So how important your mental health is. And so when these roles were kind of created and have kind of expanded now and each kind of trust mental health midwife will work slightly differently because the kind of work for the need of their service. For example, the way I worked, we had a larger caseload of women who came from out of area.

So that was kind of my focus was supporting women coming from out of area that were booking at our hospital and giving them continuity. So I would see them through their whole antenatal period. So from their booking appointment up until the birth and then being able to signpost them to the post-natal support because that’s so, so important as we know.

And I was also responsible for doing education and training for the midwives and obstetricians and maternity support workers. And I would do that alongside a psychiatrist, a psychologist because the perinatal mental health teams are so crucial in this. And it’s really important that we kind of do joined up learning and joined up working together also quite nice, I’m sure Chelsea

Just you know, you work with these teams, you send referral forms and we don’t know who they are. So being able to put a face to a name and the training kind of breaks down that barriers. The midwife obstetrician could call the psychiatrist and say, Oh, I’m a little bit worried about this woman, what should I do? Or this woman’s considering this, but she’s a bit nervous about being referred to mental health teams because sometimes there’s still a bit of a stigma.

So being able to have that kind of joined up, working through the training is really, really helpful. And I also used to teach water aerobics classes for women with mental health, and we used to do art therapy and we used to do signposting. So with mental health, it’s a whole spectrum. Like most things, some women might have mild and moderate to severe mental health, and a more severe would be something like bipolar, schizophrenia, severe postnatal depression, post-traumatic stress disorder, eating disorders.

There’s a whole spectrum of what mental health could be in a more serious context. And those women and birthing people tend to be supported by a specialist perinatal mental health team, and they do tend to get really good support that way because a perinatal mental health team will have a psychiatrist, psychologist, mental health nurse, and that kind of helps social aspect of getting you back into groups and meeting other people, a nurse or nurses, which really help with bonding once baby’s here and then there’s that other group of women, which is actually the majority of women who have the more mild to moderate.

So depression, anxiety, low mood, possibly something called Tokophobia which is fear of birth. And those women sometimes kind of slip through the net. And so signposting for those women is really helpful, especially through things like third sector. So third sectors like our charity-run organisations like Mindful Mums or Home Start, PANDAS and there’s lots of other organizations and that’s kind of where the maternal mental health service was kind of created because there was this gap in provision for women, and especially for women in the four pathways that the Maternity Health Service focuses on.

So they have four pathways and there’s Tokophobia, which is a severe fear of birth, and you can have primary or secondary Tokophobia. So about 14% of the population will have Tokophobia. And if it’s primary, it means you’ve never given birth before. So even that idea of becoming pregnant might have been quite scary for you.

Might’ve taken a long time to get to this point. And then the actual thought of birth can be quite terrifying for you and other women and birthing people might have something called secondary Tokophobia, which is where they have given birth before, and that experience of birth has caused them to be extremely fearful for their future pregnancies.

So that’s one of the pathways for the maternal Mental Health Service is supporting those women and birthing people. Another pathway is birth trauma. So if they’ve had quite an and unhelpful experience with their birth and I’m I’m hesitating and stuttering because birth trauma is like pain. So what a midwife might think a birth trauma is or what a birth might be is seen as traumatic isn’t always the same for every woman or birthing person.

So birth trauma can. Doesn’t really have a clear definition in my opinion, it’s kind of just what the woman says it is. I was a home birth midwife for many years and, you know, and I’ve had people who I thought, Oh, that was such a lovely, wonderful birth and they’ve said actually Laura, that was really scary for me. So it’s really listening to the woman and birthing person and deciding how they found that birthing experience.

And I think more sorry, you know, I was going to say, I think that’s a really important point to note across you know, all of our discussions that we’re going to have in all of the podcasts and topics that may come up, that, you know, what the definition says is different and varies for every woman. I think you raising that point mentioning that it’s that individual need and that individual experience that you look to and work around is something really important.

I think a lot of people will really appreciate knowing that professionals like you are aware of that and understand the levels of all of these issues can vary hugely. And just as you say like some people would find certain things painful and others wouldn’t. It still goes, you know, it links with trauma and other fears and anxiety as well.

