We will therefore move on to the short debate, and the short debate is to be presented by Buffy Williams. Buffy Williams.

I'd like to give a minute of my time to Laura Anne Jones, Huw Irranca-Davies and Carolyn Thomas, if I could, please. 

Postpartum post-traumatic stress disorder is a serious issue. In Wales alone over 9,000 women are suffering, sometimes in silence. Mothers have kept their symptoms to themselves so the condition has remained invisible, to a great extent. Many mothers, unfortunately, are sometimes wrongly diagnosed with postpartum depression, when in fact the trauma of a difficult birth or events directly concerning or complications after a birth can leave a mother suffering with postpartum PTSD. This can include flashbacks of traumatic moments throughout labour that has a mother reliving the fear of the trauma, troubling dreams and nightmares, symptoms of anxiety and not wanting to discuss or be reminded of the events surrounding the birth, and also feelings of isolation and hopelessness.

The birth of a child is one of the most intense and emotional experiences in a woman’s life, but, sometimes the best-planned births can quickly become an event where sadly anything but joy and happiness is felt. PTSD can have a detrimental effect on the mother and infant bond, causing distress to both mother and child. Early intervention is vital, and we are so lucky that the dedicated midwives and health professionals who are involved in the care of an expectant or new mother are key for this early diagnosis to take place. One study showed that 45 per cent of women experienced traumatic childbirth and up to 4.6 per cent of women developed PTSD. There are many reasons for a traumatic childbirth. An emergency caesarean section, intervention during labour, prolonged labour and injuries suffered during birth are just a few of the many reasons this can occur.

My own personal experience was not a traumatic birth, but the traumatic events that followed directly after and as a direct result of the birth. Those events have, and still do impact on my everyday life. I was told repeatedly by midwives and consultants how lucky I was, lucky to have survived and lucky to have had a quick-thinking midwife. 'Lucky'—lucky was a word I became used to hearing over the days, weeks and months following the birth of my daughter. But lucky was the last thing I was feeling: frightened, traumatised, confused, alone and anxious; these were words more fitting to my mindset. In some ways, I suppose I was lucky; lucky I had a team of dedicated midwives who soon became friends, and consultants who were caring and understanding. The care I received at hospital and when I eventually returned home was nothing short of outstanding; however, how many new mothers and mothers-to-be will not be lucky? How many mothers and lone mothers are suffering in silence? How many husbands, partners, families and friends are trying to support and care for a mother who is traumatised? Sometimes the birth partner who witnesses the upsetting experience also takes their own measure of distress and anxiety away from the birth; who is there to support them?

The Deputy Presiding Officer took the Chair.

There are many groups and organisations available to support mothers through this very difficult time, but when you leave the care of the medical professionals, and you are back in the family unit, you begin to worry; worry that you are a failure, worry that you are letting people down. You feel that you can’t ask for help without being negatively judged and you start to feel that no matter where you turn, no-one really understands. How many mothers right now are feeling this way? How many mothers and families are being left to struggle alone? How many children will feel this negative impact, or grow up with strained relationships within the family unit?

Support services available to women in Wales who suffer with postpartum PTSD are available through perinatal mental health teams that are set up in each local health board. Each local health board across Wales offers varying levels of support for mothers and families who are in need of mental health support. Access to these services requires referral through GP or health visitors. Some mothers are unfortunately wrongly diagnosed with post-natal depression; we need to make sure that our GPs, midwives and health visitors are supplied with the tools and training they need to best care for those mothers who are most vulnerable at a time in their lives that they should feel safe, content and cared for.

With that said, I welcome the new mother and baby unit in Swansea bay. This is a step in the right direction when it comes to the health and well-being of mothers pre and post birth. Until now, mothers who have needed serious mental health care were admitted to acute mental health facilities without their babies, or would need to travel to a specialist unit outside of Wales. We must do more to combat the stigma of postnatal depression and peripartum PTSD. We must ensure mothers have confidence to confide in our fantastic healthcare professionals. I believe that the mother and baby unit in Swansea bay does this, and should be replicated across all seven Welsh health boards.

