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Oh Pod! x UCL is a co-produced podcast tackling the taboos of healthcare issues. In this series, Shakira and Iman have insightful conversations with leading academics about common health related misconceptions, covering everything from anxiety to perinatal mental health. Each month Shakira and Iman are joined by a leading academic to offer their perspective on the big questions, cut through frivolous news and to de-bunk urban myths. Oh Pod! x UCL is a warm, inclusive, and inviting podcast. Episodes are aimed at the public. They are understandable to individuals from all levels of education and backgrounds, with no science experience required.
Led by Dr Rupy Kaur Matharu & Dr Shoba Poduval.
Brought to you by UCL and Waltham Forest Future Formed.
EP1_UCL.mp3
Iman Issa-Ismail [00:00:00] Hello and welcome to Oh Pod!. Today we'll be discussing women's mental health and we are joined by Doctor Kate Adlington.
Shakira Crawford [00:00:07] Thank you for speaking with us today about women's mental health, specifically women's perinatal mental health. Could you tell us a bit more about yourself and what it is that you do?
Dr Kate Adlington [00:00:15] Yeah. Of course. Well, thank you very much for asking me, first of all. So I'm, as you said, I'm Doctor Kate Adlington, I'm a doctor, in, and I'm training in general adult psychiatry. And my particular area of interest is a mental health in the perinatal period. So basically that's, pregnant women and, the first year after giving birth. So, mental health during that time. So, I work in that area in East London, and I also do a bit of research in that as well.
Iman Issa-Ismail [00:00:46] We have a couple of questions on cards, so I get distracted by them. They're pretty brief, so feel free to. Add as you go. Then that's a script on this. First question is, what are some lifestyle choices that you recommend for a healthy pregnancy and is an unhealthy pregnancy linked to poor mental health?
Dr Kate Adlington [00:01:05] So really good question to start off with. And I think it's really important to say that it's never too early to start thinking about healthy choices. So before you even considering pregnancy, you know, obviously it's good to think about, making healthy lifestyle choices. But one of the things we definitely say is if you are planning a pregnancy, that's a good time to start looking at lifestyle, looking at some certain factors, partly because, that can both increase your chances of getting pregnant in the first place, but it can also kind of ensure that you have, healthy pregnancy and healthy baby. So some of the key things that kind of we recommend thinking about is trying to, if you smoke, trying to certainly cut down and hope to eventually stop. And we know that's that's really difficult. So getting some support with that early before your, before you are pregnant is probably a really good idea. Also things like drinking alcohol. Again, the advice when you're pregnant is to not drink. So again, trying to think about that early and cutting down, I think just generally kind of things that we think about throughout your life, you know, getting regular exercise kind of, doing, you know, doing things in your life that keep you kind of happy and active are really important. And doing that early is, you know, before your pregnant. Making those changing changes early is, is is important. I think another thing that is recommended before you get pregnant is thinking about your diet and certain supplement. So taking folic supplements so folic acid supplements is something you can get over the counter. and usually sort of three months before you're pregnant is ideal. But just to say we've seen, you know, lots of pregnancy pregnancies aren't planned and that's.
Iman Issa-Ismail [00:02:48] A good thing. Yeah. You didn't obviously want to get pregnant. Then it happens. You're like, yeah, I didn't have that three months to prepare myself.
Dr Kate Adlington [00:02:54] Totally. And I think actually, like I think it's nearly half pregnancies aren't fully planned. So, just again, it's it's never sort of not never too early to make healthy choices, but it's never too late either. So once you know you're pregnant again, it's it's thinking about those things. So if you're smoking, try and stop, drinking, trying to cut that out. And the good thing is that is support with things like that. So seeing your GP, and there are local services that are really targeted at pregnant women to help with, things like that. Also going to a local pharmacist and asking them kind of what supplements there are, kind of what what's the best kind of, as I said, folic acid supplement. And, you know, there's lots of stuff online as well that can give you advice. So whilst we say kind of see your GP, that's it. That's a good kind of point. We know some times it is quite difficult to get an appointment. So looking online, the NHS website has got loads of advice about kind of lifestyle choices. As I said, supplements, you know, support groups, things like that. One of the things I did want to mention was obviously mental health is my thing is one of the really important things is if you have existing, difficulties with your mental health and particularly, say, if you're taking medication, that's one of the big questions that comes up is, if I'm pregnant, should I stop taking medications? And that's true for mental health or other physical health problems. So that's why it's a good idea to kind of check in before you get pregnant, because you can get some advice about things like that. What things can you do to kind of, optimise your mental health, your physical health before you get pregnant, but also really importantly, some advice around medication so that because often you don't need to stop your medication. But sometimes people, once they get pregnant, they suddenly worry and they might suddenly stop them. And actually, that might be the worst thing to do. So, it's good to get some advice around that.
