Every baby deserves a loving, safe, and mentally healthy start in life. Nevertheless, as many as 1 in 5 women and 1 in 10 men [1] experience perinatal mental health problems during pregnancy or within the first year of their child’s life.. This includes depression, anxiety disorders, bipolar disorders, post-traumatic stress disorder and other mental health conditions — often under-detected, even more untreated. Precisely because these problems stay under the radar too often, their effects are often passed on from one generation to the next.
Perinatal mental health problems increase the risk of complications such as premature birth, postpartum bleeding, pregnancy loss, stillbirth, and relationship problems, as well as behavioural, developmental and mental health disorders in children [2]. In Belgium, mental health problems are linked to the cause of death in 22% of women who die during the perinatal period.
These medical and social complications do not only cause immense personal suffering. The social cost of inaction is sky-high: each year Belgium is estimated to lose 1.5 billion euros due to the consequences of untreated perinatal mental health problems — through increased health care spending, work absenteeism and youth care services.
At the same time, the solution is both affordable and highly cost-effective: all necessary evidence-based measures combined require an investment of only 56 million euros [2] per year. Every euro invested during this crucial period yields up to 27 euros in societal return. A policy that invests in the first 1,000 days today not only delivers the highest economic return on investment but also lays the foundations for a future free from poverty, school dropout and youth crime.
The Belgian Alliance for Perinatal Mental Health (BAPMH) calls on healthcare and welfare organizations to endorse this manifesto. Together, we can enforce political action and because failing to act will cost lives and billions of euros.
[1] Howard L. & Khalifeh H. (2020). Perinatal mental health: a review of progress of progress and challenges World Psychiatry, 19:313-327.
[2] This amount is based on an estimation from the United Kingdom made by Dr. Alain Gregoir using https://global-economic-calculator.herokuapp.com/
Establish an interfederal action committee, tasked with and mandate to implement an ambitious national plan that connects prevention, care, and well-being. Such a policy also requires adequate funding: resources and remuneration must be proportionate with the assignment and the plan. We advocate for a structurally based budget that makes policy ambitions realistic and sustainable. A forward-looking policy also invests in a healthy and safe living environment where our babies can grow up and develop optimally — with the climate goals as an explicit priority.
Every (wish) parent [1] a baby deserves accessible, high-quality and culturally as well as trauma-sensitive care, regardless of region, language or background. Particular attention should be paid to families in vulnerable situations with an equally strong focus on prevention, early support and treatment.
Parents in need of mental healthcare must be able to access affordable, high-quality, and appropriate support without waiting times, tailored to their evolving need. A high-performing perinatal mental healthcare chain relies on integrated care supported by a clear and up-to-date social map that quickly guides both parents and referrers through the complex landscape of care and welfare services. This requires smooth coordination, flow and continuity — without barriers or fragmentation, and always from the perspective of parents and babies.
Introduce systematic screening of psychosocial problems, preconceptionally, during pregnancy, after pregnancy loss and the first year of life.
Knowledge of perinatal mental health should be a mandatory component in the core training for doctors, midwives, psychologists, social workers and other involved professional groups. However, that alone is not enough. Continuing education must also provide room for further development and specialization, enabling professionals to identify risks in a timely manner, act effectively, and collaborate across disciplines with expertise. High-quality care starts with expertise.
Emotional and practical support in the perinatal period, including in case of pregnancy loss, is the most powerful buffer against mental problems among parents. Structural support for maternity and family care, parent groups, peer support and community building enhances resilience, breaks isolation and prevents early symptoms from escalating.
Give both parents access to one year of paid parental leave and allow grandparents to take care leave without negative long-term financial consequences.
Safe, warm, and reliable childcare offers young children stability and development opportunities, while giving parents the space to recharge, resume work or seek help. High-quality childcare requires structural investment in training, reduced workload and fair remuneration for every professional in the sector. Those who care for the youngest deserve both social recognition and respect in wages and policy.
Strong policy requires strong knowledge. Strengthen coordinated scientific research into perinatal mental health and ensure structural monitoring and data collection across Belgium.
Encourage a broad and nuanced social debate on the protection of unborn children in the context of perinatal mental health problems. This debate should include both ethical and legal dimensions and aim for a balanced approach that protects the unborn child while safeguarding the autonomy and opportunities of parents.
[1] By "parent(s)” we refer to all forms of (intended) parenthood and caregiving, regardless of gender, family structure, or biological relationship.
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