Postnatal issues

Question 1

what is the Puerperium

Answer 1

from the delivery of the placenta to six weeks following the birth

Question 2

what is the postnatal period

Answer 2

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

Question 3

name one report into postntal issues

Answer 3

saving lives improving care report

Question 4

Do postnatal periods vary from person to person

Answer 4

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

Question 5

what is one of the key findings from the saving lives improving care report

Answer 5

556 women died during the 1 year of the B life between the years of 2013-15

Question 6

what changes in the maternal population may impact on maternal death

Answer 6

obesity,
age of mother
lifestyle- more sedentary

Question 7

what is direct maternal death

Answer 7

Death- result of something that occurred in pregnancy eg heamroging in birth- specific disorder caused by P

Question 8

what is indirect death

Answer 8

usually to do with pre-exsiting conditions eg heart conditions, sepsis ect, this is aggravated by P

Question 9

what is coincidental death

Answer 9

not due to P, example road traffic accidents, murder ect

Question 10

what is late death

Answer 10

death occurring more than 42 days but less than 1 year

Question 11

what is the leading cause of direct maternal death

Answer 11

thrombosis and thromboembolism are the leading direct causes of death,

Question 12

what is the leading indirect causes of maternal death

Answer 12

cardiovascular disease

Question 13

how are most at risk from maternal death

Answer 13

Black women and those from a deprived background are at greater risk compared to the rest of the UK population

Question 14

what are the 4 classifications of mental health issues after birth

Answer 14

Baby blues
Postnatal depression
Puerperal psychoses
Post-traumatic stress syndrome following childbirth

Question 15

what is postnatal depression

Answer 15

serious mental disorder, associated with afterbirth

Question 16

can both gender get PND

Answer 16

yes both men and women can get PND, including fathers and mothers

Question 17

what is Perinatal psychiatric disorder

Answer 17

V common in P, 15% will get it in 1st trimester

5% in 2 and 3- increase risk for depression and axity

Question 18

how many women will suffer puerperal psychosis

Answer 18

2/1000

Question 19

name three common maternal mental disorders

Answer 19

OCD, Panic disorder, generalised anxiety disorder

Question 20

what is generalised anxiety disorder

Answer 20

experienced of anxiety most days

signs include nausea, tremors, sweating, palpitations

Question 21

what is OCD

Answer 21

2% of pop affected

can causes anxiety due to rituals

Question 22

what is panic disorder

Answer 22

Anxiety disorder characterised by unexplained and repeated episodes of intense fear accompanied by physical symptoms

Question 23

name the 4 main areas of postnatal mental illness

Answer 23

Baby blues
Postnatal depression
Puerperal psychoses
Post-traumatic stress syndrome following childbirth

Question 24

what is the baby blues

Answer 24

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

Question 25

Will the majority of MI go by the 2 trimester

Answer 25

The majority of minor illnesses will resolve spontaneously by the second trimester of pregnancy

Question 26

what should be offered to women who have MI in P

Answer 26

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

Question 27

P women with a single episode of major mental illness in the past are at greater risk of what?

Answer 27

These women are at marked risk of puerperal psychosis during first 3 months following delivery

Question 28

what % of women experience PND

Answer 28

Prevalence rates range between 10-28% and affects all cultures, ethnic backgrounds and socio-economic groups. However this could be as high as 31

Question 29

What is PND

Answer 29

Considered to be any non-psychotic depressive illness of mild –moderate severity within the first year following childbirth

Question 30

name some signs and symptoms of PND

Answer 30

``` 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 family ```

Question 31

name 5 risk factors for PND

Answer 31

``` hormonal changes lack of support loss of control history with depression stress in P ```

Question 32

what effect can PND have on the baby

Answer 32

lack of relationship with mother due to less positive experiences, can lead to cognitive and language development issues

Question 33

can PND effect relationship with partners

Answer 33

Yes can have a negative impact

Question 34

Can mild PND resolve

Answer 34

this can happed around 3-6 months after birth in mild cases, however 1 in 10 with PND seek help after a year

Question 35

can men get PND

Answer 35

Yes 1 in 25 men will get PND

Question 36

what is Puerperal psychosis

Answer 36

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

Question 37

name 5 signs of Puerperal psychosis

Answer 37

rapid onset (usually within first week), hallucinations, mood swings, loss of contact with reality, intrusive though processes and loss of inhibitions

Question 38

what are some of the risk factors for Puerperal psychosis

Answer 38

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

Question 39

name 6 risk factors for maternal suicide

Answer 39

``` 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 ```

Question 40

what are some of the management strats for maternal mI

Answer 40

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

Question 41

what are mother and baby units

Answer 41

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

Question 42

what is maternal suicide

Answer 42

third largest cause of direct maternal deaths occurring during or within 42 days largest cause id direct deaths within the 1st year

Question 43

what happens if an MI starts in the 3rd trimester

Answer 43

increased risk of developing postnatal | depression

Question 44

what are some of the red flags (signs) of maternal suicide

Answer 44

significant change in mental state self-harming acts expression of incompetence estrangment from B

Question 45

what can affect on maternal suicide risk

Answer 45

``` 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 ```