What is PNMH?
PNMH refers to a mother’s emotional and psychological wellbeing during pregnancy and the first year after childbirth. This period, often referred to as the perinatal period, is a critical time when parents undergo significant physical, emotional, and social changes. While pregnancy and parenthood can be a joyful experience, they can also be challenging, leading to an increased risk of mental health difficulties such as anxiety, depression, postnatal psychosis, and birth-related PTSD.
How common are PNMH difficulties in Ethnic Minority women?
Research shows that 1 in 4 women experience mental health difficulties during pregnancy and after birth. However, not all mothers face the same level of risk. Studies reveal that ethnic minority mothers are more likely to struggle with perinatal mental health difficulties compared to white mothers. For example:
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A systematic review found that Postnatal depression and anxiety are 13% higher in mothers from racialised communities.
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The Born in Bradford cohort study found that Ethnic minority women are 55-70% more likely than White British women to have perinatal anxiety recorded in their medical history.
- Migrant women consistently report higher rates of PNMH struggles than non-migrant women.
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Why are Ethnic Minority mothers at greater risk of PNMH issues?
There are several risk factors for perinatal mental health illness and in the UK Ethnic Minority women are at an increased risk of PNMH problems due to increased exposure to these factors such as:
- Social and economic challenges: Ethnic minority women are more likely to experience low social support, financial difficulties, and the stress of migration, all of which increase mental health risks.
- Stillbirth & Neonatal Deaths: The highest stillbirth and neonatal death rates are found among Black, Asian, and Minority Ethnic groups, especially those living in the most deprived areas.
- Housing Insecurity & Financial Difficulties: Deprivation plays a major role in mental health. Research shows that 15.7% of Asian people and 15.2% of Black people in the UK live in the most deprived areas, compared to 9.0% of white people (English Indices of Deprivation 2019).
- Isolation: Racialised communities are more at risk of experiencing loneliness and often face greater barriers to accessing support.
- Refugee Populations: Refugees and asylum seekers suffer disproportionately from poor mental health, with 61% of asylum seekers in the UK experiencing serious mental distress (UK Refugee Council).
- Birth Trauma: Ethnic disparities exist in maternal health outcomes. Research by The National Institute for Healthcare found that, compared to white women, the odds of severe maternal morbidity were: 83% higher for Black African women, 80% higher for Black Caribbean women, 74% higher for Bangladeshi women and 43% higher for Pakistani women.
What can I do to support emotional wellbeing for Ethnic Minority women?
As a professional working with families from different cultures and backgrounds, you play a key role in identifying PNMH concerns and providing culturally sensitive support.
Recognising the signs of PNMH issues
- Persistent sadness, low mood, or frequent tearfulness
- Anxiety, excessive worry, or panic attacks
- Difficulty bonding with the baby
- Social withdrawal and feelings of isolation
- Changes in appetite or sleep patterns
- Expressing feelings of hopelessness, guilt, or worthlessness
Culturally competent care and safe spaces
- Create a safe, respectful space where parents feel comfortable discussing their emotions without stigma.
- Respect cultural and religious views on parenthood and mental health.
- Be mindful of language used. Terms like “mind health”, “mood” or “feelings” may be more acceptable than “depression” or “mental health”.
- Show openness to learning about different cultures and ask thoughtful questions.
- Use an interpreter when appropriate to ensure there is an understanding between client and professionals.
Knowing when and where to refer
- Refer families for additional and appropriate support when PNMH concerns are identified.
- Be familiar with and signpost families to services that offer culturally specific support
- If there is a serious risk to a parent’s or baby’s wellbeing, ensure timely access to urgent medical or crisis support.
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What support is available Nationally and in Islington?
Islington’s Perinatal Mental Health Pathway offers comprehensive guidance on the local referral pathway and available support for PNMH. At the end of this document, you will find a service directory detailing various support options, their offerings, and contact information. Below is a summary of some of the local PNMH services included in the pathway that may be helpful:
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Parent and Baby Psychology Service - This is a team of clinical psychologists who offer psychological interventions for parents expecting a baby and parents with a baby in the first year, who are struggling with the transition to parenthood.
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Specialist Perinatal Mental Health Services - This is a community based mental health service providing specialist assessment and treatment for women with moderate to severe mental health problems.
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iCope Therapeutic Support - iCOPE offers a range of different evidence-based, psychological treatments. They have a pathway specific for perinatal parents, allowing for faster assessments.
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The Maple Service - The Maple Service is a specialist psychology service for people who have experienced trauma during pregnancy or during the birth of a baby. They also support people who, sadly, have suffered from miscarriages or the loss of a baby, in the last 18 months.
We also have an Emotional Wellbeing Leaflet for parents which helps to explain the services available in Islington.
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Resources specific to Ethnic Minority women
Nafsiyat - is an intercultural therapy centre committed to providing effective and accessible psychotherapy and counselling services to people from diverse religious, cultural and ethnic communities in London. They provide short-term intercultural therapy in over 20 languages via referral to individuals, groups, and couples.
Minik Kardes Day Nursery – is a bi-lingual nursery providing full day care and Early Years Education for children from 3 months up to 5 years for Turkish/Kurdish speaking families. They also provide outreach through their Community Links service, supporting Turkish and Kurdish-speaking families across Islington’s children's centres. Through this service, they offer one-on-one support, parenting programs like Strengthening Families, Strengthening Communities, stay-and-play sessions, conversation classes, and more.
The Motherhood Group - is a social initiative dedicated to supporting the Black maternal experience through community-based events, training workshops, peer-to-peer support, national campaigns (including Black Maternal Mental Health Week UK), and culturally sensitive programs designed for Black mothers.
Tommy's Midwives Helpline for Black and Black Mixed-Heritage women - This Non-Urgent Helpline provides support to Black and Black Mixed-Heritage women and birthing people in the UK. They recognise that Black women may experience racism during their healthcare and are underserved when it comes to support. The helpline is designed to offers a safe space where women can be listened to and supported through any issue related to pregnancy, including pregnancy loss and pre-conception.
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