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In reality, it is the nurse’s responsibility – being as they have the most interaction with mothers and their families – to provide screening, assessment, and education to facilitate early detection and treatment (Perry et al., 2017). For example, establishing the struggle to fall asleep is a significant screening question to determine the risk of depression. It is important to screen both mothers and fathers for postpartum depressive illness. The Edinburgh Postnatal Depression Scale (EPDS) is a self-reported assessment designed specifically to identify women experiencing postpartum depression (Perry et al., 2017). To be aware of symptoms of postpartum depression, nurses must be an active listener and demonstrate a caring attitude. Nurses cannot depend on women to offer unsolicited knowledge about their mental health; thus, nurses must find a way to approach and initiate the conversation. Communication is a central tool when evaluating the mother’s mental state (Hatrick & Varcoe, 2015). The mother is in a vulnerable position where she wants to be able to express how she feels but also does not want to be labeled as an unfit mother. To form therapeutic relationships, the nurse must demonstrate an open-minded attitude, openness, flexibility, and most importantly a sense of trust (Gottlieb, 2013).
The occurrence of postpartum depression is higher among younger women and those with less education, therefore, the social determinants of health must be taken into consideration (Perry et al., 2017). As a nurse, one must understand that being a woman intersects with factors such as race, culture, language, education, and employment. Nurses must work closely with pregnant and postpartum women of marginalized groups and understand the intersections of socioeconomics, race, and culture as probable factors that amplify the experience of the symptoms associated with postpartum depression (Hatrick & Varcoe, 2015). For instance, mothers with strong cultural ties are deeply against medication seen as a solution. Therefore, engaging in cultural humility and culturally competent care for those experiencing postpartum depression may allow for more effective interventions (Hartrick & Varcoe, 2015).
Education of nurses and health care providers is central to increasing women’s uptake and access to care (Ierardi, 2017). Nurses must understand the level of fear and stigma associated with postpartum depression. Nurses can offer mothers and their families teaching and self-care strategies, specifically the symptoms and risk factors of postpartum depression (Perry et al., 2017). This intervention offers mothers a sense of safety and empowerment in discussing their mental and social health, along with enabling suitable social and partner support. Nurses are given a limited time to assess the mother’s mental state since women are sent home within 24-48 hours of giving birth. Nonetheless, mothers can be referred to community health nurses to help with their postpartum adjustment through personal visits or telephone follow-ups. Post-partum home visits can decrease the occurrence of difficulties of postpartum depression and are considered the most beneficial (Perry et al., 2017). In efforts to promote family-centered care, nurses must collaborate with the mother and her family members to recognize and create opportunities for enhancing the capacity to cope with postpartum depression and address difficulties (Hartrick & Varcoe, 2015). Depending on the severity, supportive treatment alone is not effective for major depression. Regarding the child’s safety, at times medication is an option that has to be considered. For many women, their experiences “continue to be undermined” by a system of care that does not give precedence to women’s informed consent (Hartrick & Varcoe, 2015, p. 215). Education and support regarding medications and the risk factors for both mother and child are mandatory so that the decision is based on informed choice. A nurse’s role is crucial to help the mother and her family when it comes to postpartum depression.
The birth of a new child and the transition of hormone levels change the established practices and habits within the relationships of partnered couples. When a mother has a diagnosis of postpartum depression, new concerns must be addressed, and new routines established to provide space for the mother to cope with the signs and symptoms of her diagnosis and successfully transition from postpartum depression. Mental illness can affect all parts of a person’s life, especially their relationship with their family. For women suffering from postpartum depression, early detection, and treatment are essential in avoiding long-term health consequences, potential damage to a mother’s relationship with her partner and child, in addition to possible negative effects on the child’s cognitive and emotional development. With having an established and supportive relationship, it helps facilitate seeking care as does outreach and follow-up.
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