WELCOME

PSYCHOLOGICAL CHANGES DURING PUERPERIUM

PSYCHOLOGICAL CHANGES DURING PUERPERIUM :-

1. Adjustment to all the new changes, new roles

2. Postpartum blues3. Cultural influences4. Attachment

PSYCHOLOGICAL ADAPTATION DURING POSTPARTUM:-

REVA RUBIN

RUBIN’S STAGES OF MATERNAL PSYCHOLOGICAL ADAPTATION:-

TAKING IN PHASE(DEPENDENT PHASE):-

First 3 days post partum. Focused on self ,not infant, on her own needs

for sleep & rest. Passive , dependent & can’t make decisions. Need to discuss labor experiences. Sense of wonderment when looking at the

neonate.

2-TAKING HOLD PHASE (DEPENDENT TO INDEPENDENT PHASE):-

Last from the 3rd to 10th day postpartum. Focus on infant. Active, independent & can make decisions. Initiates self care activities, focus on bowels,

bladder & breastfeeding. Responds to instruction about infant care &

self care. May express lack of confidence in caring for

the neonate.

3-LETTING GO- (INTERDEPENDENT PHASE):-

Last from 10 days to 6 weeks postpartum. The woman finally redefines her new role. See self as separate from infant. Gives up fantasized image of her child and

accepts the real one. Readjustment.

MATERNAL CONCERNS & FEELINGS DURING POSTPARTUM PERIOD:-

Abandonment

Disappointment

Bonding( attachement)

POSTPARTUM DISORDERS:-

1- Postpartum blues (Baby Blues)

SIGNS:-

50% of women experience some

feelings of overwhelming sadness.

Mood swings, sudden crying episodes,

irritability, anxiety, loneliness

&restlessness.

Feeling of happiness and love for the

newborn may be accompanied by

feelings of helplessness, sadness and

anxiety.

CAUSES:-

Sudden & quick change in the hormones.

The emotional &physical stress of giving birth.

It may be a response to dependence and low self-esteem caused by exhaustion.

increased sense of anxiety and tension assuming by a new role.

The fatigue and lack of sleep

HERE ARE SOME HELPFUL TIPS:-

Advice woman to exercise regularly.

Advice woman to eat a healthy, well-

balanced diet.

A woman needs assurance that sudden

crying episodes are normal.

Allow time to verbalize feelings.

Make time each day for her self to enjoy.

Join a support group for new mothers.

Talk with her partner about dividing up the

parenting responsibilities so she don’t feel

like she is doing everything by herself.

2- Postpartum depression

CAUSES:- mood changes

changes in hormone levels.

non-hormonal factors

Changes in your body

Changes in work and social relationships.

Having less time and freedom

Lack of sleep.

Worries about ability as a mother.

SYMPTOMS:-

Irritability.

Changes in appetite.

Feeling depressed the majority of the day

Feeling of worthlessness or guilt.

Feeling withdrawn or unconnected.

Lack of pleasure or interest in most activities

Significant weight gain or weight loss.

Extreme insomnia or sleeping all the time.

Loss of energy.

Problems doing tasks at home or work.

Negative feelings toward the baby.

HELPFUL TIPS:-

Ask the partner, family, and friends of the woman for help with her baby.

Advice the woman doesn’t hide her feelings. Talk about her feeling with her partner, family, and friends.

Don’t make any major life changes during or right after giving birth.

Advice her to take time to go out, visit

friends, or spend time alone with her

partner.

Advice her to rest as much as she can.

Sleep when the baby is sleeping.

Talk with other mothers or join a support

group.

3,Postpartum Psychosis

NURSING INTERVENTION TOWARD PSYCHOLOGICAL CHANGES & DISORDERS DURING POSTPARTUM PERIOD:-

Postpartum Depression Predictors Inventory – Cheryl Beck

Postpartum Depression Screening Scale – also Cheryl Beck – Self-administered followed by a clinician interview, copyright issues, reliability studied have been done but are not yet published

Ante Partum Questionnaire – self-report, not widely used

Zung Self-Rating Depression Scale – 20 item, self report

(Aaron) Beck Depression Inventory – not specifically for PPD, used in psychiatry, cost associated

Edinburgh Postnatal Depression Scale (EPDS)

SCREENING TOOLS

The thought of harming myself has occurred to me.

Yes, quite often Sometimes Hardly ever Never

EXAMPLE-QUESTION 10

SUMMARY Psychological changes Adaptation Maternal concerns Postpartum disorders Nursing interventions Patient education

RECAPITULATION

ASSIGNMENT

conclusion

Physicians, nurse midwives and other licensed

health care professionals providing prenatal and

postnatal care to women shall:

•include fathers and other family members, as

appropriate, in both the education and treatment

processes to help them better understand the

nature and causes of PPD

PATIENT & FAMILY EDUCATION

REFERNCES

Adele Pilletteri,textbook Of Maternity Nursing D.C. Dutta ,Textbook Of Obstetrics,central

Publications,6th Edition Diane M .Fraser ,Margaret ,Cooper,myles

Textbook For Midwives,churchill Livingstone Publications,15th Edition

Annamma Jacob.Textbook Of Midwifery And Gynecologic Nursing.Jaypee Publications,3rd Edition

M.C.Kenzie Vestal K.W.High Risk Perinatal Nursing,st .Louis.Saunders Publication

Www.Drdonnica.Com.Postpartum Depression.Article154

THANKS ALOT