Evaluation Of A Client With A Potential For Ppd

The author is a nurse in a level two trauma facility in a community of approximately fifty thousand people in Oregon. The community is a college-town surrounded by a large agricultural area. There is a minimal ethnic diversity within the community. The diversity present occurs mainly from internationally students and faculty from the college. There is a growing population of women who desire low interventional births in the community. The author has worked on the labor and delivery unit of the hospital for the last 14 years. The hospital is the only one in the area to offer trial of labor services to women who have previously undergone a cesarean section. The unit on average experiences around 1000 deliveries annually.

Providing an effective care and support to the patient and for their babies during labour

For any mother the birth of a newborn child can be a challenging experience. As nurses it is part of our job to ensure their experience is positive. We can help do this by providing the information they will need to affective care for their newborn. This information includes topics such as, breastfeeding, jaundice, when to call your doctor and even how to put your baby to sleep. When the parents have an understanding of these topics before discharge it can largely reduce their natural anxiety accompanied with the transition to parenthood. Health teaching for new parents is seen as such an important aspect of care on post-partum floors it is actually a necessary component that needs to be covered before the hospital can discharge the

The purpose of this paper is to explore the relationship between the role of the labor and delivery nurse to the “maternal role attainment - becoming a mother” model. The model (MRA) was proposed by nursing theorist Ramona T. Mercer in 1991 to guide nurses in implementing the nursing process while providing care to the non-traditional mother. Revised in 1995 to “Becoming a Mother”, this model soon proved useful for nurses to access, concentrate on, and attend to the needs of all new mothers. New mothers experience various stressors such as an ill infant, their own health, financial strains, and postpartum depression. This model is evidenced- based and incorporates the four global nursing concepts into it. The importance of this model is the provisions it makes for mother-infant bonding that affects the health and development of individuals and families throughout the lifespan (Role Attainment, 2005). For the professional nurse in labor and delivery, the model has significant use aiding the impact that labor and delivery nurses have on new mothers perceiving and attaining their maternal role.

Continuity of care may have different meanings, ranging from continuity of caregivers, to a shared philosophy of care by large numbers of caregivers with different professional backgrounds or ideally one-to-one care (Waldenstrom et al. 2000). The purpose of midwifery continuity of care is to allow women and their midwives to get to know each other over time. This involves not only a personal knowledge of each other, but also the ability to be able to work out, investigate, talk about and consider the complex decisions, bearing in mind the woman’s needs and expectations. The relationship has a professional purpose, which is the provision of safe and effective midwifery care (Homer, Brodie & Leap, 2008).

Postpartum psychiatric disorders, particularly depression, has become the most underdiagnosed complication in the United States. It can lead to increased costs of medical care, inappropriate medical care, child abuse and neglect, discontinuation of breastfeeding, and family dysfunction and adversely affects early brain development (Earls, 2010). Over 400,000 infants are born to mothers that are depressed. One of 7 new mothers (14.5%) experience depressive episodes that impair maternal role function. An episode of major or minor depression that occurs during pregnancy or the first 12 months after birth is called perinatal or postpartum depression (Wisner, Chambers & Sit, 2006). Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult for them to complete daily care activities for themselves or for others (Postpartum Depression). The six stages of postpartum are denial, anger, bargaining, depression, acceptance and PTSD. These stages may affect any women regardless of age, race, ethnicity, or economic status. However only a physician can diagnose a woman with postpartum depression. It does not occur because of something a mother does or does not do, it’s a combination of physical and emotional factors. After childbirth, the levels of hormones in a woman’s body quickly drop; which may lead to chemical changes in her brain (Postpartum Depression). Unbalanced hormones may trigger mood swings.

The birthing process generally leaves women with overwhelming joy and happiness. However, some women do experience a period of postpartum blues lasting for a few days or at most a couple of weeks but goes away with the adjustment of having a baby (Postpartum Depression, 2013). A condition called Postpartum Depression Disorder (PPD) leaves a dark gray cloud over 10-20% of woman after birth that is recognized in individuals 3 weeks to a year after the delivery of their baby (Bobo & Yawn, 2014). PPD leaves new mothers feeling lonely, anxious, and hopeless (Bobo at el, 2014). Postpartum Depression is a cross cutting disorder that can affect any woman after the delivery of a baby regardless of race, socioeconomic status, age, or education level (Postpartum Depression, 2013). Although this disorder affects more than 10% of women the article Concise Review for Physicians and Other Clinicians: Postpartum Depression reports that less than half of women with PPD are actually diagnosed with this condition (Bobo at el, 2014). It is important that postpartum women and their support systems receive education on what PPD consist of and ways to recognize the signs and symptoms of PPD so that a diagnosis is not overlooked. Early diagnosis is important because early recognition and treatment of the disorder yields for better results when treating individuals with PPD. In this paper I will deliver information about PPD based on recent literature,

