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When I began my speaking career to raise awareness of perinatal mental health, I always aspired to be on an ‘international’ stage. I learned that the honour of that status had to be earned and deserved, eventually being listed on relevant websites. When I do receive those invitations now, I view it as a privilege and I always approach these wonderful opportunities with the respect that they deserve. My latest international event was at the Royal College of Obstetricians and Gynaecologists World Congress which was held at ExCel in London. Here is my account and reflections:

I arrived at the venue as early as possible, to learn as much as I was able to. On arrival into ExCel, the scale of the event was obvious by the many signs on the building and by the crowd of delegates – about 4,000 from 101 countries! The array of colourful outfits in the registration queues were amazing. I felt very excited to receive my name lanyard with ‘Speaker’ on it. I just missed the opening address by the President of the College, Professor Lesley Regan. I did catch a few minutes of the Lead of Women’s Voices, Ms Kate Brian, explaining that they believe in the value of listening to and learning from the experiences of women. Their voices were to be heard throughout the Congress. I admit to feeling excited that I was going to be there in that capacity.

The next speaker was a flamboyant Dr Neel Shah from Harvard medical school, who presented the Green Armytage Anglo American Lecture, ‘Designing Systems to Improve Care for Every Mother, Everywhere’. I have never been in such a large auditorium for a speaking event before. The speakers were dwarfed by the huge screens that showed their slides on each side of the platform and, above the podium, one of themselves. I felt quite awe-struck!

As a speaker and delegate, you had the option to download an ‘App’ on your phone for the whole event. It had so many aspects to it, from the programme, to speakers, delegate information, exhibition sponsors, etc.  Very impressive and useful. It served as a great guide to all that was on offer.

I next decided to wander around the many stands. I had asked if there would be a RCOG book stall so that I could have arranged to have my books available, should anyone wish to buy copies. I was told there wasn’t. The first stand I saw was for books! Admittedly, it was for the company ‘Wisepress’. I could see many delegates looking at all the Oby/Gyn related books and purchasing them. I could not see any titles relating to mental health.  I was able to liaise with them and I understand that copies of my two books should have been there for the final day of the Congress.

I briefly met Gill Walton who is the current Chief Executive of the Royal College of Midwives. It was good to see a familiar face.

Over the next two days, I enjoyed a number of interesting conversations with some of the people on the stands, listening to what they were offering and where appropriate, asking them about the inclusion of mental health in their particular area. You may have seen my previous blog on my appeal to obs/gyn the world over, to consider mental health in their role with women. Here is a selection of those I interacted with:

• International Journal of Gynecology and Obstetrics who describe themselves as ‘The Global Voice for Women’s Health’.
• FIGO – ‘The International Federation of Gynecology and Obstetrics (Fédération Internationale de Gynécologie et d’Obstétrique – FIGO) was established in Geneva in 1954 by Professor Hubert de Watteville, the ‘founding father’ of FIGO. It is a unique organisation, the only global organisation representing national societies of obstetricians and gynecologists. Currently, FIGO has Member Societies in 130 countries or territories. Its Secretariat is based in London, the United Kingdom.’  I notice that their next their world congress is in Sydney in 2021. I see no reference to perinatal mental health! I will be writing to the conference manager.
• Oman Society of Obstetrics and Gynecology. The next RCOG World Congress will be held there in March 2020. They had a great way of collecting details from interested delegates, by offering a free draw for travel and registration. Their videos looked very inspiring. I exchanged details with one of their team, Dr. Wadha Mohammed Al Ghafri, who said she would love to communicate with me about their event.
• Babyline Training – I met their founder, Judy Ledger, through a friend I made whilst in hospital many years ago (it was while I was writing my first book). It was a pleasure to meet her daughter, Sara Ledger, who is now their Head of Research and Development. I was delighted to hear that they are looking at more training for obs/gyn in perinatal mental health. From their ‘Mind the Gap’ investigation into maternity training for Frontline Professionals across the UK (2017/18), they showed that Perinatal mental health training was only mandatory for obstetricians in 30% of UK trusts, 8% of obstetric anesthetists and for the whole team in only 3 % of trusts. In over 25% of UK trusts, perinatal mental health is NOT mandatory for ANY group of staff. I find these figures astounding and hard to believe as over 20% of women are known to suffer from a mental health challenge at this time.  I look forward to chatting more to Sara about this.
• Institute of Psychosexual Medicine and The British Menopause Society also had stands. I listened to the services they offer and discussed with both about the emotional and mental health of women. I feel that both can be impacted by the challenges of the perinatal period and wish that there was more research to explore this.