Shakira Crawford [00:04:44] Yeah, yeah, it's good that Google exists because, yeah, I tend to use Google for almost everything. Yeah. And the NHS website, it's a really useful when it comes to medical issues. And yeah. Yes, it's not always easy to get in contact with your GP or go to the doctor.
Dr Kate Adlington [00:04:57] So I can say that and I know people can kind of complain about Doctor Google and you can kind of go down like rabbit holes and it can be scary. So that's why it's really good to try and stick to kind of like acceptable websites. So usually there is the NHS one, but they usually do also signpost to other kind of accepted like there are loads of really good charity websites as well that give advice. So I think Tommy's is a good website that gives advice about planning for pregnancy.
Iman Issa-Ismail [00:05:23] Do you know if there were like sorry, any like apps or something thinks of those people? A lot of people on their phones nowadays in their communities. Yeah. So any like maybe.
Dr Kate Adlington [00:05:30] I do know this is an NHS app that's Yeah that and from there they some they do signpost. There are kind of pregnancy kind of, panic. Well pregnancy planning apps, and ones that you can use a lot of ones people use during pregnancy. Like sometimes they're paid one, some you can get free. I probably wouldn't recommend. And any in particular, but not there not to use. But there's none that I would say a better than the others, but, they are useful. So yeah, definitely.
Shakira Crawford [00:06:02] So the next question is of what are some of the medical health issues that affect women in pregnancy during the first year, and how are they treated?
Dr Kate Adlington [00:06:10] Yeah, kind of mental health complications are probably one of them are actually one of the most common complications of pregnancy, which I think most people aren't aware of. And I think if we think about it, some of you might find that surprising because I don't know, in society, like, there's this sense that kind of pregnancy and becoming a new mom, it's meant to be like the happiest time. Yeah. It's like, why isn't everyone jumping for joy? It's the best time. But I think the reality is actually both pregnancy and and becoming a new parent in general is really hard actually, and can be really hard. So some people have great pregnancies and it's all, you know, petrifying. And that's brilliant. But actually being pregnant, you can feel really rubbish, you know, especially the first trimester, sickness. You know, tiredness can bring up lots of emotional stuff for people kind of thinking about becoming a parent themselves, particularly if maybe they've had difficult experience of parenting themselves. Once babies hear, you know, no sleep, you know, struggles to feed, breastfeed, you know, what do you do? The mum guilt, you know, which you know, is is really present. So there's loads of challenges. And so it's sort of no wonder that actually people can struggle both emotionally, but also to the point that they actually develop kind of mental health problems and depression is, so we talk about perinatal depression. So that's kind of depression. People can develop it in pregnancy. About 1 in 6 women or after birth is kind of more common. So and we're not really sure why they're.
Iman Issa-Ismail [00:07:40] Not sorry include like postpartum.
Dr Kate Adlington [00:07:42] Exactly. So that's exactly it. So about one about 20% of women who give birth will go will experience depression, kind of especially in that first three months. We don't know why. There are kind of lots of theories. Is that the hormones? Could it just be like the social, you know, the social changes? We're not sure, but it is. It's it's common. And it's different to so people we also hear people talking about baby blues. So that's like in the first maybe few days, 3 or 4 days, it's actually about 50% of women suddenly feel, you know, very tearful, very low, very kind of overwhelmed.
Iman Issa-Ismail [00:08:20] I think I actually saw that on TikTok. There was a trend and there was like these women all posting their baby blues and they're crying over them. Yeah. I was like, what's going on? Yeah.
