6.19 Postpartal Psychosis

Postpartal psychosis is a major psychiatric complication in three of a thousand pregnant women.

Fifteen percent occurs during the prenatal period. Eighty five percent occurs during postpartal.

The causes are unknown but possible precipitating factors include the birth experience itself, personality traits, hormone withdrawal following delivery, and fear of the maternal role. Postpartal psychosis usually appears the third day after delivery.

Postpartal psychosis is a major psychiatric complication characterized by withdrawal, depression, hostility, suspicion, denial of existence of infant, delusions regarding the infant and mood swings

a. Signs and Symptoms.

(1) Withdrawal.

(2) Depression.

(3) Hostility.

(4) Suspicion.

(5) Denial of existence of infant.

(6) Delusions regarding the infant.

(7) Mood swings.

b. Treatment and Nursing Care.

(1) Close observation and documentation of symptoms.

(2) Protection of the patient and infant.

(3) Counseling – prognosis depends for the most part on the nature of the underlying psychiatric disorder that is almost always present.

(4) Assistance in developing coping mechanisms.

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