Perinatal and infant mental health: equalities impact assessment

An equalities impact assessment (EQIA) was completed using available current literature and research. The information will be used to help ensure policies for perinatal and infant mental health encourage equity of access to mental health services.


1. Section 4 of the Equality Act 2010

2. Tommys, Royal College Midwives, Institute for Health Visiting, Netmums. (2013) Perinatal Mental Health Experiences of Women and Health Professionals. Boots Family Trust Alliance.

3. Xavier, C. Benoit, A., & Brown, H.K. (2018) Teenage pregnancy and mental health beyond the postpartum period: a systematic review. Journal of Epidemiology & Community Health, vol 72.

4. Nuffield Trust Teenage pregnancy.

5. Jenkins, K. (2013) Young Mums Together: Promoting young mothers' wellbeing. Mental Health Foundation.

6. Ormston, R., McConville, S., & Gordon,J. (2014) Evaluation of the Family Nurse Partnership Programme in NHS Lothian, Scotland. ScotCen Social Research. Scottish Government: Edinburgh

7. Scottish Government (2019) Family Nurse Partnership in Scotland: revaluation report

8. NHS Lothian (2011) Parent Education Resources.

9. Information Services Division (2018) Births in Scottish Hospitals report. NHS National Services Scotland: Edinburgh.

10. Ban, L., Gibson, J.E., West, J., Fiaschi, L., Oates, M.R., & Tata, L.J. (2012) Impact of socioeconomic deprivation on maternal perinatal mental illnesses presenting to UK general practice. British Journal of General Practice, vol 62.

11. Redshaw, M., Malouf, R., Gao, H., & Gray, R. (2013) Women with disability: the experience of maternity care during pregnancy, labour and birth and the postnatal period. BMC Pregnancy and Childbirth, vol 13.

12. Engender - Our Bodies, Our Rights: Research Report

13. Carter, C., & Evans, R. (2015) Hidden Voices of Maternity: Parents with Learning Disabilities Speak Out. NHS England.

14. Iliadis, S.I., Koulouris, P., Gingell, M., Sylven, S.M. et al (2015) Personality and risk for postpartum depressive symptoms. Archives of Women's Mental Health, vol 18.

15. Lewis, 2001, 2004, 2007 Several confidential enquiries into maternal deaths in the UK have found suicide to be a leading cause of maternal death.

16. Oates (2003) High proportion of maternal suicides occur in women with an acute onset of psychosis in the early postpartum period.

17. UK (MBRRACE, 2018) Suicide numbers are very low in pregnancy and postnatally, it still remains the leading cause of maternal death. Available from: MBRRACE UK Perinatal Mortality Surveillance Report UK Perinatal Deaths for Births from January to December 2016

18. Gressier, F., Guillard, V., Cazas, O., Falissard, B. et al (2017) Risk factors for suicide attempt in pregnancy and the post-partum period in women with serious mental illnesses. Journal of Psychiatric Research, vol 84.

19. Fonseca, A., Gorayeb, R., & Canavarro, M.C. (2015) Women's help-seeking behaviours for depressive symptoms during the perinatal period: Socio-demographic and clinical correlates and perceived barriers to seeking professional help. Midwifery, vol 31.

20. Kingston, D., Austin, M., Heamann, M., McDonald, S., Lasiuk, G. et al (2015) Barriers and facilitators of mental health screening in pregnancy Journal of Affective Disorders, vol 186.

21. Latif, Z. (2014) The maternal mental health of migrant women. Race Equality Foundation.

22. Public Health England (2017) Health Profile for England 2017: Chapter 5: Inequality in Health.

23. NHS Digital (2019) Common Mental Disorders.

24. Halvorsrud, K., Nazroo, J., Otis, M., Hajdukova, E.B., & Bhui, K. (2019) Ethnic inequalities in the incidence of diagnosis of severe mental illness in England: a systematic review and new meta-analyses for non-affective and affective psychoses. Social Psychiatry and Psychiatric Epidemiology, vol 54.

25. Kirkbride, J.B., Errazuriz, A., Croudace, T.J., Morgan, C., Jackson, D. et al (2012) Incidence of schizophrenia and other psychoses in England, 1950-2009: a systematic review and meta-analyses. PLoS One, vol 7.

26. Babatunde, T., & Moreno-Leguizamon, C.J. (2012) Daily and Cultural Issues of Postnatal Depression in African Women Immigrants in South East London: Tips for Health Professionals. Nursing Research and Practice, vol 2012.

27. Watson, H., Harrop, D., Walton, E., Young, A., & Soltani, H. (2019) A systematic review of ethnic minority women's experiences of perinatal mental health conditions and services in Europe. PLoS One, vol 14.

28. Miller, K.E., & Rasmussen, A. (2017) The mental health of civilians displaced by armed conflict: an ecological model of refugee stress. Epidemiology and Psychiatric Sciences, vol 26.

29. Turrini, G., Purgato, M., Ballette, F., Nosè, M., Ostuzzi, G., & Barbui, C. (2017) Common mental disorders in asylum seekers and refugees: umbrella review of prevalence and intervention studies. International Journal of Mental Health Systems, vol 11.

30. Lindert, J., von Ehrenstein, O.S., Priebe, S., Mielck, A., & Brähler, E. (2009) Depression and anxiety in labor migrants and refugees - A systematic review and meta-analysis. Social Science & Medicine, vol 69.

31. Gentleman, A. (2017) Pregnant women without legal status 'too afraid to seek NHS care'. The Guardian.

32. Greenfield, P. (2019) End NHS maternity charges for vulnerable migrants, say midwives. The Guardian.

33. Bauer, A., Parsonage, M., Knapp, M., Iemmi, V., & Adelaja, B. (2014) The costs of perinatal mental health problems. Centre for Mental Health.