Dr Kate Adlington [00:08:27] So it is, it's it's really common. And actually, again, it's a recognised thing. But the way that's different from depression is it usually left quite quickly. So it's like a day or two and then you know you start to feel yourself again. Whereas depression is sort of low mood, really low energy, just not getting any enjoyment out of things. It's sort of the difference with also the postpartum this new is, is often there are kind of feelings towards, you know, you feel very guilty towards baby, you know, you feel very sad about, you know, and it can can be related to things to baby as well, but it sort of persists. So it goes on for at least two weeks, maybe longer. And you know, and so it is common, and it, but I think the problem is that because there's this expectation about, you know, it being a really happy time, everyone should be jumping for joy. There's a lot of stigma around it. So I think a lot of women don't.
Iman Issa-Ismail [00:09:22] Feel the talk.
Dr Kate Adlington [00:09:23] Yeah, they feel depression. They don't talk about it. They just sort of put on a brave face and they don't get themselves help. And I think that's why it's really important for us to talk about it and for people to talk about it because it is common and it's okay, you know, it's it's okay to feel like that, but it's also okay to reach out for support. Just to say as well that all other mental health kind of problems that can pop up at that time as well. So anxiety is another one. Actually there's something called perinatal OCD. So that's around kind of the time of giving birth and having your baby. Some women do actually develop OCD for the first time. I don't know if you've.
Iman Issa-Ismail [00:09:58] Oh, is that similar to nesting was so separate.
Dr Kate Adlington [00:10:00] It's slightly different. It's obsessive compulsive disorder. So it's where people people will maybe start to obsess about certain things. They have very intrusive thoughts about things like maybe baby's cleanliness. So they get really worried that maybe baby's getting kind of dirty or, or the health baby, and they'll get these really intrusive thoughts, and then they'll do things to try and kind of make themselves feel better. So clean baby, a lot more like keep cleaning the house, make sure there's nothing that's going to affect baby. And it just becomes really, really stressful for them and really kind of, intrusive and upsetting. So that's much that's more rare, but it's just kind of say that things like that can crop up. It's just, you know, this is a really important time when because of all the changes that happen and we're not sure why these mental health problems come can happen. So it's really important to talk about it because there is treatment. There is treatment out there. and People and women can get help.
Shakira Crawford [00:10:54] On the topic of some mothers having OCD with a new baby. I completely understand that because babies are born with no immune system, so you definitely want to keep everything clean, and some parents might overdo it and get really stressed about that, so I can understand where that anxiety might come from. Yeah, yeah.
Dr Kate Adlington [00:11:13] And I think that's one of the things, is important kind of because you worry about saying, can they worry about seeing doctors, but they definitely worry about saying mental health professionals because they worry that, you know, think, is this normal? Is it not? Is it going to. And actually part of our job sometimes is to say, you know what this this is with, you know, that those are valid concerns, that it's very worried, you know, and actually, you know, you're okay. There is support. You don't, you know, this this isn't, you know, a mental health disorder. But sometimes those worries do get kind of. I overblown and they do get carried away and they do get and they start to affect your life. So I need you need you know women need or people need support with them. So that's, you know, part sometimes it's just reassurance that people need. And just to say actually you're doing really well and that's a valid concern. And but sometimes you say actually it seems like this has got.
Shakira Crawford [00:12:08] And it's affecting your.
Dr Kate Adlington [00:12:09] Life. Exactly. Yeah. And it's gone. Exactly. Stopping you from going out or, you know, you're cleaning your house for hours and hours every day and, and you don't want to be so and but luckily there is treatment and help.
Iman Issa-Ismail [00:12:22] So yeah. Related to that we wanted to ask when do you when you don't have a good support network. Sorry. Parenting especially is especially hard. What support is available in the first year for parents. Yeah.
Dr Kate Adlington [00:12:33] So I think that's one of the really key things is kind of You know, one of the things that can help with your mental health and kind of help even the transition to parenting is having having social support and a lack of social support is associated with kind of developing mental health conditions. So, and I think that's one of the things I see preparing early in pregnancy, being aware that actually it can be tough. You're going to need people around you. And, you know, not everyone has a partner and a friend has family. So there are other ways you can get, you know, support. And it's both emotional support. So it's kind of having if we can just vent to and talk to you, but also practical support, like you sometimes want to nip out to the shop. And is someone there to look after, baby, you know, just for an hour a day or an hour a week, you know? So I think, you know, thinking about what the source of support are, I think kind of from I kind of, I guess, medical perspective, you know, we think about, you know, the support you have early in the early days. Midwife's really important. So in these early days, you usually see a midwife every kind of in the first day or week or two, you'll see them and they will be have a really good sort of font of knowledge for local services and local kind of support groups or classes or children's centres or feeding support, that they can give to you and then that you can then use kind of going forward. So that kind of. Yeah. So I want.
