The unborn baby

Question 1

When is the perinatal period?

Answer 1

Pertaining to the period immediately before and after birth

Question 2

How long does the perinatal period last?

Answer 2

20th to 28th week of gestation and ends 1 to 4 weeks after birth.

Question 3

How common is perinatal mental health?

How can it present as?

Answer 3

it affects up to 20% of women 
It can present as:
Antenatal and postnatal depression 
PTSD
Postpartum psychosis

Question 4

What is the leading cause of death fo women during pregnancy and in the first year after giving birth?

Answer 4

Suicide

Question 5

What is ante natal anxiety and depression associated with?

Answer 5

Postnatal depression

Question 6

Following the first contact with primary care or the booking of a visit what does NICE recommend?

Answer 6

That the GAD-2 should be used to assess a pregnant woman health and wellbeing at all contacts

Question 7

What can adverse influences during foetal life alter?

What do they think the influences are?

Answer 7

The structure/function of distinct cells thereby programming the individual for an increased risk of developing a disease in later life

• Decreased blood flow to the foetus
• Overexposure to glucocorticoids
• Inpact of stress on transplacental transfer

Question 8

How can glucocorticoids get to the foetus? What may cause this?

Answer 8

Maternal cortisol crossing the placenta
The emotional state of the mother can change the filtering capacity of the placenta to the foetus. If the mother is stressed more cortisol may pass through

Question 9

What may high cortisol do to the foetus?

Answer 9

High levels can be toxic to the foetal brain and adversely affect the foetal and child brain.
The HPA axis is responsible for setting the stress thermostat and results in these children experiencing higher levels of stress throughout childhood t adulthood.

Question 10

What are some obstetric consequence of antenatal anxiety?

Answer 10

LBW

Preterm labour

Question 11

What is impaired blood flow or raised resistance index to the foetus through the maternal uterine arteries associated with?

Answer 11

Intra uterine growth restriction and preeclapsia

Question 12

What are the prenatal stress and neurodevelopmental outcomes in children aged 3-16?

Answer 12

They are increased risk of child emotional problems especially anxiety and depression
Symptoms of ADHD
Conduct disorder

Question 13

What is meant by psychic re-organisation?

Answer 13

That pregnancy is a time of psychic re-organisation and old psychological conflicts may be revived during this period.
Many women will reflect on their relationship with their own mother and begin to consciously or unconsciously think about and evaluate the way they were parented.
May re-awaken negative feelings and emotions

Question 14

What is meant by maternal representations of the developing baby?
When does it occur?

Answer 14

Refers to mental images or thoughts about what her unborn baby is or will be like .
It occurs during the second and third trimester

Question 15

What has maternal representation found to be associated with after birth?
What type of mothers are more likely to have infants who are securely attached at 12 months?

Answer 15

A Childs attachment security

Mothers with balanced representations

Question 16

What mothers are more likely to have an infant who are insecurely attached or disorganised?

Answer 16

Mothers who have disengaged or distorted representations of the developing baby

Question 17

What interview technique is used to assess mothers maternal representations of their developing baby? What are the categories?

Answer 17

The working model of the child 
Categories:
Balanced 
Disengaged 
Distorted 
Disrupted

Question 18

What are maternal representations affected by?

Answer 18

Biopsychosocial factors including environment and relationships the mother to be has

Question 19

What did Huth-Bocks find in regards to women experiencing domestic violence?

Answer 19

They had more negative representations of their developing foetus and that their babies were more likely to be insecurely attached

Question 20

What does the relationship with the unborn baby predict?

Answer 20

The quality of the parent-infant interaction

Infant attachment at 1 year

Question 21

What is the parent-infant integration an important indicator of?

Answer 21

Infant attachment security

Question 22

What is meant by the ghosts in the nursery?

Answer 22

Ghosts from the parent’s childhood invade the nursery by unconsciously influencing the way parents think about and behave towards their baby.
Parents may re-enact with their baby ‘scenes from their own unremembered, but still painfully influential early experiences of helplessness and fear’

Question 23

Can ghosts in the nursery arise before the post natal period?

Answer 23

Yes they can arise in the antenatal period and impact the mothers psychic reorganisation or her developing maternal representations

Question 24

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Answer 24

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