In October 2022, NHS Gloucestershire conducted a survey to find out about women and birthing people’s experiences of mental health support in Gloucestershire, during pregnancy and after birth.
175 people completed the survey in total. Many had positive experiences but there were also lots of suggestions for improvements. The NHS has been working hard on these suggestions and we can now share some updates on what has been improved.
NHS Talking Therapies (Let’s Talk)
What is working well
‘The support from Let’s Talk was amazing.’
‘Regular calls and knowing I would be prioritised if I needed further help after my initial talking therapy.’
What could be improved
‘[I] needed help but didn’t get told of what was available other than Let’s Talk which were unable to help in [the] time frame that I was pregnant’
‘I was offered a referral to just talk which I didn’t take up because I knew it wouldn’t meet my needs’
‘I self-referred to Let’s Talk during pregnancy and was very disappointed by the extremely limited interventions available (basically CBT or nothing).’
What has been done
- The service offers priority access during and after pregnancy (up to 2 years). An appointment will be given within 28 days of the referral. There are three referral options for the therapy team:
- Phone the service for free on 0800 073 2200
- Your GP or health professional can make a referral to the team for you
- Complete the online self referral from
During assessment, therapies will be discussed with you. These may include Cognitive Behavioural Therapy (CBT) or Eye Movement Desensitization and Reprocessing (EMDR). Therapy will be given based on availability and what is most suitable for you.
- Over 50 members of the Let’s Talk team have received training in the last year about pregnancy and the 12 months following childbirth.. The team are also creating a new service leaflet.
Perinatal Mental Health Service
What is working well
‘The support received [from the] perinatal team was exactly what I needed they were there for me every step of the way.’
‘Once referred I was treated with such kindness and compassion, and it helped me to get better.’
What could be improved
‘Perinatal mental health team being able to support longer.’
What has been done
- The Perinatal Mental Health team can now see women up to 2 years postnatally if required.
Health Visiting
What is working well
‘My health visitor – she’s absolutely phenomenal. She was the greatest mental health support afterbirth.‘
‘Having the health visitor for a longer period made me feel supported and gave me the reassurance I needed I was doing the right thing.’
What could be improved
There were several suggestions that there should be dedicated, private appointments to encourage conversations around mental health and wellbeing:
‘A private space to talk to a health visitor and a space to talk as a mum about yourself not just about your baby.’’
One key theme from suggestions from service users was that they felt more training was needed to enable better, more empathetic conversations. Others also felt as though there needed to be more awareness of certain mental health services so that these could be promoted to the women and birthing people who need to access them, particularly in the antenatal period.
What has been done
- A trial project is currently running at 3 baby hubs in Gloucestershire. Birthing people can fill out a request slip for a member of the Health Visiting team to contact them for a private discussion. This will be evaluated and extended to further baby hubs soon.
- Community nursery nurses have recently had perinatal mental health awareness training.
- Health Visitors have also recently had training in emotional wellbeing and are having conversations around mental health at each contact.
Home Start
What is working well
‘Having help and support from Home Start. A safe space to go and talk with other mums.’
‘The support of meeting other mothers at Home-Start was great.’
What could be improved
‘Home start needs to be talked more about.’
What has been done
- A Perinatal Mental Health Support webpage has been created to provide advice on local mental health support services available in Gloucestershire, which includes Home Start.
- A text message from the Health Visiting service is also sent to all new birthing people 3 months after childbirth, with a link to the webpage: www.nhsglos.nhs.uk/perinatalmentalhealth
Interpreting
What is working well
‘My Health Visitor spoke to me with an interpreter and I was able to let it all out.’
What could be improved
‘Why aren’t the services all equipped with interpreters?’
What has been done
- The NHS in Gloucestershire has made improvements to working practices to ensure that all women and birthing people, whose first language isn’t English, are offered an interpreter if required.
Birth review and reflection
What is working well
‘Taking the time to acknowledge my previous losses and experiences throughout the course of my care also helped ensure that the care received during this pregnancy felt both compassionate and patient centred.’
What could be improved
‘There were several comments about the lack of opportunities to discuss the birth experience postnatally, particularly if this birth was traumatic. Many survey respondents highlighted difficulties with accessing support and how beneficial they would have found it if there was a process in place that would allow for a conversation about their birth and any trauma to take place:
‘Let’s Talk helped support my anxiety around my baby’s development but I still feel like I needed support processing the birth.’
‘Being offered a debrief after my traumatic birth.’
‘I reached out for support from my GP and health visitor and let’s talk after a traumatic birth and hospital stay but there wasn’t anything anyone could offer me as I wasn’t suicidal… A system in place for people who experienced traumatic deliveries midwives/GPS to refer them and support them and even just acknowledge [would be ideal].’
What has been done
- Gloucestershire Hospital’s Maternity Service is currently setting up a pilot Birth Review and Reflect Service. This will provide a central point of contact for birthing people who would like to review their notes with maternity services.
- The Gloucestershire Birth Anxiety and Trauma Service offer psychological support for women who are experiencing high levels of distress in relation to their maternity experience such as a fear of giving birth, traumatic birth or pregnancy and baby loss. You can make contact with them at talkaboutbirth@ghc.nhs.uk or ask your Midwife, Health Visitor or Doctor to make a referral on your behalf.