Iman Issa-Ismail [00:14:03] To know, so how early in your pregnancy or like how long do you can you get a midwife. Yeah. Like in the process.
Dr Kate Adlington [00:14:09] So it varies a little bit. But you but kind of standardly your first appointment with a midwife is your booking appointment. So that's when you're usually about kind of about 8 to 10 weeks before 12 weeks. Usually if you know you're pregnant that same age, you either contact your GP or lots of kind of hospitals, maternity services. You can actually just refer yourself. So since you've done a pregnancy test, you can contact them and say, I'm pregnant and they'll offer you an appointment. The midwife from that point, there's sort of a really kind of a schedule of midwife appointments throughout your pregnancy. It depends a little bit whether it's your first or second, but there's that. Then you have your first scan at 12 weeks, then you might have another appointment at 16 weeks and so on. And so that's really good because at each of those midwife, there's kind of lots of physical health stuff around your pregnancy, but they also kind of check in with you around kind of how you're preparing, you know, how you're doing. And that there is like a emotional, you know, checking in. But also they start to introduce kind of ideas about kind of what's happening locally for you once you've got baby kind of what services there are, what supports are available. And they also I think this is kind of from my perspective that they're like often the first sort of port of call around your mental health. So if people are struggling with that, women are struggling with that in pregnancy. They're the ones who usually ask about it in those appointments. It's not always the same midwife. It depends kind of on the hospital. So sometimes you are seeing a different person each time. There are different thoughts on that. Some women kind of like the idea of seeing the same person, but sometimes it's just not possible. And then after you've given birth, there's another schedule. So you usually see a midwife, like on date, you see them in hospital if you give birth in hospital or if it's at home like day one. And I think it's like day three, day five. So they're, they're quite intensively involved in those first kind of week or two, which again is really good because that's, you know, if things are starting, if women are starting to struggle at that point, they can kind of check in and, and refer you on both just for general support in the community, but also kind of for more specific mental health support. But the other person is people who are really good for that as well is their health visitor. So all women see a health visitor. They come to see you in the first couple of weeks at home, after you given birth. And again, their job is definitely like the the kind of contact point with your community for kind of like community support. So they'll check in with you, check in with baby. They weigh baby. They check in with how feedings going and things like that. But they also have really good resources around who can you see in the community if you're struggling with feeding or where? What are the local support groups say if you're, single mom, you know, are there any special support groups specifically for that? Or, you know, where can you can get baby weight, things like that. So it's kind of you don't just feel left like, yeah.
Shakira Crawford [00:17:10] With all the changes that come with pregnancy, what advice do you give to parents to help them to adjust to the first year?
Dr Kate Adlington [00:17:19] One of the big ones is what I've said just before about is it's not, you know, it can be really hard. And don't worry if it is, because that's normal. And don't you know, the most important thing is, if you are finding it hard, is that you feel able to talk about and tell people. So that's really important and reach out. Kind of find your network, find people who that support you. You know, look out for local mums groups or, you know, kind of social groups that you can get involved with because those you kind of it's almost like find your tribe because it is a massive change. You know, people they lose, they sometimes get a bit disconnected from, from their old networks. You know, you stop working, you know, which is a big thing, both in terms of identity but also kind of losing that financial, you know, support, again, if you're a single parent, but even and if you have a partner, you know, as a woman, if you stop working that can feel, you know, make me feel quite vulnerable. So just having that support group is really important. I think, and things like social media actually really. So go on Instagram and just look to see if they're any kind of local, just kind of local mums who are kind of chatting about what's going on. I live in what I live in North. And so actually and there's, an Instagram account called E17 baby, which I would never follow for I had a baby, I had one, and actually it's really useful because she kind of posts about loads of different stuff that's going on in the community, kind of waste ways to check in, you know, groups, health, you know, things various, your health, but also things related to social. So for me, I think that's really important. I would say that it's my I kind of my area of interest research was around loneliness. And like around that period and kind of how that links to depression. So for me, I think that's really important. Yeah. So yeah, I think my main advice is around that kind of thinking about kind of your, yeah, thinking about you as a kind of individual and your needs kind of, you know, what your social support is. And I think the other thing, sorry, which I didn't say was that's also around that kind of feeling, the pressure of being a new mother. There's this kind of theory in psychology about being a good enough mother. And I think people put a lot of pressure on themselves as parents to kind of get everything right, everything to be perfect.
