Substandard mental health care for pregnant women and new mothers results in long-term costs of more than £8bn every year, according to a new study from the Maternal Health Alliance (MHA).
While some of this cost is related to the mother’s problems (such as bills for health and social care, lost earnings and the economic effect of suicide), much comes from the future impact on children, partly because a mother’s psychological distress while pregnant can harm the foetus, and partly because a lack of good care by the mother in the first year of a baby’s life can damage a baby’s development.
I feel slightly uneasy about reports like this. Obviously it’s wonderful that someone is paying attention to women’s mental health needs during pregnancy and birth, particularly when they are currently so badly served by the NHS. But I have two concerns.
One relates to the calculation of the potential damage to the child of being cared for by a mother with psychological problems. It’s very important that babies are not neglected, but it’s by no means certain that a mother’s depression or other psychological disorder during pregnancy and the first year of a child’s life will inevitably have a long-term detrimental impact on a child. Indeed, a lot of women who feel distant from their child do their very best to compensate for that lack of maternal love by caring for it as well as they possibly can. Sometimes if the mother is coping badly, then other family members will step in to help.
The second issue I have is the emphasis on cost. Eight billion pounds is a huge figure, and I suppose the argument is that if we invest properly in providing good mental health services, then we won’t have to spend it on trying to repair the damage done to emotionally maladjusted children, who may have behavioural problems or learning difficulties.
But is the desire to save money the only reason for looking after mothers’ mental health? Does everything important in life have to be costed? Surely the case for looking after mothers’ mental health is that it’s the right thing to do. We want mentally healthy mothers and well-adjusted children because it’s good for everyone: wouldn’t we all prefer to live in a society where most of its members are happy and fulfilled rather than depressed, anxious or frustrated?
And really, what that ultimately leads us to ask is: why are so many new mothers suffering mental health problems in the first place? Wouldn’t prevention be better than cure?