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OB Exam 2
Postpartum Mood Conditions or Affective Disorders
| Question | Answer |
|---|---|
| postpartum blues | lasts 2-3 days, mom is crying and irritable but can still take care of themself and the baby, may be result of sleep deprivation |
| postpartum depression (pregnancy related) | fatigued, unable to do ADLs, don't want to work with their baby |
| Postpartum Anxiety (Pregnancy-related) | irritability, can't process information shared with them |
| Post-traumatic Stress Disorder | heightened level of depression, can't handle intrusive thoughts, isolate themselves and are hypervigilant |
| Postpartum Psychosis | very severe condition, could injure themselves or baby |
| rule for screening for PPD | institution needs to evaluate any mom for PPD prior to d/c, 10 or more needs conversation!! |
| Maternal mental health conditions are | the most common complications after childbirth |
| Maternal mental health conditions can cause | Clinical and health-related consequences for mothers, newborns, & families |
| we care about maternal mental health conditions because | the inability to bond impacts relationship with baby and can cause cognitive issues |
| high economic burden with maternal mental health | UK country burden estimates euro 6.6 billion US $14.2 billion following couplets for 5 years postpartum |
| consequences of mothers with mental health during pregnancy | Increased risk of adverse birth outcomes |
| consequences of mothers with mental health postpartum | Impaired ability to function Low self-esteem Decreased satisfaction with infant/relationship Impaired ability to function |
| consequences of infant/child when mom has mental health postpartum | Impaired bonding and breastfeeding Developmental delays (cognitive/behavioral) Temperament and behavioral issues in childhood |
| Moms can be smiling and seem happy but | they aren't so ask questions!! |
| risk factors for maternal mental health issues | Medical complications (pregnancy, delivery, or otherwise) Family or personal history of mood disorders Substance abuse Autoimmune disorders like thyroid disorders & diabetes Life stressors ISOLATION or lack of practical/emotional support |
| medical complications as a risk factor for maternal mental health issues | traumatic births can lead to improper bonding due to longer hospital stays and baby in NICU - a critical piece of bonding is changed!!! |
| clinical strategies | Incorporate screening using a validated tool at multiple perinatal timepoints Consider earlier postpartum visits for those who may be high risk Normalize mental health concerns by discussing it openly with postpartum individuals |
| Incorporate screening using a validated tool at multiple perinatal timepoints | at least once during pregnancy and once in the postpartum |
| Normalize mental health concerns by discussing it openly with postpartum individuals | Begin after delivery and continue with follow-up phone calls and supportive resources |
| Consider earlier postpartum visits for those who may be high risk like | 2 weeks instead of 6 weeks |
| who does PPD affect | patients and partners |
| how is PPD different from PP blues | PPD worsens over time |
| how many people does PPD affect | 1 in 7 people |
| tool used to determine if pt has PPD | Edinburgh Postnatal Depression Scale (EPDS) |
| score of what on EPDS suggests PPD | score of 10 or more |
| depression in partners | Present as anger or sadness Rates are highest 3-6 months PP |
| how many partners experience depression | Occurs in up to 25% of partners |
| What can nurses do with depression in partners | promote holding/cuddling, parental leave for partners, increase attachment |
| Postpartum Anxiety prevalence | Higher suspected prevalence than PPD |
| postpartum anxiety is | Often underdiagnosed d/t failures in screening & awareness |
| symptoms of postpartum anxiety | Debilitating and excessive worrying Intrusive thoughts Physical symptoms |
| since there are Gaps in Care & Nurses Roles, | you have to be observant - is everyone engaged, cuddling/holding, etc |
| Post-Traumatic Stress Disorder prevalence | 4% of general OB population, but higher in high-risk groups |
| symptoms of PTSD | Reliving of trauma; flashbacks Negative mood; irritability Dissociative episodes; avoidance behaviors |
| postpartum psychosis prevalence | Rare – 1 or 2 patients per 1,000 live births |
| onset of postpartum psychosis | Onset can be abrupt and considered an emergency |
| risk factors for postpartum psychosis | family history, PMHs of psychosis |
| symptoms of postpartum psychosis | delusions, hallucinations, mood changes, behavioral changes, disorientation and confusion |
| management of postpartum psychosis | rapid response intervention - supervision and immediate inpatient treatment, if that doesn't happen then Mom fantasizes and plans suicide |
| role of nurses in maternal mental health issues pt 1 | Identify at-risk patients early on and put systems in place Open education and discussion with mother AND family/support Ensuring that mother has support in place PRIOR to discharge FOLLOW-UP phone calls to "check-in" |
| role of nurses in maternal mental health issues pt 2 | Making sure women KNOW their resources Offering SCREENING & REFERRALS—nurses are part of this process and often begin this REASSURING mothers they are NOT alone |
Created by:
leh195