I want to pay tribute to all maternity staff in Wales. I know the team that cared for me went above and beyond the call of duty. There are many support groups, such as Mums Matter by Mind Cymru, and whilst we celebrate progress in specialist care in perinatal mental health, it is vital we do more, it is vital we listen better, and it is vital that we all work to remove all stigma surrounding any forms of mental health. I hope mothers who suffer with any form of PTSD take strength in the knowledge that they are not alone. Please reach out. Ask for help. I'd urge the Minister to build on the good practice of the Swansea bay mothers unit, and ensure mothers who suffer any form of PTSD or depression are better supported in the future. 

I'd firstly like to start by thanking Buffy for giving me a minute in this debate, and also thank her for bringing up this very important issue. Deputy Presiding Officer, as with many health conditions, postpartum PTSD is often misdiagnosed. It may not even be reported at all, or just written off as something you'll get over or forget about. We've come a long way in how we talk about and recognise and treat mental health conditions, particularly in this Chamber, and from the second Assembly that I was in until now, we have come an enormous way in talking openly about these things. So, you giving your—. I'm getting emotional myself. You giving your real-life experience, Buffy, is very, very important, and it's us all giving our real-life experiences like this that changes policy. So, we're speaking up for the people that are in silence. 

As someone who—. Sorry, hold on a second. As someone who has experienced a traumatic birth herself, but was lucky enough not to have—. My symptoms after were very mild in postpartum PTSD. I was very lucky to have support straight away, and I talked about it openly, and I was lucky enough to have a partner there, which often concerns me when we talk about all the COVID restrictions about partners not being present at births, and things like that, because that went a long way to supporting all those feelings and that experience that I went through, because I was able to talk about it with someone understanding what I'd been through. But talking about this stuff is so vitally important, so well done. I didn't mean to get upset—I didn't think I'd get upset, but I think I did because you triggered me off, and I'm glad you did show that emotion. It's nothing to be ashamed of, because it's important that we get across the importance of this, and how it affects even people that you don't think it's going to affect. 

So, we need to recognise the approximately 1,000 cases of postpartum PTSD that have occurred in Wales every year as what they are, and treat them and manage them appropriately. Alongside the immediate impacts, even after a hopefully healthy baby is born, there can be a longer term impact too that we may also need to make sure is given the attention it deserves. A traumatic birth, especially a first birth, as Buffy said, may put women off having more children, and may even mean they're physically not able to have more children. If that woman has always dreamt of a large family, this may trigger feelings of grief for the family that they have lost, which will stay with them, and needs appropriate support, too.

So, Deputy Presiding Officer—sorry I've gone over time with my emotions—with the Welsh Government committing to improve the parlous state of mental health provision in Wales, I would urge them to ensure that proper provision is available to women across Wales, as Buffy has outlined, who often suffer with this condition in silence. 

My thanks to Buffy, and also to Laura as well for speaking so bravely, and from personal experience, and for allowing me to speak in full support of their calls, and also to raise the work of my constituent, Mark Williams, who has done so much to campaign, inspired by his wife's and his own tough personal experiences, for the voices of both mothers and fathers to be heard in perinatal and postnatal mental health, and who would want me to be here today speaking out, too, for Buffy's call for greater support for women who suffer postpartum post-traumatic stress disorder, and for some men who can be affected, too. So, in my limited time available, it allows me to signpost people to the support that is available from others out there, like Mothers for Mothers, of which Mark is proud to be an ambassador, and the group he founded himself, Fathers Reaching Out. Buffy and Laura have been courageous today in sharing their stories, and if it helps just one person out there to know that they are not alone, and it leads to more support for women who suffer postpartum post-traumatic stress disorder, then they have both done a great service to the Senedd today and to the public that we all serve. Thank you. 