So I think that’s a really important message to say, yeah, 100% agree. I was a nurse first and when I did my nursing, we were always drilled into our head, you know, pain is whatever the patient says it is. So I kind of try and remember that with birth. So even though I would think, oh gosh, that was a really traumatic birth, you know, that woman must be really affected,

and they’re like, No, I’m fine, you know, So I think it’s listening to them and yeah, and although the maternal mental health services are focused for women who have with the more severe end of a reaction to that experience at their birth some more severe PTSD symptoms, that doesn’t mean that the maternal mental health service doesn’t do anything to kind of help support the other areas, so they kind of do linking with third sector that we talked about in the beginning, about linking with charities and other forms of support, talking therapies.

So I think that’s important to note that the maternal health services for the more moderate to severe. Yeah. And then the other pathway is for women who’ve experienced loss and loss the whole spectrum of loss. So from those women who’ve had to have a termination for whatever reason, for women who’ve had early pregnancy loss, stillbirth, neonatal death, and historically, those women, even if they were under a perinatal mental health team, if their pregnancy or baby has sadly died, then they would have been discharged from perinatal mental health team because the perinatal team holds themselves as like a service to help with bonding relationships.

And it was such a really harsh thing for me as a mental health midwife to be supporting someone. And then those services kind of fade away when they’ve gone through such a traumatic time. So I think it’s really crucial that these maternal mental health services are open to those women and birthing people. And some of those maternal mental health services will also be open to partners.

And we know the important role that fathers and non birthing mothers play. You know, they might have found a birth traumatic, they might have they’ve lost a baby or a pregnancy, so they’re not kind of forgotten within the system. Yeah. And then the last pathway is for women in birth and people who have children removed due to social care.

And this is such an unmet need for such a long time. You know, you can imagine that for whatever reason, these women have had the decision to have their child taken away from them and they have all this input in pregnancy. They see a midwife, they see a counsellor, they have social services, they have all this input. And then if the baby is separated, then they just lose all of that.

It’s just all taken away. And we know from reports that those women are the most at risk for severe mental health and crisis. So it’s a much, much, much, much, much needed service for those women as well. And see, that’s kind of how it got developed and how it slightly difference was kind of like filling the gap mind the gap for the Londoners, it’s the same thing.

Yeah, that was that was really brilliant and detailed overview and what you explained was such a wide range of therapies and variation in terms of levels of support and care, and referrals to other disciplines and healthcare professionals, which I think a lot of people won’t know is necessarily available. And these services are relatively new, but exactly, as you said, are filling such an unmet need and doing such important work for so many women who have experienced, as you say, loss or trauma or have differing levels of anxiety and fear around all of this.

And there is more information about all of these all four pathways and the services on our website, which is www.transformationpartners.nhs.uk. If anyone wants more information on that. Chelsea, did you want to did you want to come in on that? Yeah, I did. I’m just digesting everything you said, Laura, because I think you’ve placed it so nicely what different midwifes can do.

And it’s really important for even the other health care professionals to know where to go and to turn to. But I just love that you really broke it down to what it was like for the women or birthing persons experiencing their maternity journey, because I think it’s so difficult as a healthcare professional to see the different levels of struggling and the different levels of anxiety and depression and not always have an appropriate service for people to go to.

And, you know, with these new maternal mental health services, they really are trying to meet the broadest range of experiences from the maternity journey. So thank you for breaking those down. Do you want to say a little bit more of kind of what you now do in this new maternal mental health service? So I guess a bit of a day in a life.

So I’m a woman and I’m coming to meet you and you as my midwife in this service. What would it look like? Yeah, so I feel very privileged because no day is the same. So it’s just so enjoyable. I see myself more as a cheerleader almost, and PA because I’m working across three big trusts now, and a key part of my role has been ensuring equity so it doesn’t matter where in South London a family might turn up that they would get the same level of care for their mental health.

