Black mothers are more than twice as likely to be admitted to hospital with perinatal mental health conditions than their white counterparts, a Guardian analysis of NHS figures has found, with racial inequality described as ‘horrific’.
Between 2020 and 2023, there were 777 admissions to NHS England hospitals of people with a primary diagnosis of mental health disorder – which occurred in the six weeks after giving birth. Of these, black women made up 12%, despite accounting for only 5% of deliveries during the same period. They were also more than twice as likely to be hospitalized than their white counterparts, according to the analysis.
Several factors have contributed to the ethnic disparities, including “structural inequality, with ethnic minority women on average being worse off socio-economically, difficulties in accessing services and cultural attitudes towards mental illness,” said Dr Katie Merwick, a senior clinical researcher and honorary advisor. psychiatrist at NHS Lothian.
Dr. Rosena Allin-Khan, the Labor MP for Tooting, said the disparities were “hugely worrying”, and that “every new mother deserves the very best support when she has a child”.
She added: “We know all too well that black women face worse maternal health outcomes, and it is horrifying to see this extend to maternal mental health.
“It is imperative that women have access to services within the community so that support can be received early. After fourteen years of Tory mismanagement of our NHS, which has created sky-high waiting lists, it is not surprising that many women are struggling to access community support.”
For black patients, there were 0.91 hospitalizations per 1,000 deliveries due to perinatal mental illness, compared to 0.43 admissions per 1,000 for their white counterparts.
The figures showed that black women were more than three times more likely than their white counterparts to be hospitalized for severe cases of perinatal mental illness and behavioral disorders related to the six weeks immediately after giving birth.
For serious mental health admissions, there were 0.7 admissions per 1,000 deliveries for black patients, compared to 0.2 admissions per 1,000 deliveries for white patients. Asian and mixed background patients also had an increased risk of hospital admissions; 0.25 per 1,000 deliveries for Asian patients and 0.54 admissions per 1,000 deliveries for mixed-race patients.
The hospital admissions the Guardian analyzed ranged from mild to severe mental and behavioral disorders, and included postpartum mental disorders, including postpartum psychosis.
According to the Royal College of Psychiatrists, around 1,200 new mothers in England and Wales experience postpartum psychosis every year.
Postpartum psychosis is considered a medical emergency that can cause depression, confusion, hallucinations and delusions, and – if left untreated – can lead to serious consequences. The disease usually manifests itself in the fourteen days after delivery.
The numbers further reveal the stark racial disparities in maternal health care, with Black women nearly four times more likely to die during childbirth than their white counterparts.
According to NHS England, a record 57,000 new and expectant mothers received specialist support for mental health issues in 2023.
Birte Harlev-Lam, executive director of midwifery at the Royal College of Midwives, said: “The provision of perinatal mental health care in the UK and particularly in areas of high social deprivation, where women often need the most support, has for too long been a postcode lottery. Action is also needed at national level with a multi-agency approach to better support black, Asian and minority ethnic women suffering from perinatal mental health problems.
“There needs to be more collaborative working between doctors so that problems are spotted earlier, better training – and more time to undertake such training – and specialist midwives to meet the increasingly complex needs of these women and families. Mental health problems, along with physical factors, are among the leading causes of maternal mortality in Britain, and yet this is not reflected in the resources allocated to them.”
An NHS spokesperson said: “The NHS is committed to supporting women with mental health problems – every part of England now has a specialist perinatal mental health team and we have recently opened 39 maternal mental health services, with almost nine in ten women reporting receiving mental health care during pregnancy.
“However, we know there is still more to do, including to tackle racial disparities, and we will continue to work closely with NHS Trusts to ensure safer, more personalized and equitable maternity care for all women, babies and families.
“If you are pregnant or have recently given birth and are struggling with your mental health, ask your GP or other services for support – the NHS is here to help.”