Thank you, both of you, for raising this. I'm going to speak about my experience and also my daughter's, who has given me—. She has said that I'm allowed to speak on it. She also thinks it's really important because she has a lot of friends that are suffering as well.

My first child was born in hospital. She was large. I lost a lot of blood and nearly fainted while trying to pick her up. So, the second was induced, but this time nobody believed I was actually in labour, and it was nearly born in the hospital toilet. I was finally wheelchaired into the labour room in a panic. Determined that my husband would not miss the birth of the third child, a home birth was planned. That went well but, unfortunately, it was Christmas. I was inundated with visitors who wanted to see the newborn. My husband was ill in bed and I wished I was in hospital instead, having a rest. 

The week I became a Member of the Senedd, I also became a grandmother. My daughter, a teacher, caught COVID at 12 weeks. A week later, she fainted several times and it was discovered that she had an irregular heartbeat, and we don't know if it was due to the pregnancy or the virus. She then later caught shingles. The baby was induced early because of reduced movements. He was unexpectedly large and she had two hours of stitches that were needed to repair the damage. Thankfully, they are both fine and I had to make sure they were both fine before coming to the Senedd on my first day.

You never forget giving birth to your children. It's not textbook, and it's still one of the most traumatic and difficult experiences, with little time to recover, and your life and identity are taken over by a demanding little person, and people forget to ask how you are doing. When I see my daughter, I always ask her first how she's doing before going to see the baby.   

I call on the Deputy Minister for Mental Health and Well-being to reply to the debate, Lynne Neagle. 

Thank you, Deputy Presiding Officer. I'd like to start by thanking Buffy Williams for bringing forward today's debate, and thanking all the Members who have contributed. It is a subject close to my heart. Indeed, one of the last things I did in this Chamber in the previous Senedd was to help bring forward a debate on perinatal mental health. It is a subject that absolutely belongs at the top of our agenda in Government, never more so than during this incredibly difficult time. We continue to hear about so many new families starting their journeys apart and without the support they could otherwise have expected.

I pay tribute to Buffy and to Laura for sharing their stories and experiences. I know it is not an easy thing to do. A huge part of properly addressing the issue of postpartum and post-traumatic stress disorder comes back to addressing the stigma around even discussing it. So, what you are doing today will make a real difference. We hear countless stories that involve well-meaning medical staff, friends, families and colleagues immediately assuming that a new birth brings only joy. It makes it difficult, impossible, for some to say 'no', that things weren't right, they continue not to be right and that they need help. Even when a tough experience has been acknowledged, you often hear, as Buffy has said, 'Weren't you lucky?', when, actually, you feel anything but lucky. 

I have to say, this is something I recognise myself, having experienced a traumatic first delivery. That was an experience that lives with me to this today. The clarity and the trauma of those moments, and the days and weeks that followed, don't go away. Those experiences and the others we've heard about today will inform the work I do in this area every day, and it will be the basis on which I will measure the services available to women in Wales.

It is vital, as Buffy has said, to acknowledge and signpost the support that is in place for individuals when they need specialist help. Following a diagnosis, mothers will be offered a range of interventions depending on the severity of their needs. This includes cognitive behavioural therapy. Services also work with the third sector and can signpost partners to voluntary organisations who offer support for bystander trauma. And it's crucial we also recognise the impact on partners and others of a traumatic birth, and thank you, Huw, for your comments and for championing the organisation in your constituency.

