I recently had my first child, so have experienced this additional service that is provided for free by the NHS first hand. When it was first offered to me, I wasn't sure what it was and I couldn't find too much information on it online so I thought it would be useful to explain what it was for me and my experience. Please let me know if you have any questions, I'd be happy to answer anything at all.

What is a Mental Health Birth Plan?

This is an addition to the standard Birth Plan that focuses on mental health aspects of your birthing experience and it is shared to yourself, your partner (if you would like), your GP, Midwives, and any other required health professionals - for example, a psychologist or social worker. I was informed that this is treated almost like law, it trumps most things in regards to your birthing experience and should be followed to the letter.

Support will be organised during your pregnancy. For myself, I had a virtual appointment at least once every week or two. I was also referred to a psychologist and had in-person visits from a Nursery Nurse. These can be quite full on - there were some weeks where I had 4 appointments which on top of working a full-time job was overwhelming. However, if you say that you feel overloaded, they should adjust the amount of appointments to suit what's best for you. Most of these appointments are to offer help with techniques to manage your mental wellbeing, as well as assisting with any questions/concerns you have during birth or once the baby has arrived. In the final weeks coming up to your due date, some appointments should be focussed on creating your Mental Health Birth Plan.

Within my Mental Health Plan was the following:

• Details of your care providers - Midwives, GP, etc.
• Mental Health History
• Current Mental Health
• Strengths and Relapse Signs
• Working Strategies - Breathing Exercises, etc.
• Current Sources of Stress
• Current Medications
• Physical Health Overview - this included my Gestational Diabetes
• Support/Family Network
• Safeguarding Concerns
• Previous Childbirth Experiences
• Plans for Birth
• Plans for During Delivery
• Plans for After Birth
• Baby Feeding Plans and Support
• Medication Plans
• Mental Health Review
• Postnatal Care - Wellbeing At Home, Medications, Support Network
• Crisis & Contingency Plan

It's good to have armbands just in case... If you don't need them in the end, that's ok. At least they were there if you did.

What to Include?

My Experience

As stated, often I found the amount of appointments overwhelming. They check in with your mental health at every appointment - rating on a scale of 1 to 10, and occasionally I was asked to fill in a form to review my mental health more thoroughly. I found the check-ins helpful and it was nice to be able to discuss my concerns and get clarification on things. The team would also chase things on my behalf, for example, I don't take tablets so need liquid medication and they emailed the hospital/my GP to ask the procedure with this as usually you're discharged with tablets.

The Nursery Nurse I was assigned I didn't find too helpful other than questions when it came to breastfeeding. She always came asking what I wanted to know and I never knew what I wanted to know. It  was my first child and it's hard to know what you don't know so it felt like a lot of pressure to try and come up with things to fill the hour appointment slot. She didn't seem to be able to offer anything to me unless I was able to come up with something specific. My original Nursery Nurse did leave come the New Year and I was assigned a new Nursery Nurse, and I find her much more helpful and less awkward. So I think it's down to who gets assigned to your case.

When it came to being at the hospital for my elective cesarean section, they didn't have my Birth Plan or my Mental Health Birth Plan. After being assured that myself, my partner, the hospital, my GP, etc. would be given a copy, no one had a copy. I had to email in the morning asking for my Mental Health Birth Plan once I discovered that not only did I not receive a copy, neither had the hospital. However, I wasn't sent an emailed version of my plan until after my surgery - so it was too late. My Mental Health Birth Plan was completely disregarded. Even when I asked for things while at the hospital, it was disregarded. 

I feel like the whole process of the Mental Health team/Birth Plan was a waste. It took so much time out of my working day while I was pregnant for something that didn't even happen or help. I can't express how let down by the NHS I feel, and the disappointment continues in my postnatal care. I really don't want to put anyone off, but I do want to warn people to not totally get your hopes up. I was so trusting of the people assigned to my case, and it made the whole experience a lot worse because not only was I struggling with aspects of my mental health during my time at the hospital, I was also feeling such disappointment and rejection. Be prepared for even the Mental Health Birth Plan to not go to plan, even when they say it's something that can't be ignored. I had midwives and perinatal team members calling the hospital before my surgery to ensure certain aspects of my plan and that still didn't make any difference, those things still didn't work out.

I think if I were to do it again, I wouldn't have as many appointments and a certainly wouldn't trust in it as much as I did. I'd probably insist on only having appointments once every two weeks, or even once a month until the few weeks before the due date to put the plan together because that did take a few appointments and you need to give them time to send it out - if they do send it out...

While I experienced several faults during my pregnancy, almost everyone I spoke to was lovely and kind, patient. I do recognise they have a difficult job and with the state of the politics and NHS can understand it's a challenging time. Many places are still recovering from COVID and there's confusion/change happening within the industry as a result. 

The link below is for details for my local team, but it may vary depending on your region in the UK. The information on there is for everyone, but if you don't live in my area and would like to seek support then please talk to your midwife or GP.

https://www.mpft.nhs.uk/services/mental-health-perinatal-community

If you are struggling, even if you don't think you're that bad or if you think that someone out there has it worse than you - it doesn't matter, please get in touch with someone or talk to your friends, family, someone. Your wellbeing is important. 

~ Sovay ✧