Around the world, many mothers have very smooth postpartum experiences, but on the other hand, some tend to have unfavourable physical or mental health complications. When it comes to mental health and postpartum, a common disorder that affects mothers and their infants is postpartum depression. According to Bicking and Moore (2012), about 15 percent of women experience symptoms of postpartum depression while they are pregnant or within the first year after giving birth. It is very important for nurses to provide adequate care for these mothers so they can prevent much harm to the infants and themselves when going through this stage. Postpartum Depression can cause less attachment from mothers and infants and nurses play an important role when facilitating care for them and their family by assessing and implementing care. For this essay I will first discuss the risk factors and negative effects of the disorder along with how to assess for it in mothers. I will also outline what different interventions can be put into place to improve the symptoms of this disorder and how to evaluate these interventions.
In order for nurses to provide care for a mother with postpartum depression, they must first know what the risk factors and negative effects for this disorder are. This will help when assessing and promoting health for the patient. According to a study done by Frey, Hidalgo, Krawczak, Minuzzi, and Simpson (2016), sleep correlates with postpartum depression as the group of women who were at highest risk for the disorder expressed that they had the worst overall sleep cycles. Activity, eating habits and social behavior were the other factors that were found to contribute to the causes of postpartum depression. (Frey et al., 2016). It is also explained by Bicking and Moore (2012), that a very strong factor contributing to postpartum depression is whether the mother has had struggles with her mental health in the past, has high stress levels or insufficient support (Bicking & Moore, 2012). The negative effects of this disorder in infants include weaker results on cognitive-linguistic assessments, less language expression later on in their life, and it is also proven that it could cause deficits in the cognitive functions of preterm babies (Bicking & Moore, 2012). The possible adverse effects for the mother consist of negative parenting actions along with behavior that expresses less attachment to the infant (Bulaevskaya, Mischel, Munsen, & Scheans, 2016). Without the understanding of how extreme these effects are, the mothers may not see a need for seeking help if they are exhibiting postpartum depression so it is critical for nurses to provide this type of education to mothers before this can happen.
When providing care for patients with postpartum depression, the nurse needs to collaborate with the patient and her family when making decisions in order to implement proper care. While focusing on the family-centred care model, neonatal nurses must centre their care on not only the infants, but the parents as well (Bicking & Moore, 2012). In doing this, nurses must engage in therapeutic relationships with the family, respect the decisions of the family, and understand what their goals and options are when seeking care (RNAO, 2015). This will encourage the patient and their family to stay engaged in the health care system and look for help when they need it in the future.
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Essential steps when working with mothers who have postpartum depression are assessment and intervention. It is very crucial that postpartum depression is detected early on in the postpartum stage due to the possible risk factors for the mother and infant. When assessing mothers for this disorder, nurses must be familiar with the symptoms of this depression so that they can identify symptoms when the patient is exhibiting them (Bicking & Moore, 2012). The symptoms for postpartum depression consist of a lack of energy, depressed mood most of the day and almost everyday, sleeping problems, decreased appetite, significant weight loss without a diet, or significant weight gain (German, Lantiere, & Umylny, 2017). These symptoms must persist longer than two weeks and affect the mothers functions as if they were having a considerable episode of depression (Bicking & Moore, 2012). If a nurse suspects that their patient may be experiencing these symptoms or if their infant has been in the NICU for two weeks, one month, two months, or four months after birth, the mother must be screened for the disorder (Bulaevskaya et al., 2016).This is because the mothers of infants who are hospitalized in the NICU are more at risk of developing postpartum depression (Bicking & Moore, 2012). When screening for postpartum depression, a common tool that is used is the Edinburgh Postnatal Depression Scale (EPDS) which is a series of questions that can inform you of how high of a risk you are to the disorder (Bulaevskaya et al., 2016). Once it is known that someone has a high risk for the disorder, nurses must add interventions to their care. If the mother has had a child before and has experienced postpartum depression it is a good idea to find out what she used to improve it before (Curtis, Jacques, Lasher, Robertson, & Tom, 2013). This is due to a study that found that 60.6% of women who had the symptoms in their first child also had it in their second and many women expressed that treatment from their first experience helped during the second (Curtis et al., 2013). Some interventions that nurses can implement into the mother’s care include promotion of self-care strategies such as more sleep, relaxation, time for themselves, and exercise (RNAO, 2018). Nurses can also educate the mother on the risk factors of the disorder and how important it is to get the help they need as part of their interventions (Bicking & Moore). Another intervention that could help with creating better attachment between the mother and the infant during this time is infant massage (Lindensmith, 2018). The nurse can teach the mother how to do this and evaluate how the mother does it to her own infant (Lindensmith, 2018).
Upon implementing care to mothers with postpartum depression, nurses must also evaluate whether the interventions have been proving successful or whether they need to change the plan of care. For promotion of self-care strategies implemented toward the mother, the nurse should assess whether or not any symptoms are improved and how they are feeling overall after they participate in these strategies. If the mother is overall happier with her life and living a healthier lifestyle after, that intervention would prove successful for that patient. For the infant massage intervention, it is important to assess whether the mother conducted this task properly and whether or not the mother and infant bond is any stronger than when it was first discovered that she had postpartum depression. If the mother expresses that she is happy with her relationship to her infant and there is a good sense of attachment, this is a positive factor and this intervention helped to improve the conditions of both the mother and infant.
Neonatal nurses have a very important role when assessing, implementing, and evaluating care for mothers and their infant because postpartum depression can cause negative effects such as less attachment, cognitive deficits, and poor parenting actions if it is left untreated. Nurses must know the symptoms, risk factors, and negative effects of postpartum depression, they must respect and include the mother and her family when making decisions and promoting care, they must assess the patients, implement interventions along with evaluating their care afterwards. Without the help of nurses, the mother’s symptoms of fatigue, depressed mood, sleeping problems, decreased appetite, significant weight loss or gain may cause them to exhibit negative parenting behaviours toward their infant in which could cause cognitive deficits, and issues expressing language in the future, along with more stress in the infant. Although these effects don’t seem very destructive, they are very concerning effects that can be prevented by nurses.
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