Nearly all new mothers experience a few days of low mood, anxiety and tearfulness with symptoms being strongest around the fifth day after birth. This is a normal reaction to the hormonal and other changes after having a baby.  However, if the symptoms are still there 10-14 days after the birth, it’s important for the mother to see her GP, midwife or health visitor for an assessment.

Mild anxiety is when someone feels 'overwhelmed by responsibilities and unable to cope' (Mind, 2006). 10 -15% of the general population get some form of postnatal depression and the risk factors which make depression more likely are factors which often affect parents in foster care, such as:

• being very young
• having a partner who is abusive or unsupportive
• losing your own mother in childhood.

This makes it important that foster carers are aware of symptoms and know how support a parent who is affected. Remember you can always speak to the midwife or health visitor yourself if you are worried.

What to look out for or ask about

• Loss of interest in things that she used to be interested in
• Feeling sad or tearful a lot of the time
• Being unusually irritable
• Finding it hard to sleep even when the baby is asleep, or sleeping more than normal
• Lack of motivation to do normal things like getting washed and dressed, washing her hair or clothes
• Finding it difficult to connect with the baby, either before or after birth.

What you can do to help

• Encourage her to talk. This might be easier if you are prepared to share any experience you have had of feeling down or depressed
• Help her to take time out for herself, away from the baby. Even having a shower can be difficult if the baby cries a lot
• Encourage her to talk to the GP, midwife or Health visitor
• Support her to go to her appointments with her psychiatrist, psychotherapist or counsellor.

All other new mothers are encouraged to have a support network to enable her to rest, have meals cooked and have family members help with some baby care. Despite this, the system we are part of often asks us to withhold this support to new mothers who are already vulnerable. Sometimes placement plans put a lot of emphasis on assessing a mother’s ability to care for her baby without help.

Part of your role with a new mother or a parent who is depressed may be to advocate for her right to the support that all other women are encouraged to get. You may find it useful to show official publications like this one from the Royal College of Psychiatrists which specifically encourages women to get support with practical tasks, try to catch up on sleep and get time away from the baby.

You will find a lot more useful reading on the Best Beginnings website section on perinatal mental health

The symptoms of a serious perinatal mental illness include those listed above, but are more severe. The woman may:

• feel completely hopeless and incompetent
• be extremely tired but often not able to sleep
• have difficulty concentrating or making decisions
• have morbid thoughts about herself or the baby (including thoughts of suicide or harming her baby)
• have severe anxiety making her feel as if she is going mad
• have panic attacks, palpitations and difficulty breathing.

Two women in every thousand develop postnatal psychosis, where they believe things that aren’t true, see and hear things that aren’t there and behave in uncharacteristic and uninhibited ways. This can happen to any woman but is more common for women who stop or change medication for an existing psychotic illness.

Postnatal Post Traumatic Stress Disorder (PSTD) is experienced as nightmares, flashbacks, anger, and difficulty concentrating and sleeping and can be triggered by a traumatic labour.

Experiencing the symptoms of these conditions is very painful and distressing for women and yet they are often not taken seriously by those around them, including health professionals who cannot understand why the woman suffering won’t just ‘snap out of it’.

As foster carers, we need to be aware of the signs of severe mental illness and recognise the seriousness of the situation so that the woman in our care can get the help she needs quickly.

Although women with no previous history of mental illness can develop serious perinatal illness, women who have had a previous serious mental illness are much more at risk of a serious postnatal illness, even if the previous illness was many years ago.

It is really important to tell a health professional urgently if you think the mother you are caring for has any of these symptoms. You may even need to make the baby safe and call an ambulance. She needs urgent help.

It is also important to remember that with the right treatment, most women completely recover and go on to look after their children safely.

Eating disorders are a group of serious mental illnesses and pregnancy can be a very difficult time for women with eating disorders as their body changes.

You can find out more about eating disorders in pregnancy at the Eating disorders and pregnancy website and about eating disorders generally at BEAT: Eating disorders support charity which has a helpline.

The first port of call for someone with concerns about their mental health is the GP, midwife or Health Visitor.

This useful list of questions to ask a GP may be helpful. The health professional may make a referral for specialist help from the Perinatal Parent-Infant Mental Health Service who offer psychiatry and psychotherapy services.

In some areas, any professional working with a woman can make a referral and women can often self-refer, so it’s worth finding out the policy in your area.

If you are caring for a father, a couple, or the father has regular contact, it is also important to remember that new dads can also get depressed. They can also feel overwhelmed, frustrated and isolated if their partner is depressed.

Here are some helpful websites for dads and partners:

Postnatal Depression: A survival guide for dads
Postpartum psychosis. A guide for partners