When Helen Mackay had a baby 14 weeks ago, she really struggled with her mental health.
“I slipped into a dark place. I was scared to leave the house,” she said.
Ms Mackay is one of millions of women worldwide with perinatal mental health (PMH) issues that occur during pregnancy or the first year of a child being born.
Now Scottish midwives are asking for more specialist training so they can better support new mothers.
About 15-20% of women develop postnatal depression and anxiety, and suicide is the leading cause of death in the first year after pregnancy.
Ms Mackay, 34 from Thurso, had a good relationship with her midwife but she stayed silent about her symptoms.
She felt guilty about not immediately bonding with her baby and was scared to speak up.
Her mental health improved after she opened up to those around her about how she felt.
“I think the first step is maybe training midwives to start talking about PMH from an early point,” she said.
“We are told a lot about labour, breastfeeding and how it will affect you physically but alongside this should be focus on how it might affect you mentally.”
A total of 97% of midwives want the extra training, according to a study released by the Royal College of Midwives (RCM) in Scotland.
They would like more education to be able to better respond to women’s perinatal mental health needs when they arise.
Eight in 10 respondents also said they wanted extra education on how to assess PMH needs in their patients.
However the study also showed that 88% of midwives faced at least one barrier in getting this specialist training – mainly a lack of time and managerial issues.
Nearly a third of midwives said they were “not confident” in their knowledge or understanding of PMH at the moment.
Emma Currer, from the Royal College of Midwives (RCM), told BBC Good Morning Scotland the shortfalls in training were due to the historic focus on the physical aspects of health care, particularly in pregnancy.
She called for employers and health boards to recognise where the gaps in services lie and to allow midwives the time and resources they need for training.
Ms Currer said it was essential midwives were given the opportunity to consolidate the skills after training to feel confident in delivering care.
Earlier this year the Scottish government announced that more than £50m was to be spent on improving access to mental health services for expectant and new mothers.
Glasgow midwife Leah Hazard, who qualified six years ago, said she had “limited training” in PMH in the form of a short module at university.
She said midwives have to take their own initiative and seek the training, but acknowledged it is just “not always possible” to do so.
‘Stretched to the limit’
Meanwhile Ms Mackay said she found it “incredible” that midwives wanted more training.
“They are so wonderful at looking after us and it’s great to know they want to do more, even though most of them are already stretched to the limit.”
A Scottish government spokesman said: “We fully agree it is important that midwives are trained to support the mental health of pregnant women and new mothers.
“That’s why all midwives receive training to recognise and manage perinatal mental health. In addition to this we have funded a perinatal mental health education initiative through NHS Education for Scotland (NES) to support additional training where required.”
He said midwives are already trained and supported to identify perinatal mental health issues.
“Our Best Start policy outlines that all primary midwives under the continuity of carer model should be trained and supported to identify and manage perinatal mental health in the women they care for,” he added.
“We will continue to support NES to develop training and education materials on perinatal mental health that are accessible to midwives and others working with pregnant women and their families.”