Psychologicalchangesduringpuerperium1 121109014209-phpapp02

psychological changes in puerperium

1. WELCOME

2. Psychological changes during puerperium

3. Psychological changes during puerperium :- Adjustment to all the new changes, new roles Postpartum blues Cultural influences Attachment

4. Psychological adaptation during postpartum:-

5. Reva Rubin

6. Rubin’s Stages of maternal psychological adaptation:-

7. 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.

8. 2- Taking hold phase (dependent to independent phase):- Last from the 3 rd to 10 th 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.

9. 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.

10. Maternal Concerns & Feelings during Postpartum period:- Abandonment Disappointment Bonding( attachement )

11. Postpartum disorders:-

12. 1- Postpartum blues (Baby Blues )

13. 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.

14. 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

15. 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.

16. 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.

17. 2- Postpartum depression

18. 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.

19. 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

20. 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.

21. 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.

22. 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.

23. 3,Postpartum Psychosis

24. Nursing intervention toward psychological changes & disorders during postpartum period:-

25. 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

26. The thought of harming myself has occurred to me. Yes, quite often Sometimes Hardly ever Never Example-Question 10

27. summary Psychological changes Adaptation Maternal concerns Postpartum disorders Nursing interventions Patient education

28. recapitulation

29. assignment

30. conclusion

31. 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

32. refernces Adele Pilletteri,textbook Of Maternity Nursing D.C. Dutta ,Textbook Of Obstetrics,central Publications,6 th Edition Diane M .Fraser ,Margaret , Cooper,myles Textbook For Midwives,churchill Livingstone Publications,15 th Edition Annamma Jacob.Textbook Of Midwifery And Gynecologic Nursing.Jaypee Publications,3 rd Edition M.C.Kenzie Vestal K.W.High Risk Perinatal Nursing,st . Louis.Saunders Publication Www.Drdonnica.Com.Postpartum Depression.Article154

33. THANKS ALOT