Postnatal issues Flashcards
what is the Puerperium
from the delivery of the placenta to six weeks following the birth
what is the postnatal period
the period after the end of labour during which the attendance of a midwife upon a woman and baby is required, not being less than 10 days and for such a longer period as the midwife considers necessary
name one report into postntal issues
saving lives improving care report
Do postnatal periods vary from person to person
yes, this is due to different experiences from the mothers view to the fathers view, some people may have a stress free P while others may be very stress full, this can impact on this period
what is one of the key findings from the saving lives improving care report
556 women died during the 1 year of the B life between the years of 2013-15
what changes in the maternal population may impact on maternal death
obesity,
age of mother
lifestyle- more sedentary
what is direct maternal death
Death- result of something that occurred in pregnancy eg heamroging in birth- specific disorder caused by P
what is indirect death
usually to do with pre-exsiting conditions eg heart conditions, sepsis ect, this is aggravated by P
what is coincidental death
not due to P, example road traffic accidents, murder ect
what is late death
death occurring more than 42 days but less than 1 year
what is the leading cause of direct maternal death
thrombosis and thromboembolism are the leading direct causes of death,
what is the leading indirect causes of maternal death
cardiovascular disease
how are most at risk from maternal death
Black women and those from a deprived background are at greater risk compared to the rest of the UK population
what are the 4 classifications of mental health issues after birth
Baby blues
Postnatal depression
Puerperal psychoses
Post-traumatic stress syndrome following childbirth
what is postnatal depression
serious mental disorder, associated with afterbirth
can both gender get PND
yes both men and women can get PND, including fathers and mothers
what is Perinatal psychiatric disorder
V common in P, 15% will get it in 1st trimester
5% in 2 and 3- increase risk for depression and axity
how many women will suffer puerperal psychosis
2/1000
name three common maternal mental disorders
OCD, Panic disorder, generalised anxiety disorder
what is generalised anxiety disorder
experienced of anxiety most days
signs include nausea, tremors, sweating, palpitations
what is OCD
2% of pop affected
can causes anxiety due to rituals
what is panic disorder
Anxiety disorder characterised by unexplained and repeated episodes of intense fear accompanied by physical symptoms
name the 4 main areas of postnatal mental illness
Baby blues
Postnatal depression
Puerperal psychoses
Post-traumatic stress syndrome following childbirth
what is the baby blues
postnatal MI, occurs 2-4 days after birth- Linked to hormonal changes / surges
Affects 50-80% women, esp first time mothers
signs- tearfulness, irritability, headache, tiredness, emotional unstability during the transition to motherhood
Will the majority of MI go by the 2 trimester
The majority of minor illnesses will resolve spontaneously by the second trimester of pregnancy
what should be offered to women who have MI in P
support- counselling,
Women with a single episode of major mental illness in the past should be seen as part of joint care between primary and specialist care
P women with a single episode of major mental illness in the past are at greater risk of what?
These women are at marked risk of puerperal psychosis during first 3 months following delivery
what % of women experience PND
Prevalence rates range between 10-28% and affects all cultures, ethnic backgrounds and socio-economic groups.
However this could be as high as 31
What is PND
Considered to be any non-psychotic depressive illness of mild –moderate severity within the first year following childbirth
name some signs and symptoms of PND
Low mood/miserable most of the time
• Constantly exhausted
• Feeling unable to cope
• Feeling guilty about not being able to cope about
not loving the baby enough
• Overwhelming anxiety about the baby
• Tearful for no reason
• Difficulty in sleeping
low energy
Low sex drive
withdraw from friends and familyname 5 risk factors for PND
hormonal changes lack of support loss of control history with depression stress in P
what effect can PND have on the baby
lack of relationship with mother due to less positive experiences,
can lead to cognitive and language development issues
can PND effect relationship with partners
Yes can have a negative impact
Can mild PND resolve
this can happed around 3-6 months after birth in mild cases, however 1 in 10 with PND seek help after a year
can men get PND
Yes 1 in 25 men will get PND
what is Puerperal psychosis
Regarded as a severe mental disorder.
Affects 2/1000 women.
Psychotic illness requiring immediate psychiatric intervention – often sedation is required.
Untreated depression can turn into psychosis
name 5 signs of Puerperal psychosis
rapid onset (usually within first week), hallucinations, mood swings, loss of contact with reality, intrusive though processes and loss of inhibitions
what are some of the risk factors for Puerperal psychosis
Primigravidae (first pregnancies) with major obstetric complications
Older married mums with a long gap between marriage and the birth of their first B
Family history of bi-polar
previous history
Major event before or after birth
name 6 risk factors for maternal suicide
white older mum history of MI B under 3 months in contact or receiving treatment form psychiatric services Generally well educated Working in caring / health industry
what are some of the management strats for maternal mI
Identification of any underlying stressors – lack of social support.
Referral to postnatal support groups / peer support
Active engagement of significant others in care of baby
Counselling /CBT / debriefing services
Medication
Prompt referral to psychiatric services- mother and baby units
what are mother and baby units
Usually for women suffering with severe postnatal
depression or puerperal psychosis
allow mother to receive support from professional and keep her baby with her, this differs from normal units
what is maternal suicide
third largest cause of direct maternal deaths occurring during or within 42 days
largest cause id direct deaths within the 1st year
what happens if an MI starts in the 3rd trimester
increased risk of developing postnatal
depression
what are some of the red flags (signs) of maternal suicide
significant change in mental state
self-harming acts
expression of incompetence
estrangment from B
what can affect on maternal suicide risk
Fear of treatment Fear of children being removed Stigma of mental illness Cultural lack of recognition Belief that health workers not interested Denial by woman / partner / family
