Perinatal Mental Health

Question 1

Why is the concept of attachment important?

Answer 1

• Quality of caregiver responses to attachment behaviours over time determines the child’s expectations of safety and security. Traumatising experiences, early, can have adverse outcomes in later life in terms of emotional interaction and development

Question 2

Describe how pre-existing mental illness may impact a pregnant woman and her pregnancy. How might pregnancy impact upon mental illness?

Answer 2

• Impacts upon woman and pregnancy
  
  • Planning [more unplanned]
  • Obstetric care [avoidance]
  • Foetal health [IUGR, increased complications, neonatal morbidity and mortality]
  • MB relationship [postpartum lack of emotion, impaired competence and risks of harm during and post-pregnancy, decreased attachment]
  • Psychotropic medication effects [teratogenicity, breastfeeding risks])
• Pregnancy may have an impact on the woman (risk of relapse, incorporation of baby/pregnancy into delusions)

Question 3

When does depression arising during pregnancy tend to peak? What are the risks at this time?

Answer 3

• Peaks during T3 and tends to resolve after birth
• Lack of care about pregnancy, poor health behaviours, risk of suicide, increased spontaneous abortion/hypertension/preeclampsia