Supporting pregnancy, birth and early attachment

Though it is uncommon for an older woman to be placed in foster care whilst pregnant, you may have a pregnant teenager who is a looked-after child placed with you so that she can settle before her baby is born. This is a preferable scenario to being placed straight after the birth, and gives you time to build a trusting relationship and for you to help her prepare mentally and physically for being a mother.

There is a huge amount of information online about pregnancy and birth, and this can provoke anxiety in pregnant women. The sites in this section provide information which is evidence-based and not commercially sponsored or scaremongering. Because all women have different issues in pregnancy, we have curated a list of trusted sites with helpful information for your own learning and to share with the pregnant mother in your care.

Remember, sometimes something just doesn’t feel right to a pregnant woman, and as a foster carer, you should always encourage her to go for a check-up if she thinks something is wrong. Have a look at the #AlwaysAsk campaign by baby charity Tommy’s.

All women are different in how they approach birth, and the support you provide will depend on her needs. Women in foster care may be embarrassed to go to antenatal classes, feel too young, or not want to go without a partner. It is best practice in midwifery that women in the care system are looked after by a small team of named midwives who they get to know, so you can encourage her to discuss this with her midwife. Depending on where you live, she may also have a Family Nurse who will work with her until the baby is 2 years old.

Women can choose where they give birth, and many hospitals encourage a visit ahead of the birth to help parents familiarise themselves with the environment.

Occasionally you may be asked to be a birth partner. This may fall within your comfort zone and feel like a huge privilege. However, if in your own births you felt out of control or the birth was difficult or traumatic, you need to think carefully about whether this is the right thing for you. Being kind to yourself is really important, and there will probably be another good solution. If the arrangement is for you to be the birth partner, you need to make sure this is what the mum really wants and not what has been imposed on her. Women have the right to be supported by the person of their choice, and it is really important we know who this is and try to make this happen.

Its more common for a woman to come into a foster placement after the birth. She may come straight from the hospital, or from the family court, not knowing foster care was a possible outcome. There are some things you can do to help make this a little easier (see the Good Beginnings section), but this situation will always be stressful and disorientating. She may be struggling with low mood or mental health problems and will usually be separated from her support network. If she has come to the placement for a parenting assessment, she will have the additional anxiety of the possibility of failing and her baby being removed.
The midwife will usually do a mixture of home visits and postnatal clinic appointments for up to a month after the birth. She will also have a Health Visitor who will visit in pregnancy, when the baby is about 10 days old and then depending on the needs of the mother and baby will do regular home visits or see the mother and baby in a local clinic. This is a great source of support and would be your first port of call for any concerns or queries you may have about mum or baby’s health.

How can you help?

• Help her get as much rest as possible. If you know she’s had a bad night, this may mean taking the baby for a couple of hours in the morning so that she can catch up on sleep. If the placement plan means you cannot leave her alone, and you have other children in the house, consider other arrangements with your support network when you need to be out of the house for the first week or two.
• Encourage her to eat regularly. Some women lose their appetites after birth, or don’t make time to eat. Eating well is really important for energy levels, breastfeeding, and physical healing, especially if she’s had stitches or a caesarean.
• Skin-to-skin. Research has shown that lots of skin-to-skin contact between a baby and her parents promotes attachment, feeding, and reduces levels of stress hormones in mothers and babies. You can encourage either parent to hold the baby, wearing only a nappy, on their chest, for extended periods of time. This could be whilst relaxing watching TV in the evening – the baby can be tucked under a loose top with a small blanket over the top. Skin-to-skin is important whether the baby is breast or bottle feeding.
• Support with feeding. Being responsive to baby’s feeding cues and being comfortable and relaxed whilst feeding are important, whether breast or bottle feeding. If you are not familiar with breastfeeding, it may feel as though baby is feeding all the time and you may worry the baby isn’t getting enough milk. This is a common concern, but feeding a lot is normal. You know the baby is getting enough milk if he is doing wet and dirty nappies. There are lots of resources to support breastfeeding in the Learning Zone.
• You can remind the parent that the distance between their face and baby’s whilst being held is the exact distance the baby can focus, and encourage eye contact, talking and singing to the baby. If this is not part of their experience, they may find this awkward or embarrassing. Modelling it in your interactions with the baby will help.
• Being up and down emotionally is normal after birth and having someone to talk to is very important for a new mother’s mental health. In all the busyness, make sure there are times when you sit down together in private to give her opportunity to talk about how she is feeling.
• Lots of encouragement. Many mothers feel inadequate and worry they are doing things wrong. Praising her care of the baby and noticing and commenting on the baby’s response to her are powerful tools in building her confidence and self-esteem.
• Link her in with other parents if possible and appropriate.