Members can be assured that I will be asking for regular updates about the capacity for delivering this support, and it must be available in a timely and sustainable manner. We know that the pandemic has made it more difficult to provide the vital named midwifery and health visitor support following birth. I will be asking for updates for Members on how that is now working on the ground, following the more flexible guidance now issued. It's important we acknowledge that experiences have been more difficult for so many families through the pandemic, and may have increased the risk of birth trauma for some families. Women need, more than ever, the opportunity to discuss their experiences and their trauma, to fully understand what happened and prevent longer-term impact. Restrictions on visiting maternity units during the pandemic have been so very difficult for new parents, particularly if the birth has been traumatic. Health boards are required to continue to take into account individual circumstances, including mental health needs, but we need to be sure this is working as it should, and therefore health boards have been asked to review visiting restrictions on an ongoing basis. Lateral flow testing is also now available in maternity units to support better access.

I know, though, that, despite all these mitigating changes, experiences will be more difficult for too many. It would be wrong not to acknowledge that, and it's crucial we recognise that the impacts of birth trauma can occur long after birth, not least because not all women will be diagnosed with PTSD within the time frame for perinatal services. I know that all health boards offer a variety of services to support women in discussing experiences and referring on as necessary, but I want to see this taken forward to look at best practice pathways for women and families in Wales. Perinatal mental health services, like other mental health services, have continued throughout the pandemic. Across Wales, community perinatal teams have been working hard to ensure support has been available despite COVID-19, both digitally and via the telephone, but we know that providing face-to-face support when clinically necessary is vital. 

There are some broader themes and longer term developments that I think Members will also be interested in. For example, we're investing in Traumatic Stress Wales, an initiative that aims to meet the needs of parents who've experienced trauma. Some of this work has been accelerated due to the pandemic. An emotional stabilisation training package has also been developed for use across sectors. The training aims to support people to feel more confident to help people who've been affected by trauma, and I'm pleased to say that, as part of this work, there is a specialist workstream being developed on perinatal mental health. This will improve the effectiveness of psychological therapies for people who experience trauma and fear giving birth. Health visitors, midwives, neonatal staff and the third sector are all making a contribution to how this will work in the future, with the aim of developing a perinatal trauma pathway. We all want to improve transitions between services within the pathway, as well as increasing the capacity of specialist and non-specialist mental health services.

An additional £42 million has been earmarked for mental health support this year, with £7 million of that funding targeted at improving key priority areas, including perinatal mental health. As Buffy mentioned in her speech, the opening of the specialist mother and baby unit in Swansea bay is a significant step forward. This will help new mothers to get the specialist support they have a right to expect closer to home. The opening of the unit marks a significant step in providing improved perinatal mental health support for mothers in Wales, and we will closely monitor the transition to providing perinatal in-patient provision in south Wales to ensure the unit is delivering as it should.

I'm personally committed to driving the further work needed to ensure this provision is also made available for mothers who live in north Wales. There has been significant engagement between Betsi Cadwaladr University Health Board, the Welsh Health Specialised Services Committee and NHS England regarding a joint unit to offer provision for women in north Wales. Both the ease of access for women from north Wales and Welsh language needs will be fundamental to this development.

I'm also pleased to let Members know that health boards have now recommenced their work in improving community perinatal support. The push to meet standards set by the Royal College of Psychiatrists had been interrupted by the pandemic, but that vital improvement work now continues. We also have a rolling programme of audits by the Royal College of Psychiatrists to understand compliance and to understand where more work is needed.

Too often, the voices of women haven't been heard on issues that are central to their lives. We cannot let the pandemic push back the progress we have begun to make, particularly in relation to perinatal mental health. I'm determined that we catch up and leave no parent behind in our duty to support and protect families at their most vulnerable moments. Once again, I'd like to thank Buffy for bringing this vitally important debate forward today. I know that countless mothers and whole families will be grateful for her leadership in putting this on the agenda today and breaking down barriers for discussion. I, for one, will be very grateful if she continues to hold my feet to the fire and the feet of the whole Welsh Government to the fire on this issue. Diolch yn fawr.

Thank you, Deputy Minister, and I thank all contributors today on an issue that is always emotional, but you did well, every one of you.

That brings today's proceedings to a close.

Have a nice break and recess.

The meeting ended at 19:11.