So I’m working with the specialist mental health midwives in each of those sites, making sure they’re full-time, making sure they have access to training for them. Because like I said, you know, university was like a day or two so making sure they have the skills and tools to support women and birthing people well. And a real joy of this job has been working with women and birthing people with lived experience to help shape the service.

So the service I work in has been up and running for just over a month. And so they’ve been but they’ve had lived experience with us from the beginning. So developing the leaflets, how the service should run and making sure that we’re going out into the community so other services are aware of us because one thing that quite often happens is there’s this thought that there’s this hard to reach group, but actually services are being harder to reach and we’ve been able to work pretty closely with other services like the public health team, GP’s third sector support to be able to go into different children’s centres, faith groups to kind of say this is the

service that’s turning up, how would it be helpful to run? So that was my job until five months ago and now it’s maintaining those relationships and working with the specialist midwives and mental health midwives, but then also working alongside my team, which are mainly psychologists. If anyone has ever met a psychologist, they’re just wonderful humans and they’re great listeners, which is good, and they’re the ones who are offering the therapy to women and birthing people.

And that can range from CBT to EMDR to group therapy. Each maternal health service works very differently, and then I work alongside them. So our focus at the minute for our team is every maternal mental health service might work slightly differently as we start to evolve, is around loss. So I’m helping work alongside if they’re pregnant, following a loss and being around for advice and support.

And we’re developing a pregnancy after loss journalling group and through art therapy and writing and I’m also around to help organise things like debrief pathways if that’s needed. And I’m around if somebody wants to go back into the hospital, maybe they haven’t been back in since their loss, that can be quite nerve-wracking. So just kind of being there for them and also working, on I’m sorry, go ahead.

Oh, yeah. Can I ask you a little bit more about that? I think, you know, listening to this is absolutely fascinating. All of the aspects of care that are available that you wouldn’t necessarily think are within the NHS and one of them, which I wondered if you could said a bit more about was that debrief pathway that you mentioned and discuss a little bit about that.

And perhaps if you’ve seen more of an increase in that in terms of post-COVID and the effect that the pandemic has had on that. Has it, you know, amplified things more? Yeah, 100%. I was talking to Chelsea about this before. You know, unfortunately, with COVID, because of all the restrictions that were put in place, people having to birth on their own, having to go scans on their own, not being able to be around their family, we definitely saw a huge increase in anxiety and in, of course, birth trauma and so one of the works, one of the products have been working on in the area where I’m working is to

make that easier to find out what support is available for women or birthing persons who might want birth debrief and that kind of looks different depending on where they are, depending on how well they are. And because it might be something that the consultant midwife could offer, which is a very senior midwife who specialises in being able to support women through something like birth trauma, to kind of go through their notes, talk about how they felt about it.

And then a really great tool for us as health care professionals is the consultant, midwife or professional midwifery advocate sometimes does this role, and they can then feedback seems to us as staff within our training about thinking about language, how that felt for that family, and how we can kind of improve the care we’re giving. It might be through an obstetrician and it could also be through the maternal mental health service like a long psychological therapy.

It sounds like the services are evolving all the time and the links that you have with women and birthing people to shape the services and meet people’s needs is it just sounds amazing. Sorry, Chelsea, no that’s what I was going to say. I said I love as being a lived experience practitioner, I love when we’re brought in and if anybody’s listening and doesn’t, I mean, it’s a lot of words for what we do but it is just asking women and birthing people what was the service like? how do we make it better?

What was your experience? And it’s great that there’s the other side of that as well because it’s you know, Laura, you’ll know this. It’s such a negative culture and climate around midwives right now. And this really just goes to show how varied the role is and how much, you know, they they do want to make experiences better, and especially with the roles like the consultant and the PMA, really feeding back those themes not only from women but what staff need to do and what they need to be trained in to better support people is, you know, that’s that you can’t ask much more from services and yeah, you’re just, everything you’re doing sounds

amazing. And I know COVID really amplified the climate that midwives work in. It became a lot harder but also amplified the negative experiences that women were feeling. And you talked about the need for more kinds of birth reflections and breaking down what did happen. Was there anything else? I know you and I have talked a lot about this that we noticed the increase of intrusive thoughts and and what that meant for women.