Iman Issa-Ismail [00:19:41] It looks even harder now because social media, so many people are all showing off, like their perfect babies and their perfect motherhood. And it's kind of like I'm not doing as well as she is.
Dr Kate Adlington [00:19:49] Yes.
Iman Issa-Ismail [00:19:50] Like that big. Like it's like it's like, oh, I'm looking for help. But at the same time I'm seeing people doing better than me. So it is a feeling of like, I don't feel like I'm good enough.
Dr Kate Adlington [00:19:57] I think that's a really good point. She was saying, like, look on there for support. But actually the first you have to look quite hard to find the kind of real.
Iman Issa-Ismail [00:20:05] Yeah.
Dr Kate Adlington [00:20:05] Support. Right. Instead of that, the shiny. so actually. Right. That's probably not for social media. Everybody isn't the best for everything.
Iman Issa-Ismail [00:20:13] So 5050. Yeah. But yeah.
Dr Kate Adlington [00:20:15] It can it can work. But but yeah. And it is just that it's like actually sometimes just being enough, being good enough is fine. And you know, you're you're your own worst critic. You're, you know, you you're better. You baby won't know if you, you know, you've chosen exactly the right. You know, you haven't dressed them in the perfect outfit or you know, you haven't. You know you haven't gone to every single baby group going or you doing just enough for them is absolutely fine. And just finding your feet. People often say like, don't leave the house for the first two weeks. I think that's this pressure to get out there doing stuff. And it's it's really hard. So kind of giving yourself time getting into it. But at the same time, you know, having some contact with the outside world and having some support is really important. Yeah.
Iman Issa-Ismail [00:21:03] So similar to that, I guess, on the topic of, suicide is the most common cause of death during the first year of perinatal. So the work you do is central. Sorry. Can you speak more on it?
Dr Kate Adlington [00:21:15] Yeah. Of course. And, yeah, I thank you for asking that because it is it's sort of it's a it's a really tough topic. And people often, you know, talking about suicide in young mums and pregnancy is really hard. But I don't think I think it's not well known that suicide is one of the is the leading cause of death set in the year after birth. It's really surprising, but unfortunately is it is the case and it is obviously linked to the fact that, you know, mental health, these perinatal mental health problems do happen and they are common. So basically there's there's a report that gets published every year. It's called the Embrace Report, where they look at the all deaths of women in pregnancy and in the first year just to look at the causes, and try and think kind of, you know, you know, it shouldn't happen. What is happening and why is it happening? And that's how we know that, suicide is is common. It happens in pregnancy, but particularly in the, in the postpartum year, or that first year after birth. And we also know that substance misuse is, so, so drug overdoses and alcohol use is a cause of kind of a number of deaths as well. So from a mental health perspective, we, we there's this kind of public health reason to think about mental health, try and support women because it does it can lead to death, but it can also. It's not just that it can lead to impacts on these women's quality of life. It can impact on their, you know, their relationships, their relationship with baby as well. It kind of impacts, you know, their ability to kind of interact with baby. So, it's really important that we, you know, that we address women's mental health both to try and stop these deaths by suicide, but also to try and improve people's lives. Just to say as well, on looking at kind of this report that show, you know, looks at deaths importantly as well. It has highlighted the deaths in that in that perinatal period are much higher in black women and women from ethnic minorities. So, there's a really good campaign called Five Times More, run by women from the black community that it was called five times more because, when, when they started it, the data showed that black women were five times more likely to die. Then more recent report is four times more likely. But it's still obviously, you know, it's it's.
Iman Issa-Ismail [00:23:42] Still.
Dr Kate Adlington [00:23:43] Too high. Yeah, way too high. And I think that's why we have to think about mental health within that. Because, mental health is a big cause of death during that period. We know that, black and ethnic minority women are more likely to experience mental health problems. They're less likely to seek support in the community during this period. And when the DC support, they're more likely to be hospitalised, go into hospital. So what we know is that, you know, there are things we can do mental health, improve. Women, black women and ethnic minority women's experiences that can hopefully a. You know, try and improve that unacceptable death rate and an unacceptable kind of, you know, I guess experience of services. So I think that's, that's kind of important thing that has come out of that report. But the we need to think about and improve definitely.