Society must realize postpartum depression is treatable and manageable. Depression of any kind is a serious illness that requires not only further study, but a shift in thinking so it is less misunderstood and more widely recognized. Early identification of PPD symptoms must be increased in order to alleviate the tremendous burden this illness causes on families and new mothers and while current diagnosis practices are expanding to include earlier identification and increasing successful treatment, it is critical that the medical community work together to expand and add to the prevention of postpartum depression. In conjunction with a greater tolerance and understanding of this mostly hidden disease, perhaps depression will no longer be such a hidden and misunderstood mental

Postpartum depression (PPD) affects about eighty-five percent of new mothers and persists as long as a year after childbirth (Texas Medical Association, 2015). In spite of the scope of this problem and the benefits of screening women, it’s not standard procedure (New York State Department Of Health, 2016). This policy brief was written for healthcare providers that treat new mothers at risk for PPD with the goal of improving screening and the number of women receiving appropriate treatment. The recommendations address measures to improve early identification and follow-up care for women found to have PPD.

According to two recent studies, 7-13% of all postpartum women suffer from depression. Even more alarming, the prevalence of postpartum depression (PPD) in mothers who have pre-term infants rises to 30-40% according to a recent review (Robertson E, Grace S, Wallington T, Stewart DE., 2004; Schmied V, Johnson M, Naidoo N, et al., 2013). Mood and anxiety disorders, specifically PPD, are severe, yet common complications in women of reproductive age. Undertreated depression in postpartum women is associated with health risks for both the mother and infant, making the goal of euthymia a top priority in the care of postpartum women. Current practice regarding PPD focuses on the triad approach of early detection and prevention, the use of pharmacotherapy, and the use of psychotherapy. However, the treatment of mental illness during pregnancy requires weighing the benefits of pharmacological treatment for the mother, to the risk of the medications on the growth and development of the fetus as well as the theoretical risks associated with undertreated depression. However, many studies are showing that the risks of postpartum depression to both the mother and infant significantly outweigh the risks of pharmacological treatment during pregnancy. Also, due to the ethical issues surrounding trials of pharmacotherapy during pregnancy, further research to determine evidenced-based methods of treatment are still necessary. The most important intervention to date is a

Of those women, 1053 completed both the initial assessment as well as the follow-up 6-8 weeks after giving birth. The patients self-reported their “height, pre pregnancy weight, and pregnancy weight gain immediately postpartum; their body mass index (BMI) before pregnancy was also calculated.”7 Six to eight weeks later and using the Edinburgh Postnatal Depression Scale (EPDS), patients again self-reported their postpartum weight along with their answers to the questionnaire. The well validated standard for the EPDS is a score of ≥12 to predict PPD. Those that screened positive were referred to other support services and more information regarding whether or not they had support services for PPD was also

The neonatal unit is a unit that is designed to take care of premature infants. The nurses are not only taking care of the infants but also the parents. While parents have children in the neonatal unit their stress level is much higher. When a mother gives birth to her and her spouse’s child, she is experiencing

This is the beginning of the mother’s involvement with the midwife. This is an opportunity for both parties to establish a personal relationship, partnership. This is where education exchange can occur, recognition of responsibilities, options and choices are determined which are supported and discussed with the mother and her supporters. (Pairman, 2010, pg. 431-432)

This means recognizing each woman’s social, emotional, physical, spiritual and cultural needs. It also acknowledge that a woman and her newborn baby does not exist independently of the woman’s social and emotional environment. This includes incorporating an understanding in assessment and provision of health care (Yanti et al., 2015). The fundamental principles of women-centred care ensures a focus on pregnancy and childbirth as the start of family life, not just as isolated clinical episodes. These motherhood phases take into complete account the meaning and the values of each woman. Providing women centred care helps women make an informed choices, being involved in and having control over their own care, this also includes their relationship with their midwives (Johnson et al., 2003). This demonstrates that midwives are able to attend for women during pregnancy, childbirth and in early parenting years. In addition to this, midwives also provide education for women in order to have a healthy lifestyle (Woods et al.,

Post-partum depression and psychosis can be one of the more challenging situations I encounter on my unit. I think it is because it is supposed to be a joyful time, celebrating the birth of a baby; but then the mom ends up in a hospital. The Edinburgh Postnatal Depression Scale (EPDS) can be valuable tool to identify moms at risk. It takes less than 5 minutes to complete, is available in 12 languages and is written at a low reading level (ACOG, 2017). The problem I see is families not following up with recommendation to seek psychiatric counseling until symptoms worsen.