Because, again, when you break down the experience of birth trauma, it’s so different. But I think maternal OCD and just the word intrusive thoughts has a lot of different definitions and spectrums to it. I think just before you jump in Laura I’d say that we were having a discussion about this the other day and intrusive thoughts sounds quite scary.

And I think a lot of women think, Oh no, that’s not what I’ve been having or that it’s something similar, but not quite that. And this goes back to the point that you were making at the beginning, where women’s experiences are very different in terms of pain and how they would perceive something. And I think intrusive thoughts is one of those as well.

I don’t think that women realise what they necessarily are or that those things that they’re thinking and feeling might be that. And I think it’s quite a scary word and phrase to say yes to. Is that, I guess is that the experience that you’ve seen from women, as you said, not necessarily wanting to say, be referred further would say, yes, I think that’s may or is that what this is?

Is this what I’m thinking? 100% and even in midwifery world when we first started doing the standalone training about the different diagnoses around mental illness and maternal OCD, people just think of like, you know, they wash their hands a lot. They don’t realise that actually, it’s much more than that. And then on the flipside, for a woman or birthing person to say to a midwife, they might have met once or twice or might have been seen for the first time postnatally when they haven’t slept for a few days.

The chance them opening up to that midwife is really difficult. It’s such a brave thing to do. And then so you need that midwife to react well if you know if you open up like that. So I think that’s been really important part of the role of the perinatal mental health midwife and the maternal mental health services is making sure that midwives are equipped to know what those thoughts are, but also supporting women because we all have intrusive thoughts.

You know, you might think when you’re walking down the street that, oh, I know what happened if I fell right now, if I jumped in front of that car, what would happen? then think, why did I think that? and then you just ignore it and carry on. And so those are normal. Completely normal, weird thoughts that we have.

But in pregnancy and postnatally, what can happen is those thoughts can come into our head around the baby and they can ruminate, they keep coming back, coming back, coming back. So you can’t let go of those thoughts and they can become quite terrifying. So for example, I had someone before who didn’t want to leave her house because she was scared that if she went outside, she might step in dog feaces and then walk back into the house.

The dog feaces might end up on the carpet, and then she could fall over and touch the carpet and then she could actually touch her face and ingest it and then poison her baby. So these thoughts that were just spiral around in her head and make her absolutely terrified so that she didn’t go outside. Other people who would pick their baby up and think what would happen is if I threw the baby out the window, even though they have no intention at all of doing that, this thought would come in their head and they would start to think, what is wrong with me?

Like, I must be a horrible mother. And they aren’t. They aren’t. And I think as well as those thoughts that, you know, women having them or birthing people having them, they don’t want to say them out loud because it’s again, I think it’s one of those issues that isn’t talked about very much. And it’s quite a hard thing to say to someone, you know, even a midwife, you might not have met them before and you are sleep deprived and you’re having these thoughts and you think, I can’t possibly say that out loud to someone.

I’m thinking that because what is going to be what’s going to be the reaction and what is going to be the consequence. But actually, you know, for you and other midwives to say that is completely normal and, you know, you are not alone, I think it’s so important for people to hear. 100%, and I think to reassure women, if you are having these thoughts, please do speak to someone because we can help you to get support.

And there’s even a dedicated website, and it was created about ten years ago called Maternal OCD, which is just full of a wealth of information from women with lived experience. We can go and read their stories and think, Oh, I’m not alone. There’s not anything wrong with me. I just need a bit of support to get well. And ironically, I was saying to Chelsea, as we were just talking about this, they’ve just about a really helpful booklet to celebrate their ten-year anniversary, which has got podcasts on it, stories where to get help, what kind of help is available if you’re having intrusive thoughts.

And I guess the big, big messages is like, a don’t feel alone. You’re not a bad mother and there is help out there and we will. Yeah, we will link to that and to all the websites that you’ve mentioned as well. Great. Thanks for that Laura and yeah, totally echoing that I’ve, you know, in my own circle of friends you know that that first conversation of are you having these thoughts is even scary so I know going to a health care professional and saying it, but I was just trying to look up the percentage I think at the link of it.