I decided to check into the hotel adjacent to ExCel where the speakers were staying. I had a very comfortable room in Aloft. I unpacked, freshened up and set off back across to the Congress. In the lift I met another speaker who was wearing a beautiful sari. We chatted and she explained that she was very concerned because on her flight to the UK from Mumbai she had lost her USB stick and her assistant was doing her best to get the slides to her. I mentioned that I now save mine to OneDrive so that I know that I can always find them should I have an issue.  We made our way up to the room allocated for speakers and she went to speak to the IT team there for RCOG. After some lunch I wandered back to the huge auditorium. The next speaker was introduced … yes, the lady I had met in the lift!  It transpired she was Dr Duru Shah from Mumbai. Her biography is incredible, including being one of the Twenty Top women achievers of Indian healthcare – and to think, I had been offering her ‘speaker tips’!

I stayed in the auditorium to hear Professor Tom Bourne presenting on ‘Psychological effects of early pregnancy loss’. I was so pleased to know that something was finally being addressed about the mind and not just the body. He also mentioned partners too. Do you know that sometimes early miscarriage is referred to as ‘biowaste’!? Yes, to the parents! I noticed a Canadian couple referred to recently, in a BBC article . I used the RCOG App to ask a question, which was ‘how can we get more recognition for mental health in the perinatal period from the obstetrics and gynaecology specialism?’. His response was that we need to get more research done and, from the evidence, this will happen. I understand that AND the fact that over 20% of women in their clinics will have some form of perinatal mental illness, surely should be indicative that they NEED to do more?

I went back up to the speakers’ room as there were some chairs to sit down and have a drink from a real cup! Why do we still have so many disposable drinking vessels at such events adding to unnecessary waste? I chatted to another speaker who has been an obstetrician and gynaecologist for many years. She expressed surprise as to why perinatal mental health was on the programme.

I felt somewhat disheartened as I wandered around the Exhibition Hall again for the drink’s reception. I felt a little lost as everyone seemed to be in groups. I remembered the skill that I learned from the networking guru Will Kintish,  many years ago. He always recommends that the best person to speak to when you are alone at an event, is another person on their own! It worked. I spotted a young lady on her own and asked if I could join her. She was from Australia and was a junior doctor. We had an enjoyable chat after which I decided to go and dine in the hotel, then headed to bed for an early night.

I had a comfortable night and decided to have a relaxed start to the next day, when I would be presenting. I went down to breakfast dressed casually. I could see several ‘speakers’ (their lanyards) and felt I was anonymous without mine on. I ate, changed into appropriate ‘uniform’ and joined the Congress again. Once again, it was buzzing with delegates from all over the world. I wandered into the Exhibition Hall and spotted Dr Raja Gangopadhyay, who had recommended me to speak. He is an obstetrician and gynaecologist who has a passion for mental health. We spent time together chatting and meeting other people.

We went up to the Speakers’ Room and joined Maria Viner, from Mothers for Mothers. She was going to be starting the perinatal mental health session, sharing her story as part of the ‘Women’s Voices’ aspect of Congress. We also chatted to Kate Brian and Catherine Nestor,  the Chair and Vicechair of RCOG Women’s Voices Network. Very dynamic ladies.