Shakira Crawford [00:24:36] Is the advice and support different for young mums and single parents than they would be for parents that are married or parents that have both guardians, the mother and the father, and what they need extra support for, for adjusting to motherhood.
Dr Kate Adlington [00:24:52] Yeah. So I the advice probably it obviously depends is different for every person. But I think we know that both kind of young mothers say whether it's teen age or before they age 25 and single parents, they have kind of worst outcomes for mental health. And their face, you know, all these things that we talk about, challenges for any parent. Those challenges, I think are worse in those situations because you're less likely to probably have peers who are in the same situation just by nature. The fact they're, you know, there are fewer people having babies at that at that point. So you're just it's harder to find kind of your tribe, you know, there there are fewer, people there. So you kind of got less social support. You, you know, generally got less support, perhaps because if, you know, if you don't have a partner, that just makes it slightly harder. You know, things like financial situation is probably just a little bit kind of less steady. You've had less time to kind of maybe build up, you know, kind of find income. You might be in the education system and then that becomes a bit kind of more difficult to figure out kind of what you're going to do. So and, we also know that young mums and single parents are more likely to experience domestic abuse as well. So for lots of different reasons, there are just all these challenges that already there are just kind of more you're facing more at that point. So I think there's even more reason why you, you know, you would benefit from kind of social support or groups or but actually, I think the provision is worse. I think actually that it's quite patchy. Support looking for support specifically for young mums and single parents. It's things that are particularly designed for those people is slightly patchy. So I definitely think it's an area we need more research and there needs to be more provision. But certainly it's something that, if you're going to maternity services, it will get flagged up. So they were always in maternity stuff. So you know, when you're seeing your midwife, they will ask you if you've got a partner and it does get it will get fucked up. Not in a bad way if you don't. But often those services will have, you know, maybe special streams or special advice for women who are, you know, single and similarly often there are actually kind of special, kind of clinics, for example, for younger mums, or they'll be special midwives for younger mums, because they, you know, they do have unique challenges and they will know kind of how to refer to, services that are there for them. But I think, I think it's an area that perhaps it does need to be more research and that there needs to be more provision, because I was actually I was looking for a came I was trying to look for kind of charities that are out there that specifically support, for example like teenage mums or younger mums and there isn't there isn't a lot out there actually, and kind of existing charities. So things like there's the National Childbirth trust. So NCT they do mention, you know, they'll have pages that mention younger mums and young mums experiences, but there's not much out there. There's specifically kind of like really focussed on this. So I think it's an area that needs kind of more investment and more research. Definitely. Yeah.
Iman Issa-Ismail [00:28:12] So following from that, the next question is, can you inform us of the services and classes that are available to support new parents during a post pregnancy? I kind of we kind of covered it a little bit. Yeah. Does any.
Dr Kate Adlington [00:28:22] Yeah. So just I did I guess I didn't talk about antenatal classes. So unshared classes are classes that you can attend in pregnancy. Lots of maternity services do their own kind of NHS ones that are usually free. And it might be like a day that you can go along to the hospital and they'll talk about things like often they're really focussed on kind of preparing for birth. Probably rightly, because I think that's a big anxiety in pregnancy is labour and giving birth.
Iman Issa-Ismail [00:28:52] To think about it. Yeah. That that specific section.