It says over 90% of women do have these intrusive thoughts. But it definitely, there’s a really good quote that I tried to find of your thoughts are not what you actually want to do. There’s really little relationship between your thoughts and your actions. And it’s you know, it’s women knowing that if they come to you, it’s not an immediate kind of safeguarding red flag or anything.

It is just saying these are sometimes normal things that happen while you’re pregnant or postnatally. I don’t know if you know that the actual stats of it, Laura, but it is really high of people that do have intrusive thoughts during this, the perinatal period I think it is about 90%. Yeah, definitely, because I think even outside in normal life like yeah, we all have them.

It’s just that we have a village to say at that moment. Be like, What was that? I’m ignoring it. I’m not even, maybe not even acknowledging it, just carrying on with your life. Like, what was that? I’m ignoring it. So it’s, it’s an inability for it, like keeps coming back and it affects your sleep. It affects your ability to want to change your baby or hold your baby because you’re scared of those thoughts.

That’s when it becomes problematic. And we want to offer support to help you get better. And I think this is, there’s many taboos and many myths and many issues that aren’t spoken about enough and that people feel ashamed of. And I think this is probably one of the biggest because, you know, as a first-time mum, I never heard about this.

I never knew anything about this. It wasn’t mentioned. I didn’t, I hadn’t heard about it at all. And so I think it’s you know, I think a lot of the understanding comes from women trying to do their own little bit of research at whatever time in the morning, sleep deprived and terrified. And so by having these conversations and, you know, for both you and Chelsea to say that this is, this is normal, this happens, you know, you might need a little bit of extra support or you might not.

But this is this is okay. I think that is a massive and really important statement of fact for women and birthing people to be aware of. And I just wonder if people are listening that maybe knew a little bit about this, didn’t know anything about this, sort of what happens next once you’ve spoken to someone about this or you want to speak to someone about this, what should you do?

Where could you go to to get a little bit more help or some support or just, you know, talk to someone else about it, that has been through it and can offer advice? Yeah. So the website is excellent resources, got loads of links to support and resources called Maternal OCD. Like I said, we’ll link it, but I’ll say your midwife if you don’t feel like you can open up to your main midwife, whatever reason, you know, it’s like everything at work.

There’s always somebody that you don’t want to talk to. You can ask to speak to someone else. You could speak to your GP if you have a good relationship with your GP, you can also self-refer to something called Talking Therapies. It’s called something different all around the country might be called IAPT, Time to Talk, but if you were to look up IAPT on Google, it’ll tell you where your local service is and that’s like a talking therapist type CBT type service and that’s self-referrals.

You don’t even have to wait to see a GP or midwife. You could refer right away. Being pregnant, you get accelerated to the top of the list. So you should ideally get a phone call and start something like CBT within 4 to 6 weeks. Ideally, COVID has impacted the wait list a little bit, but it’s not a terribly long waitlist.

And then if you start to access those services and they realise actually you need something a bit more dedicated, somewhat more specialised, like a perinatal psychologist, for example, or maybe if you need a little bit of medication to tide over until you get well again, then they can refer you to a perinatal mental health team. So it’s almost like a safety net.

So if you felt like, oh I couldn’t talk to my midwife or I couldn’t talk to my GP, Talking Therapies IAPT is a really good first step to try And like I said, the Maternal OCD has got really good links to helplines and support on there as well if you want to get advice, I think that’s really important to acknowledge that there’s, that there’s different levels for everybody and you know, in these services, these maternal mental health services, there is a variety and a real range of options and treatments to suit every women and birthing person out there who might just want a little bit of support or might need a bit

more in the overview that you have given into all of it, I think will have opened a lot of people’s eyes to what is available, because I think sometimes people might think there’s a bit of a drop-off, you know, post once you’ve been discharged from your midwife. You know, I’m talking from experience in COVID, you sort of feel like there’s a bit of a gap and you’re not really sure who the best person to go to is or where to get advice and support.