Finally, it was time for us to wander through to the room where we would be speaking. Dr Raja and also Leila Frodsham were the chairs of the session, entitled ‘MANAGING THE AMBER AND THE RED – HOW CAN WE SUPPORT PNMH? PERINATAL MENTAL HEALTH’.

Maria shared her powerful story of her journey of postnatal illness. She works with Mothers for Mothers, based in Bristol.

Next, I gave my presentation. I focussed on

1. My story, briefly
2. Role of Obstetrician & Midwifery team in Perinatal mental health care: such as providing information to all pregnant women, care coordination, signposting & supporting.
3. A brief global perspective, e.g. https://www.who.int/mental_health/maternal-child/maternal_mental_health/en/
4. Some measures for lifestyle modification for all pregnant women (regardless of their previous mental health history). This could reduce the risk of both physical and mental health complications during pregnancy and beyond. https://www.ifwip.org/wellbeing-during-pregnancy/
5. The need for excellent communication between obs/gyn and the rest of their team
6. Personal use of language and listening skills
7. The need for parity of esteem between the mental & physical aspects – encouraging delegates to get involved back in their own countries.

The time flew by, and I sat down, pleased with how it had gone.

Next were talks on ‘Setting up a Perinatal Mental Health Service’ – Dr Lesley Roberts, Royal Surrey County Hospital and Dr Jennifer Cooke, Sussex Partnership NHS Foundation Trust. I loved the obvious passion that these two ladies have for this and hope they inspired others in the audience.

Prescribing for PNMH problems – Dr Trudi Seneviratne, South London and Maudsley NHS Foundation Trust. I have met Trudi at a number of events and have always admired her work. She was recently featured in the Louis Theroux  BBC documentary ‘Mothers on the Edge’ .  She is also an inspirational figure who has been awarded an OBE for her services to perinatal mental health.

We then had presentations of research:

• Mode of birth and development of maternal postnatal PTSD: a mixed methods systematic review – Jemima Carter
• “Dads in Distress”- persisting depressive and traumatic symptoms in fathers following poor fetal, neonatal and maternal outcomes – Alka Kothari
• Knowledge and attitude of obstetric and midwifery staff towards perinatal mental health, current practices and their opinion regarding perinatal psychiatry services at University Hospital Kerry (UHK) – Sabahat Zafar
• STRAWB2 (stress and wellbeing after childbirth): a randomised controlled trial of targeted self-help materials to prevent PTSD following childbirth – Pauline Slade

Congratulations to Alka Kothari who was chosen for the paper presentation award. It is great that the awareness of fathers has also been raised.

Delegates left and some of us stayed for some photographs.

It would have been good to have stayed for the next day, as I know that as a speaker, once you have presented, delegates are then likely to speak to you in passing. One lady did approach me to share her own story. She told me that she is very aware of the need for perinatal mental health awareness in obs/gyn. Not only did she feel added guilt due to being a doctor, she felt unable to tell her colleagues for fear of judgement. She thanked me for my talk and said I had inspired her to be more assertive about making positive changes in her own working environment.

She made me feel that my contribution had been worthwhile!

Before leaving, I changed back into casual clothes and made the journey home. I wrote some of my previous blog on how the Congress had made me feel. I repeat my Call to Action for further involvement of Obstetricians and Gynaecologists across the world to be more aware of the impact of mental health.

I am delighted to see that the RCOG in the UK is actually having a Perinatal Mental Health Annual meeting in London on 10^th and 11^th October  I do hope that they can inspire others across the world to begin to do so.

Thank you, Dr Raja for recommending me to speak at the RCOG World Congress. It was a very well organised event by the team involved and I was delighted to have been a part of it.

As I waited by the train door for it to stop at my station, a young mother and baby were also in the vestibule. She was rocking her to sooth her to sleep. The baby noticed me, gave eye contact and gave me a beaming smile – oops, no sleep was forthcoming. I returned the smile and stepped onto the platform feeling like the baby had thanked me for the role I had just done. I look forward to the next speaking opportunities.

Elaine 🙂