While many associate having a baby with it being the greatest day of their lives, it is also a time when a woman is most vulnerable to developing or relapsing into a mental illness.
In Australia, perinatal depression and anxiety affect one in five mothers, making suicide the leading cause of maternal death.
In recent years, the tragic deaths of new mothers like Sarah Skillington have shed light on a growing and often overlooked issue: the failure to listen to a mother’s concerns during the postpartum period, knowing the danger signs, and providing adequate care.
At the age of 33, Sarah Skillington welcomed her first child, a baby daughter. Just days later, she tragically took her own life in her bathroom at a mental health unit that specialised in caring for clinically depressed new mothers.
Sarah had previously struggled with minor anxiety and had never experienced suicidal thoughts before the birth of her child on 6 November 2023.
Coroner’s Court Investigations: The Inquest Remains Ongoing
The Coroner’s Court has heard her pregnancy had been uncomplicated, with only minor issues arising from the birth.
Sarah was then presented to the hospital on the 16 November, where she was assessed and categorised as ‘low risk’. The hospital placed her on ‘category one’ observations’, where she was to be checked on every two hours by staff.
This assessment and its appropriateness have been scrutinised by the Coroner, with the records indicating that the treating doctor did not plan to assess Sarah for another four days, by which time she had already taken her own life.
The Court has heard concerns with evidence gathered from other records on the clinical file, observation records and CCTV footage, raising serious doubts as to the accuracy of the observation records.
The quality and efficiency of the observations will come under scrutiny with the court hearing that the medical staff are unable to say when Sarah took her own life.
Victorian Coroner David Ryan heard that the workplace watchdog WorkSafe was considering launching criminal charges against those it holds responsible for allowing Ms Skillington to take her own life while undergoing care.
This tragedy highlights a potentially systemic failure to diagnose and properly manage postpartum mental health concerns, even when women are proactive in seeking help.
Tragic cases like Sarah’s are far too common — and often preventable. There is a profound need for healthcare providers to offer timely, compassionate care to new mothers, who are at their most vulnerable.
The Dangers of Dismissing Maternal Concerns
Postpartum mental health is often minimised or misunderstood, and when mothers’ concerns are ignored, the consequences can be fatal.
Women like Sarah, who seek help and express their struggles, should never be left to suffer in silence. Healthcare systems must listen to new mothers, identify the warning signs of postpartum complications, and provide the care they need.
Conditions like postpartum depression, anxiety, and even postpartum psychosis can worsen when not properly managed. The emotional and psychological toll on new mothers can be overwhelming, and the failure to address these issues can lead to tragic outcomes.
Guidelines
In 2023, Centre of Perinatal Excellence (COPE) released the latest revision of the Australian Perinatal Mental Health Guidelines, funded by the Commonwealth Government and approved by the National Health and Medical Research Council (NHMRC). The guidelines provide vital information to the broad range of health professionals delivering antenatal and postnatal care, to assist them in the identification, prevention and treatment of mental health conditions and mental illness.
The guidelines include detailed advice around assessing the safety of both mother and child, the management of suicide risk and the development of safety plans.
It also emphasises the importance of routine universal screening for all expectant and new mothers to detect those at risk of and those experiencing mental health concerns.
It suggests that women should be screened both early in pregnancy and again at around 30 weeks. Mothers should be screened 6-12 weeks after having their baby and again at least once in the first year postpartum.
While the guidelines recommend that mothers and babies are treated together where it is safe to do so, the reality is that nationally there are not enough units, especially in public units, and not enough beds.
Symptoms to Watch for After Birth
According to Perinatal Anxiety & Depression Australia (PANDA) and the Centre of Perinatal Excellence (COPE), mothers should be vigilant of the following symptoms, which may signal serious postpartum complications:
- Persistent sadness or feelings of hopelessness (potential indicators of postpartum depression)
- Severe mood swings or irritability (disrupting daily functioning and bonding with the baby)
- Intrusive thoughts or anxiety (including fears of harming oneself or the baby)
- Withdrawal from loved ones or disinterest in the baby (indicating possible severe depression)
- Difficulty sleeping, even when the baby is asleep (a sign of heightened anxiety or depression)
- Detachment from reality or hallucinations (signs of postpartum psychosis, requiring immediate medical attention)
Mothers experiencing any of these symptoms must seek medical attention promptly. Early intervention is critical to prevent further harm and ensure the well-being of both mother and baby.
What to Do If You Are Struggling After Birth
If you or someone you know is struggling emotionally or physically after childbirth, it is vital to take action. Some steps you can take are,
- Seek Immediate Medical Help: If something feels wrong, don’t hesitate to reach out to your doctor, midwife, or mental health professional.
- Advocate for Yourself: If your concerns are brushed aside, insist on further evaluation or seek a second opinion. You deserve to be heard and cared for.
- Reach Out for Support: Contact family, friends, or support groups that understand the challenges of postpartum life. You are not alone.
- Consider Legal Action: If you have experienced medical negligence, legal action can help hold healthcare providers accountable and seek justice for the harm done.
Advocacy
Sarah’s tragic experience also highlights a significant gap in the legal and healthcare systems: the lack of proper recognition and accountability for birth trauma and postpartum care negligence.
Birth Trauma Law continues to advocate for women who suffer from medical negligence, misdiagnosis, and inadequate postpartum care. The legal system must hold responsible parties accountable and ensure that no mother is left without the care and support she deserves. Deaths like Sarah’s are preventable with the right care.
Healthcare providers and institutions must prioritise maternal mental health and recognise the unique challenges mothers face after childbirth. The healthcare systems need to listen to new mothers, identify the warning signs of postpartum complications, and provide the care they deserve. Contact us today and learn more about what legal steps you can take.