Maternal Mental Health Flashcards
(42 cards)
What are the two main periods when maternal mental health issues can occur?
Antenatal (during pregnancy) and postpartum (from birth until up to a year)
What are the possible presentations of maternal mental health issues?
- Continuation of existing Mental Disorder
- Relapse in pre-existing condition
- New onset Mental Disorder
- Baby Blues
Why are doctors particularly concerned about mental health during pregnancy?
- Risk of relapse for women with pre-existing conditions
- Pregnancy can be stressful (physical complications, anxiety, social difficulties)
- Effect of substance abuse on developing fetus
What is Baby Blues?
- Occurs 3rd to 5th day postpartum
- Lasts a few hours to days
- Symptoms include overwhelmed feelings, tearfulness, exhaustion, irritability
- Resolves naturally with support, rest, and good nutrition
What defines Postpartum Depression (PPD)?
- Occurs within 4 weeks of birth
- Affects 10-16% of women
- Diagnosis can be missed, often dismissed as hormonal imbalance or Baby Blues
- Suicide is a leading cause of maternal death in New Zealand
What are some risk factors for Postpartum Depression (PPD)?
- Previous History of Depression or PPD
- Discontinuation of medication
- Childhood abuse
- Negative attitude towards pregnancy
- Lack of social support
- Having twins or triplets
- Losing a baby
- Pregnancy and birth complications
What biological factors can contribute to PPD?
- Sudden change in hormone levels
- Lack of sleep
- Pain and feeding issues
What are some societal stressors contributing to PPD?
- Sudden change in lifestyle
- Societal expectation of the ‘Happy Mother’
What feelings of loss are associated with PPD?
- Loss of autonomy
- Loss of opportunity
- Loss of relationships
- Loss of finances
- Loss of sexuality and femininity
- Loss of occupational identity
How should PPD be detected?
- Screen all women who have had a baby
- Consult with patient and/or family
- Use Edinburgh Postnatal Depression Scale and PHQ-9
What are the effects of untreated PPD on mother-infant interactions?
- Decrease in affectionate behavior
- Decreased responsiveness to infant cues
What are the long-term effects of untreated PPD on childhood development?
- Increased behavior problems
- Poorer educational outcomes
- Diminished social competence
- Increased rates of mental disorder and risky behavior
What is Postpartum Psychosis (PPP)?
- Occurs in 1-2 episodes per 1000 births
- Rapid onset in the first 2 weeks postpartum
- Associated with suicide and infanticide
- Can be a recurrence of bipolar disorder or schizophrenia
What are common symptoms of Postpartum Psychosis (PPP)?
- Extreme agitation
- Paranoia, confusion, disorientation
- Inability to sleep/eat
- Losing touch with reality
- Delusions and hallucinations
- Disorganized behavior
What are clinical considerations for treating breastfeeding mothers with mental health issues?
- Careful risk/benefit assessment of treatment
- Weigh risks of treatment against untreated illness
- Mood stabilizers and antipsychotics have teratogenic effects
What percentage of fathers experience depression from the 1st trimester to 1 year after delivery?
5-10%
How can paternal mental health affect children?
- Directly via quality of interactions
- Indirectly via support to the mother and family environment
What is the importance of screening for maternal mental health issues?
To identify and treat conditions that can impact the mother, child, and family
Fill in the blank: Suicide is the leading cause of maternal death in ________ and several other Western countries.
New Zealand
True or False: PPD is seen across all cultures and socio-economic statuses.
True
What is the incidence rate of Postpartum Psychosis (PPP)?
1-2 episodes per 1000 births
When does clinical onset of Postpartum Psychosis typically occur?
Mostly in the first 2 weeks post-partum
What are the potential tragic outcomes associated with Postpartum Psychosis?
Suicide and infanticide (rare: 1-3 of 50,000 births)
What can trigger Postpartum Psychosis?
Recurrence of pre-existing bipolar disorder or schizophrenia or may be new onset
