Postpartum mental health

Question 1

This condition is seen in around 60-70% of postpartum women

3-7 days following birth and is more common in primips

Mothers are characteristically anxious, tearful and irritable

Answer 1

Baby Blues

Question 2

Affects around 10% of postpartum women

Usually starts within a month and peaks at 3 months

Answer 2

Postnatal depression

Question 3

Management of postnatal depression

Answer 3

• CBT
• Certain SSRIs such as sertraline and paroxetine (if symptoms are severe)
• they are secreted into breast milk but it isn’t harmful to the infant

Question 4

Affects approximately 0.2% of women

Onset within the first 2-3 weeks following birth

Features include:
- severe mood swings
- abnormal perception (e.g. auditory hallucinations)

Answer 4

Puerperal Psychosis

Question 5

Where should puerperal psychosis be managed

Answer 5

Admission to hospital
(Mother & Baby Unit)

Question 6

What is the risk of recurrence in puerperal psychosis?

Answer 6

25-50% risk of recurrence in future pregnancies

Question 7

What SSRI is best avoided in postnatal depression and why?

Answer 7

Fluoxetine due to long half life