But you’ve really, you’ve highlighted the best ways to do that. So I think that would be really important for a lot of people listening and just to make others aware that there are, there are services available at all levels across London. Yeah. And before COVID, there was this great app called the Hoop app, HOOP, oh my God, It saved my life when I had my son because I can put in my postcode, it would tell me where there was a baby group on.

It would tell me where there was something. I put dry shampoo in my hair and I would go, Yeah, you know, even on the days of like very little sleep because it’s the best thing ever, but it’s also the most hard, difficult, isolating thing at times. So I think we can all agree on that. I think, oh my gosh, it’s significantly.

Yeah. So I feel like we can’t all look like Beyonce every day. But you can get out of the house. And I think that’s still really important, even post-COVID. So there’s obviously on your website, you’ve got really good links to peer support that’s available around London. And I think finding the right group for you. So I think one thing I haven’t mentioned that’s really important, obviously, though, is listening to this can probably understand or speak English, but services are available through interpreters.

So if there’s anybody that didn’t speak English, that wouldn’t be a barrier to accessing a maternal mental health service or perinatal mental health service or Talking Therapies, there’s also groups that are more targeted to women, like in South London we’ve got a Spanish speaking mum’s group and there’s also the motherhood group for Black women. There’s lots of different groups that you could find out in your local area that it’s helpful to kind of reach out and see, Oh, I want to find something that’s to kind of help me get through this choice.

But oh, my goodness, difficult journey of motherhood. Parenthood. Yes, I think that is something that kind of we would echo again is that it’s really good to look local and see what is nearest to you and available to you, because that will be you know, you just mentioned loads that, you know, there will be those groups out there that aren’t far that you might not even know about.

And we will link all of the groups that you said again to this. Chelsea, would you want to add anything to the end of that or highlight anything else that Laura has mentioned? Yeah, I could talk to you both. I mean, motherhood brings a lot to conversation, doesn’t it? But yeah, it is just echoing that and I think echoing that sometimes when you’re sitting there and you know, something just isn’t right.

And, you know, some people may say it’s tiredness, you just need a nap, it’s this or that. But, you know, Meg and I have talked about this a lot, that there is this real self-worth to it. Like you really are worth feeling your best. And the the hardest part is going to this first step. We hope we provide this with enough support and links and local groups that if you do feel comfortable taking that step because you are really you are really worth going to get help.

But I absolutely appreciate that overwhelming feeling of, that is just one more thing I have to do. But I hope these podcasts and the couple we’re going to do, really help you know, you’re not alone. I know we’ve talked about intrusive thoughts today and just different aspects of perinatal mental illness or not feeling your best, but there’s lots of places that you can go and that will make you feel not alone, I guess is my point.

And we hope that these podcasts and talking to Laura and other healthcare professionals, really show how much support is out there and how much it can be adapted to be exactly what you need. It could be at a very low level or a very high level, but you’re definitely just worth it to go get that support.

Definitely. And Laura, if your, you know, there’s someone listening that thinks, okay, I I’m going to do something now. I want to speak to someone a little bit more about this and maybe access some of the amazing-sounding therapies, support, help offers and guidance are available. What would be that first step, what should they do first?

It depends on where they are in their journey. So if they’re pregnant, please speak to your midwife. Almost every trust I know in England and Wales and Northern Ireland and Scotland, I think they have 160 specialist mental health midwives now, which is incredible because we definitely didn’t have that seven years ago. So you could ask to speak to a mental health midwife, you could ask to speak to your GP, if you’ve given birth, speak to your health visitor and reach out to the IAPT Talking Therapies.

Find a local group. There’s there’s so many little groups that are going around. Access the website that you guys have created, which is amazing with all the peer support links there. And yeah, and just you are not a bad mother, you will get better and just ask for help. I think that you are not a bad mother, just ask for help,

I think that is a perfect statement to end on because I think that that will really resonate. So, Laura, thank you so much for your time and all of your knowledge in explaining the differences in midwives, in services, the support available and to Chelsea for her knowledge, expertise and insight, I think and I hope this will help a lot of women.

So thank you very much. Thank you. Thank you.