Perinatal mental health – what do you need to know

May 2025 has seen both Mental Health Awareness Week, and Maternal Mental Health Awareness Week.

Maternal mental health in the perinatal period, encompassing pregnancy and the first year after childbirth, is an often overlooked area. The perinatal period is a time of significant change and vulnerability for many women. Employers have both a legal obligation and a moral imperative to provide a supportive environment during this critical time.

Understanding Maternal Mental Health

Maternal mental health refers to a woman’s emotional and psychological well-being during pregnancy, and during and after the post-natal period. Conditions such as perinatal depression, anxiety, and postpartum psychosis can significantly impact a woman’s ability to function at work. According to the Maternal Mental Alliance, approximately one in five women experience a mental health problem during this period.

Understanding Employer Legal Obligations

Employers have a duty to be aware of their legal responsibilities to support maternal mental health:

• The Health and Safety at Work Act 1974 establishes that employers are required to ensure the health, safety and welfare of all employees. This would include mental health considerations and employers should be prepared to evidence what steps/ considerations/ assessments/ policies and procedures deal with this positive duty of care.
• The Management of Health and Safety at Work Regulations 1999 mandate that employers must specifically assess and manage risks to pregnant women and new mothers. Further, once on notice from an expecting mother, or that a women has given birth, an employer must demonstrate that they have reviewed and, where necessary, adjusted risk assessments. A robust review system and positive engagement with the staff body is recommended to lead from the front and proactively promote good practice.
• The Equality Act 2010 makes it unlawful to discriminate against a worker because they are pregnant, a new mother, or are breastfeeding. The Equality Act also covers mental health conditions arising during the perinatal period if these meet the definition of a disability. This protection applies regardless of length of service and covers all workers. Keeping adequate records and having robust family policies which are reviewed annually help ensure staff have confidence that support is available.
• The Maternity and Parental Leave etc. Regulations 1999 (MAPLE) provide protection to employees on maternity leave, including the right to return to the same job (or a suitable alternative if not reasonably practicable) and protection against dismissal due to pregnancy or maternity. Sound training to senior management teams on these provisions will help ease litigation risk and potentially avoid situations such as the 2022 tribunal claim where an employee was awarded £7,500 following being dismissed for notifying her Employer that she was expecting having just returned from a period of maternity leave.
• Employment Rights Act 1996, amongst other things, sets out that if risk cannot be avoided for an expecting mother, and no suitable adjustments can be made, and employers cannot offer suitable alternative work then it may ne necessary to suspend the Employee on full pay for “health and safety” reasons.

The Importance of Proactive Mental Health Support

Neglecting mental health risks can lead to significant consequences for employers:

In 2024 Deloitte research supported that individuals’ perception of their own mental health has improved over time but is yet to return to pre-pandemic levels with 62% reporting their mental health as “not good”.

In 2024 20% of parents felt the support provided by their employer around mental health was inadequate.

The Royal College of Psychiatrists’ Dr Livia Martucci (Chair) reports that around one in five new and expectant mothers develop perinatal mental illnesses such as anxiety, depression, eating disorders, post-traumatic stress disorder and psychosis.

Legal Risks: Failure to comply with legal obligations can result in claims of discrimination or failure to make reasonable adjustments, automatic unfair dismissal, personal injury arguments, all leading to potential employment tribunal cases and reputational damage and ultimately high cost both in productivity hours and money.

Practical Steps for Employers

To foster a supportive environment and comply with legal duties, employers should consider the following actions:

• Ensure access to mental health resources either online, paid subscription services, e-modules or local focus groups. This might include counselling, therapy but with cognisance of perinatal risk indicators.
• Robust return to work process incorporating tailored arrangements, factoring in the unique circumstances of each individual and with consideration to temporary or permanent requests to change hours/patterns/work role.
• Do more than pay lip-service to Work-Life balance. Have regular catch ups/ check ins – not tick box exercises. Have appropriate training to senior managers on how to appropriately make enquiries into performance/coping/objectives setting.
• Use KIT days properly, as an opportunity to explore what a return looks like from an early stage.

Employers pay a crucial role in supporting maternal mental health and ensuring a productive and cohesive place of work where the workforce is engaged. By understanding and fulfilling legal obligations and fostering a supportive workplace culture, employers can not only mitigate risk but also enhance employee satisfaction and productivity.

This blog is not legal advice. For tailored advice on navigating the legal aspects of workplace maternal mental health, consider contacting us below:

Robert Lindsay Dorrian, Senior Solicitor: rld@bto.co.uk / 0131 322 3662