Dr Kate Adlington [00:28:54] Yeah. It's a massive it's a huge thing and lots of women and kind of talk about mental health. You know, for some women it's so, it's such a fear. It is a phobia. There is no such thing as phobia of childbirth. Which is understandable because when we look at it on, the television is screaming at blood. You know. And you know, there are risks associated with childbirth. But thankfully in this country we have a really good house, you know, and in the vast, vast majority of cases, babies are born safely and women are okay. But you know that there can be complications. And so and so it's really good that there's lots of education before that. Women know their choices. They know how to prepare. They go into it kind of fully aware. So that's a big part of antenatal classes. And I said NHS do some of those classes, but you can lots of people also do private classes. So I think I mentioned the National Childbirth Trust. So people talk about NCT classes because they run these antenatal classes. The thing about them is they are actually quite expensive. So I think they and lots of women do or lots of family have, you know, couples or women use them to kind of find, other women who are having babies around the same time to kind of make, make kind of little friendship groups. So you have your babies similar time you hang out afterwards, but because they're very expensive, I often I think that, you know, exactly to people who can't afford it, they're kind of always kind of locked out of that little bit. So luckily there is there are NHS classes as well, that are free, but there is a bit of a disparity there. But so that's one thing that's important kind of in preparing. But after birth there are I think I mentioned a couple of times there are kind of children's centres, so every local area will have a children's centre where you can go. They often do things like weighing clinics so you can go a long way baby, but they're also run kind of mum and baby sessions. That'll be playgroups and they can tell you about kind of playgroups locally where you can go, you know, often for free to kind of hang out with other mums. You know, again, there are lots of things like lots of, like yoga centres now run kind of mom and baby yoga, or, you know, singing classes, nursery rhyme classes or reading classes with babies. So things like that are kind of good, you know, social support again, because I kind of focus more on the mental health side of things. You know, if people are struggling from that perspective, usually the first port of call is the GP. And actually the GP see kind of 6 or 8 weeks for a check with baby. Anyway, and it's also meant to be so it's meant to be a check for baby, but it's also meant to be a check for the mum to make sure everything's okay and check in kind of emotion physically, but also emotionally and with mental health. So the GP can also kind of if you're, you know, struggling with the mental health at that point, suggest source of support in the community. So there are kind of psychol, you know, psychology services, if you know, you feel like you need someone to talk to at that point. But there are also specialist perinatal mental health services. So that's just, you know, place that people like me. So psychiatrist or mental health professionals will work. So if things are kind of feeling a bit worse and you need a bit of kind of specialist input, they can offer things again, psychological support, support from kind of social workers if needed, support from psychiatrists or other doctors. So they're there in the camp and they work in the community as well. So that's a really important source of support and that people know about them. And I mentioned the GP, but you can actually often not see services. You can refer yourself. So it's worth kind of if you feel like you're struggling just googling kind of perinatal mental health, perinatal mental health services just to see what's available locally as well.
Shakira Crawford [00:32:51] So mental health can really take a toll when you're dealing with multiple births, such as triplets and twins. If there's complications during pregnancy and after pregnancy, is there any support for parents going through that situation and how can they cope with that?
Dr Kate Adlington [00:33:06] Yeah. I a having, having had not had multiple births, but having had kind of recently I've had two children. I've got a three year old and a six month old. I honestly thought of having two at the same time, I cannot imagine. So, it's got its own very unique, challenges. And I think any way multiple when you're pregnant with multiples like twins or triplets there, that can be more kind of physical health complications. You're more likely to have interventions like Caesareans or whatever. So it's just a different experience. And, you know, there are different challenges. Usually again, maternity services have their own, you know, they're very experienced in dealing with that. But they might, you know, they'll have their own, pathways for those, for those women and kind of have their own kind of source of support as well. Things like antenatal classes, often there might be, special kind of groups, you know, even pregnancy where women can go in and with be with other moms who are also having twins. So they're kind of meeting other women who are in the same situation. And again, kind of those unique challenges, you know, it it might be they can still seek support, you know, through perinatal mental health services or through the GP, you know, going they they will be able to refer them on. And I think again, kind of on lines online, kind of support through charities like National Childbirth Trust, they and the NHS websites, they will have, you know, specific kind of support and advice for those. You also mentioned the kind of if people have, difficulties or complications. So and I think I touched a little bit on childbirth and trauma, and I think that is a big thing. We're beginning to think a bit more about. I think in the past it was just like you have a difficult birth and that's just it, you know, stiff upper lip, you get on with it. But I think women who do have traumatic childbirth, you know, it can happen that it's very long or, you know, they've needed, you know, an emergency C-section, you know, caesarean or it's just, oh, it's just been one of the kind of the biggest things that women say who say they've had a traumatic birth. Often. It's just that things were happening and it wasn't communicated to them, or they expected one thing and something different happened. So it's not just one type, but it's often about the women's experience. If they felt it was traumatic and they felt out of control, or they felt things were done to them without their permission, they can go away afterwards really feeling very traumatised. And we're increasingly kind of recognising that that can then affect their mental health going forward. So we talk about PTSD. So post traumatic stress disorder is something often in the past people think about, you know, people have gone to war or things like that. But it's it's actually if you felt like your life is in danger, anything where you feel like your life is in danger. So often women maybe might meet this criteria of PTSD after childbirth just because it was really frightening for them and they didn't know what was going on. And, with a very traumatic experience. So that actually there are starting to be new services in the community that really focus on women who've who've experienced trauma. So whether it's in childbirth or maybe even trauma in the past, that has kind of almost been reawakened by the experience of becoming a mother. So there there are new services that are starting, to really only the first one or 2 or 3 years have started to kind of be set up to really help those women. So it's good to know about them. And again, those ones that you can probably I think lots of them you can refer yourself. And it's a lot it's usually talking therapy. So it's sitting down and talking to someone about your experience. Can can help women, but it's important just to be aware of that. And that is another thing that kind of can affect women kind of after birth.
