Legislative Council Wednesday 24 June, 2020

Ms FORREST question to LEADER of the GOVERNMENT in the LEGISLATIVE COUNCIL, Mrs HISCUTT

With regard to the care of pregnant and post-natal women since March this year:
1 What specific assessments have been undertaken to assess for antenatal anxiety and depression; and
   1.1 Have additional antenatal assessments undertaken in light of the risk of COVID-19 and limitations placed on visitors in hospital and support for new parents, particularly for pregnant women in North West Tasmania?

2 What specific assessments have been undertaken to assess for postnatal anxiety and depression; and
   2.1 Were additional assessments undertaken in the post-natal period in light of the risk of COVID-19 and the limitations placed on visitors in hospital and support for new parents?

3 Will additional assessment and support for women’s mental health and wellbeing be provided to monitor the risk of post-natal depression in North Western Tasmania; and

4 Will a suitable Mother and Baby unit be made available to support mothers and babies from the North West Coast requiring additional parenting support or with post-natal depression and/or puerperal psychosis?

Answers:
1 Maternal screening for antenatal anxiety and depression is undertaken using a validated tool as part of the first booking in appointment. A discussion is held at each appointment with the midwife to assess the woman’s mental health status.
During the period when COVID-19 changed service provision, antenatal assessments were maintained using telemedicine platforms. Emotional wellbeing checks are completed at every antenatal visit. The Edinburgh Postnatal Depression Scale (EPNDS) is completed at booking in appointment and again at 30 weeks.
A Pregnancy, Birth and Early Parenting Website has been established to provide advice to pregnant women on self-care and wellbeing in addition to providing online information on pregnancy.
For those women who were due to deliver during the period the North West Private Hospital was closed, they had the option of relocating to Launceston and had daily phone calls from the antenatal staff at Launceston General Hospital as well as both antenatal and emotional wellbeing checks.

2 The Extended Care Midwifery Service maintained service delivery throughout the COVID-19 restriction period which included post-natal care. Each visit included assessment of emotional wellbeing as well as any issues related to breastfeeding. Face to face visits were continued with appropriate screening mechanisms in place and staff wearing appropriate personal protection equipment (PPE).
The Child Health and Parenting Service (CHaPS) screen all new parents at 8 weeks with the EPNDS, a validated screening tool to identify potential postnatal anxiety or depression and staff can refer or provide additional parent support where appropriate. Staff discuss perinatal wellness with all new parents who are clients of the CHaPS service.
CHaPS have been providing 2, 4, and 8 week appointments with a combination of face to face and telehealth during the COVID-19 response and have continued to screen for perinatal and wellness.
CHaPS state-wide Parenting Centres provide targeted support for families in relation to parenting support and perinatal wellbeing and have been providing telehealth appointments during COVID-19.

3 The Tasmanian Government offers a range of services to support mothers and families in the perinatal and post-natal period, from primary care options through to acute treatment. Mothers can receive support through antenatal clinics, Child Health and Parenting Services, and the Perinatal and Infant Mental Health Service. Mother baby workers are also based in the North and North West.

4 Where clinically recommended, a mother can receive inpatient treatment and care for postnatal depression and anxiety at the Mother Baby Unit at the St Helens Private Hospital in Hobart. The Department of Health, via the Tasmanian Health Service, has an agreement with the Mother Baby Unit for public patients to receive treatment in this facility. For families who are in the North and North West, a subsidised transport service can be provided to enable access to this service. As part of the LGH Masterplan, which will inform the next stages of the $87 million LGH Redevelopment, the THS will be undertaking clinical planning. It is expected that consideration of perinatal services will be a part of this process. Importantly, the Federal Government is also delivering additional funding to support improved perinatal mental health services in the North and North West.