Women who book into maternity hospitals will soon have their mental health history and current status logged electronically, in an effort to combat post-natal depression (PND).
The disorder — which affects about 15% of mothers — is known to start during pregnancy, and early detection is key in successful treatment. Women who have a previous history of psychiatric illness are more likely to suffer from PND.
As part of the National Maternity Strategy, all pregnant women who come for their first visit to hospital will have details of their past history and medication put on their electronic patient health record.
The Maternal & Newborn Clinical Management System is already in use at Cork University Maternity Hospital and University Hospital Kerry, and will be introduced at the Rotunda Hospital in Dublin in November, followed by Holles Street in January. The Coombe will follow later next year, and the remainder of the Republic’s 19 maternity units will have the system in place by 2020.
Kilian McGrane, national director of the National Women’s and Infants’ Health Programme (NWIHP), said: “Perinatal health features strongly throughout the national maternity strategy. We are trying to capture a woman’s mental health status or their risk of it, and making sure supports are in place to follow them through their ante-natal and post-natal journey.
“It will note if there are any reasons for concern, and whether or not there is a referral path. The core objective is to identify women at risk at the earliest point of interaction with the service, and to give them the support they need.”
John Sheehan, consultant psychiatrist at the Rotunda, said depression is just as common in pregnancy as afterwards, with both at a rate of around 15%.
“For about a third of women, the symptoms of PND begin in pregnancy and, of those who score very high on our questionnaire before going home, about 75% became clinically depressed. Those with bipolar disorder are particularly at risk of developing PND and its more severe form, post-partum psychosis,” he said.
“This is about standardising care. It’s about early detection and raising awareness. If we believe a woman is at risk, we will link in with the GP and the public health nurse.”
Obstetrician Peter McKenna, a former master of the Rotunda and now clinical director of the NWIHP, said suicide is now recognised as a common cause of maternal death.
“Between 2009 and 2012, five women died by suicide while either pregnant or within 42 days of delivery.
“Prevention of suicide is extremely difficult, but the potential for stopping it can be put in place.
“There are a range of mental-health adjustments in the wake of pregnancy, that goes from almost normal to the most profound psychotic episodes.”
Digital Rights Ireland said it would be important to control access to such sensitive data.
The HSE said it takes the confidentiality of patient information very seriously. “Only authorised staff who have a duty of care and confidentiality to patients have access to patient records,” it said.