On Friday 27 September, Prof Deirdre Daly, Director, and Dr Susan Hannon of the Trinity Centre for Maternity Care Research presented at the ninth plenary session of the North/South Inter-Parliamentary Association (NSIPA) as guest speakers on perinatal mental health in Ireland.  

This was the first meeting in eight years of NSIPA, a forum for discussion on issues of mutual interest and concern between members drawn equally from the Members of the Northern Ireland Assembly and Members of both Houses of the Oireachtas.  

Prof Daly and Dr Hannon were invited to present based on their pioneering work through the MAMMI Study, a longitudinal, cohort study looking at a range of morbidities experienced by women during and after becoming mothers in Ireland, including mental health issues. They were joined by researchers from Northern Ireland, including Dr Helen Connor, Chair of the Perinatal Special Interest Group in the Royal College of Psychiatrists and Dr Julie Anderson, Chair of Royal College of Psychiatrists. 

The presentation and resulting discussion highlighted that there are differences in the way perinatal mental health services are offered in the Republic of Ireland and Northern Ireland. However, the forum allowed for lessons learned and good practices to be shared. Issues were also identified which are relevant to both jurisdictions in terms of accessing cross-border healthcare, especially in the context of different legislation. 

Prof Deirdre Daly, Professor in Midwifery, said: “One issue that is of deep concern in both Ireland and Northern Ireland is the absence of a hospital unit/facility where a mother who is really ill with postpartum psychosis can be cared for with her baby. At the moment, there is no mother and baby mental health unit on the island of Ireland.  

Without doubt, the greatest beneficial change in services would be extending postpartum care beyond six weeks. We know from the MAMMI study and HIQA’s (2020) National Maternity Experience Survey (NMES) that six weeks is far too soon to end maternity care and that many women may not experience a health problem until much later than this. Care needs to be extended to a minimum of three months postpartum with easy access to services long after this timepoint.    

Additionally, there needs to be clear and unambiguous referral pathways for women to self-refer to services, be they in the hospital or in the community for months after childbirth. At present, service provision varies considerably across the Republic of Ireland. What women want postpartum is ‘Somewhere to go, someone to ask and someone who asks’. 

On a positive note, the Department of Health funded five postnatal hubs on a pilot basis in 2022. These hubs offer extended and ‘bespoke’ care in their areas and, importantly, offer women integrated care across the hospital and community. We are in the process of evaluating the services provided by these hubs, but early feedback suggests that women’s experiences are positive.  

The Department of Health recently announced additional funding of €2m to fund an additional four hubs and this is most welcome. In our view, these hubs offering extended postpartum care in all areas of Ireland should be established on a permanent basis. This would be beneficial for all women, and there is scope for extending the duration of care offered within the hubs.”