34. Scottish Government (2011) Census Data Explorer. National Records of Scotland.

35. Scottish Government (2018) New Scots Refugee Integration Strategy 2018-2022

36. NHS Health Scotland (2016) Good Mental Health For All.

37. Scottish Government (2018) New Scots Refugee Integration Strategy 2018-2022

38. McFadden, A., Siebelt, L., Jackson, C., Jones, H., Innes, N. et al (2018) Enhancing Gypsy, Roma and Traveller peoples' trust: using maternity and early years' health services and dental health services as exemplars of mainstream service provision. University of Dundee.

39. Liu, N.H., Daumit, G.L., Dua, T., Aquila, R., Charlson, F., Cuijpers, P. et al (2017) Excess mortality in persons with severe mental disorders: a multilevel intervention framework and priorities for clinical practice, policy and research agendas. World Psychiatry, vol 16.

40. Ban, L., Gibson, J.E., West, J., Fiaschi, L., Oates, M.R., & Tata, L.J. (2012) Impact of socioeconomic deprivation on maternal perinatal mental illnesses presenting to UK general practice. British Journal of General Practice, vol 62.

41. Scottish Government (January 2011) Reducing Antenatal Health Inequalities: Outcome Focused Evidence into Action Guidance

42. Asif, S., Baugh, A., & Wyn-Jones, N. (2015) The obstetric care of asylum seekers and refugee women in the UK. The Obstretrician & Gynaecologist, vol 17.

43. Public health Scotland Women tend to live longer but be in poorer health for longer than men.

44. CMACE (2011) Saving Mothers' Lives: reviewing maternal deaths to make motherhood safer: 2006-08. Centre for Maternal and Child Enquiries.

45. Edward, K., Castle, D., Mills, C., Davis, L., & Casey, J. (2014) An Integrative Review of Paternal Depression. American Journal of Men's Health, vol 9.

46. Wong, O., Nguyen, T., Thomas, N., Thomson-Salo, F. et al (2015) Perinatal mental health: Fathers - the (mostly) forgotten parent. Asia-Pacific Psychiatry, vol 8.

47. Paulson, J.F., & Bazemore, S.D. (2010) Prenatal and postpartum depression in fathers and its association with maternal depression: a meta-analysis. The Journal of the American Medical Association, vol 303.

48. Fletcher et al., 2011 Poor paternal mental health is associated with poor child outcomes.

49. Ramchandani et al., 2005, 2008 Oppositional/conduct disorders.

50. Dahl, B., Fylkesnes, A.M., Sorlie, V., & Malterud, K. (2013). Lesbian women's experiences with healthcare providers in the birthing context: A meta-ethnography. Midwifery, vol 29.

51. Dennis, C., Fung, K., Grigoriadis, S., Robinson, G.E., Romans, S., & Ross, L. (2007) Traditional Postpartum Practices and Rituals: A Qualitative Systematic Review. Women's Health, vol 3.

52. Semlyen, J., King, M., Varney, J., & Hagger-Johnson, G. (2016) Sexual orientation and symptoms of common mental disorder or low wellbeing: combined meta-analysis of 12 UK population health surveys. BMC Psychiatry, vol 16.

53. Stonewall Scotland, Scottish Trans, Equality Network, LGBT Youth (2018) LGBTI Populations and Mental Health Inequality. Stonewall: Edinburgh.

54. Scottish Government (September 2018) Scottish Health Survey 2017: Volume 1: Main Report.

55. Public Health England (March 2020) Ensuring pregnant trans men get equal quality care Ensuring pregnant trans men get equal quality care - PHE Screening (

56. Behrendt, A., & Moritz, S. (2005) Posttraumatic Stress Disorder and Memory Problems After Female Genital Mutilation. The American Journal of Psychiatry, vol 162.

57. Scottish Government (2016) Scotland's national action plan to prevent and eradicate FGM

58. Scottish Government (2018) New Scots Refugee Integration Strategy 2018-2022

59. Scottish Government (2011) Census Data Explorer. National Records of Scotland.

60. Callister, L. (2006) Doing the month: Chinese postpartum practices. The American Journal of Maternal Child Nursing, vol 31.

61. Dennis, C., Fung, K., Grigoriadis, S., Robinson, G.E., Romans, S., & Ross, L. (2007) Traditional Postpartum Practices and Rituals: A Qualitative Systematic Review. Women's Health, vol 3.

62. Sharma et al., 2016 Literature shows that some families do not accept postnatal midwife and health visitor home visits.

63. HMIPS (2006) Report on HMP and YOI Cornton Vale. HM Inspectorate of Prisons for Scotland.

64. SPS (2012) The 2011 inspection for numbers of women and babies in the MBUs and pregnant women in the general population area of the prison.

65. Rose Report (2016) Women in Corton Vale were care experienced. Numbers of 80% of pregnant women in Corton Vale showed depressive symptoms and the vast majority were being housed in the general population area of the facility.

66. Refer to Definitions of Protected Characteristics document for information on the characteristics

67. In respect of this protected characteristic, a body subject to the Public Sector Equality Duty (which includes Scottish Government) only needs to comply with the first need of the duty (to eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under the Equality Act 2010) and only in relation to work. This is because the parts of the Act covering services and public functions, premises, education etc. do not apply to that protected characteristic. Equality impact assessment within the Scottish Government does not require assessment against the protected characteristic of Marriage and Civil Partnership unless the policy or practice relates to work, for example HR policies and practices.

68. See EQIA - Setting the Scene for further information on the legislation.



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