During gestation and postnatal stages of pregnancy, a midwife builds a relationship with a woman offering guidance and support.
But what is a midwife’s role in identifying mental health in pregnant women?
According to the Stanford School of Medicine, Centre for Neuroscience in Women’s Health, approximately 20% of women experience changes in mood or suffer anxiety disorders before and after birth (postnatal depression). 
This should not be confused with the general stress or emotions women go through during pregnancy.
To identify symptoms of depression, extreme anxiety and other mental health problems, midwives have a duty to ask the woman about their mental wellbeing – from in the past to the present.
The NICE Clinical Guideline 2014: Antenatal and postnatal mental health provides some of the ways you can determine the best course of action for a pregnant woman with a mental illness. 
- “Develop an integrated care plan for a woman with a mental health problem in pregnancy and the postnatal period that sets out:
- The care and treatment for the mental health problem
- The roles of healthcare professionals, including who is responsible for: Coordinating the integrated care plan, the schedule of monitoring and providing the interventions and agreeing the outcomes with the woman.”
During pregnancy, hormones do change but the severity of these changes can vary from woman-to-woman. Some women may openly speak about their mental health and their general feelings, but others may not reach out to you so easily.
As a midwife, look out for possible symptoms to help assist with the wellbeing of the woman. Remain sensitive but assertive.
All midwives are required to ask whether a woman has experienced or has been treated for a mental health illness in the past. Some studies have suggested if a woman has been depressed, they could potentially relapse during pregnancy. According to a 2006 study of 201 pregnant women, who have experienced depression in the past, 83 (41%) relapsed during gestation. 
All cases of depression are unique and it’s important to ensure all women receive the best quality care when it comes to mental health.