Introduction When a woman gives birth to a child, it can be one of the most joyous and exciting moments in her life, yet it can also be difficult and stressful. There are a range of emotional, behavioral, and physical changes that occur shortly after a woman gives birth. These changes are common; however, many women who experience these emotions may have postpartum depression, with symptoms ranging from mild to severe. Many women require medical treatment. Although all causes of postpartum depression are unknown, there are many factors that can put a woman at risk.
This essay provides an overview of postpartum depression, the impact it has on the individual client, the newborn, and the family, the physical and mental assessment findings, and its impact on my future nursing practice. Overview Postpartum depression is an illness that consists of severe mood swings and feelings of inadequacy that occur within six months to a year after giving birth. These symptoms may be so severe that they may cause suicidal thoughts or an inability for a mother to care for her newborn.
According to Diana Barnes (2008), “50 to 80% of mothers will experience some change in mental health within the first year after delivery…10 to 15% are at risk for postpartum depression” (para. 2). The risk for postpartum depression increases if there is a history of depression, a weak support system, an unplanned or unwanted pregnancy, or a stressful situation (marital conflict, illness, or pregnancy complication). The etiology of postpartum depression is unknown.
According to Smith and Jaffe (2007), within 48 hours after delivery there is a dramatic decrease in estrogen, progesterone, cortisol, and thyroid gland hormones, along with changes in the immune system, metabolism, and blood pressure that may all trigger depression. Emotional factors include feeling less attractive, struggling with a new identity, feeling a loss of control, and anxiety about caring for the newborn. Some lifestyle influences may include difficulty breastfeeding and financial problems.
Impact on individual client, newborn, and the family Postpartum depression has potentially serious consequences for the mother, the newborn, and their families. The impact of postpartum depression causes a mother to frequently feel exhausted, emotionally empty, and guilty because she cannot show love to her baby. The mother feels overwhelmed by feelings of harming her baby and may lack the emotional energy to relate to her newborn, which prevents her from perceiving the baby’s attempts to communicate.
Depressed mothers are less likely to play with, read to, or even breastfeed their baby and tend to be inconsistent in their care causing a disruption in the bonding process. Many mothers are embarrassed to get help out of shame. Postpartum depression also has an extremely high impact on the newborn. Katja Gaschler (2008) states, “three-month-old infants of depressed mothers look at their mothers less often and show fewer signs of positive emotion than do babies of mentally healthy mothers” (p. 5). Postpartum depression during the first few months of life may also cause negative effects on a child’s development including: social problems (difficulty establishing relationships, social withdrawal, and acting out destructively); behavioral problems (temper tantrums, sleep problems, hyperactivity, and aggression); cognitive problems (walking and talking late and learning difficulties); and emotional problems (low self-esteem and anxiety).
The family as a whole is also greatly impacted by postpartum depression and goals of treatment must address the emotions of the entire family, especially the marital couple. A woman’s husband or partner may have his own feelings regarding the birth of their child, his new role in the family, as well as concerns about his partner’s health. Other members of the family may struggle with their own hidden emotions as well. The family should offer support by giving the mother a break from her childcare duties, be understanding, and provide a listening ear.
Physical & Mental Assessment There are many physical and mental assessment findings the nurse may observe in a client with postpartum depression including: a lack of interest in life, negative feelings towards the baby, fear of hurting the baby, decreased appetite, no energy or motivation, along with disturbed sleeping patterns. According to Julia Frank (2005), “as many as 80% of women experience some mood disturbances after pregnancy…they feel upset, alone, afraid, or unloving toward their baby, and guilt for having these feelings” (Overview section, para. ). A woman may have thoughts of suicide, confusion, and an impaired memory. Some physical symptoms include: shortness of breath, headaches, rapid heart beat, numbness, chest pain and unexplained weight gain or loss. The most widely used screening tool to detect postpartum depression is the Edinburgh Postnatal Depression Scale, a self-assessment tool used to evaluate mothers after childbirth. Addressing the Issue As a future nurse, I would plan to address this issue by providing the optimal level of care to the client.
I would become familiar with the risk factors associated with postpartum depression and understand the screening methods used to help identify women at risk. I would understand the range of treatment options which involves counseling, medication, and hormone therapy. I would also suggest alternative therapies which, according to Lowdermilk and Perry (2006) include: acupuncture, aromatherapy, herbal remedies, lavender tea, massage, relaxation techniques, and yoga.
I would provide women and their families with the appropriate referrals for treatment, encourage women to share any negative feelings they may experience, and use careful observation when assessing the client. As a nurse, I would also listen actively and show a caring attitude toward the client. I would be sure to ask the appropriate questions regarding her symptoms in order to get a better understanding of the extent of her illness. I would be sure to assess the client’s family members, as they may need to express their feelings about the woman’s illness.
As the nurse, I would also tell the client about the many methods used to deal with postpartum depression while at home, which according to C. Epperson (1999) include; finding someone to talk to, getting others to help with childcare, household chores, and errands, finding time for self (reading, exercising, walking, bathing, or meditating), keeping a diary to write down emotions, assure the client that she does not have to be “supermom”, and encourage her to join a support group. In conclusion, postpartum depression has a significant impact, not just on the woman, but on her partner and the family as a whole.
There is an even greater impact on the infant who is so dependent on the mother for its care. Postpartum depression is a serious condition that can interfere with a mother’s ability to care for her self and her newborn. The symptoms range in severity and there are many predisposing factors. With treatment, support from family, and attention to her own needs, a mother can get on the path to a healthy and happy motherhood. References Barnes, D. (n. d. ) A Closer Look: Understanding Mood Disorders. Retrieved July 14, 2008, from www. ostpartumhealth. com. Epperson, C. (1999). Postpartum Depression and the “Baby Blues”. American Academy of Family Physicians. 59 (8), 2259-2260. Frank, J. (2005). Postpartum Depression. Retrieved July 14, 2008, from www. emedicinehealth. com. Gaschler, K. (2008). Misery in Motherhood. Scientific American Mind. 19 (1), 66-73. Lowdermilk, D & Perry, S. (2006). Maternity Nursing (7th ed. ). St. Louis: Mosby Elsevier. Smith, M. & Jaffe, J. (2007). Postpartum Depression. Retreived July 14, 2008, from www. helpguide. org.