Iman Issa-Ismail [00:36:58] So mental health and pregnancy can affect the non birthing parent too. What mental health issues have you seen in men and are they supported.
Dr Kate Adlington [00:37:05] Yeah. And again another really good question. And I think it's another area that has been quite neglected. And we're starting to have more awareness that actually it's an issue. And we need to think about because we do see in and often it's fathers. But you're right. We talk about the non birthing partner because there can be you know, all types of partner we see, you know, lesbian couples, gay men obviously becoming parents through adoption or surrogacy. Increasingly trans men, will start to go through the pregnancy experience. And I think we're way behind even thinking about language and provision for that. So, we've been talking a lot about women and pregnancy and breastfeeding, but increasingly we do need to think about kind of trans health trends. You know. Trans health issues in pregnancy and afterwards and using the right language. So, so specifically thinking about perinatal mental health. So we talk about perinatal depression. Certainly non birthing partners can be diagnosed with perinatal depression postnatal depression. So fathers you know female partners because they sort of there are very specific biological changes for the women. We've also talked about well the social changes that happen becoming a parent. And they happen to both parents if they're, you know, all parents. So you know, the non birthing partner will also have changes in their networks, their social structures. You know, just kind of, you know, they may have had trauma or difficulties in their own background in their own parenting and they get faced with their having their own child. So yes, they, you know, absolutely. They can also experiences mental health difficulties that are very specific to becoming a new parent. And we're only just really thinking about that now. And the NHS is has, has actually said we need to think about that. We need to start offering services.
Iman Issa-Ismail [00:38:56] So there aren't a yeah at the moment.
Dr Kate Adlington [00:38:58] Not well I think starting to. So some perinatal mental health teams, for example, will be trying to offer support for partners as well, will offer a psychology sessions maybe with partners, but not all of them off. Not all of them will accept referrals specifically for the non birthing partners. I think it's very variable around the country. There are again online, there are some online support groups. If you look I think I can't remember the name of it now, but there's, I think there's post natal fathers or something that if you, if you look online you can find. But it again it's quite patchy. There was something I found and this obviously touches on LGBTQ plus issues of parenting. There's, Pink Parents I think is an online, website that kind of addresses parenting needs in that community. But again, we're really behind the curve, I think. And it's it's becoming an area where there's more research and more thought about, but I definitely think there needs to be more provision because because these issues, mental health issues, do you support the number thing affect the non birthing partner as well parent. And there are lots of different kind of parenting systems. And you know I think increasingly we can think about, you know you know, the network around the baby, with different parents, different kind of, you know, grandparents and huge involved communities, you know, you can.
Iman Issa-Ismail [00:40:28] Take for the commute, takes a village to raise a child.
Dr Kate Adlington [00:40:30] Exactly. Yeah, exactly. Completely. So, and we're kind of I think we're stuck a little bit in that quite kind of heteronormative mom dad kind of system in the NHS, which is important because it serves some people, but it doesn't serve everyone. And we need to think about how we can be more inclusive.
Shakira Crawford [00:40:48] Thank you so much for joining us today. Doctor Kate Adlington on women's perinatal mental health.
Dr Kate Adlington [00:40:52] Thank you so much for having me.
Iman Issa-Ismail [00:40:54] Thank you guys for watching. And if you found this interesting, we have two more episodes coming out on mental health too. So please tune in and thank you for coming to see us at Oh Pod. Bye.