References

Aiken CE, Aikin AR, Scott JG, Brickelsby JC The influence of hours worked prior to delivery on maternal and neonatal outcomes: a retrospective cohort study. Am J Obstet Gynecol. 2016; 215:(5)634.e1-634.e7 https://doi.org/10.1016/j.ajog.2016.06.026

Al-Maliki A, Kaufer D, Ishizaki S, Dreher K Fear and threat in war zones: Fear of Giving birth in an Israeli Prison.Doha: Bloomsbury Qatar Foundation Publishing; 2012

Aquino MRJRV, Olander EK, Needle JJ, Bryar RM Midwives' and health visitors' collaborative relationships: A systematic review of qualitative and quantitative studies. Int J Nurs Stud. 2016; 62:193-206 https://doi.org/10.1016/j.ijnurstu.2016.08.002

Aranzamendez G, James D, Toms R Finding antecedents of psychological safety: a step toward quality improvement. Nurs Forum. 2015; 50:(3)171-178 https://doi.org/10.1111/nuf.12084

Bayrampour H, Hapsari AP, Pavlovic J Barriers to addressing perinatal mental health issues in midwifery settings. Midwifery. 2018; 59:47-58 https://doi.org/10.1016/j.midw.2017.12.020

Bergink V, Gibney SM, Drexhage HA Autoimmunity, inflammation, and psychosis: a search for peripheral markers. Biol Psychiatry. 2014; 75:(4)324-331 https://doi.org/10.1016/j.biopsych.2013.09.037

Bosanquet K, Mitchell N, Gabe R Diagnostic accuracy of the Whooley depression tool in older adults in UK primary care. J Affect Disord. 2015; 182:39-43 https://doi.org/10.1016/j.jad.2015.04.020

Cantwell R, Gray R, Knight M Caring for women with Psychosis. In: Knight M, Nair M, Tuffnell D (eds). Oxford: National Perinatal Epidemiology Unit, University of Oxford; 2017

Postpartum psychosis: I'm afraid how you'll judge me as a mother and a person. 2017. https://mosaicscience.com/story/post-partum-psychosis-birth-mental-health-babies/ (accessed 11 January 2019)

Cox JL, Holden JM, Sagovsky R Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987; 150:(06)782-786

Davies W Understanding the pathophysiology of postpartum psychosis: challenges and new approaches. World J Psychiatry. 2017; 7:(2)77-88 https://doi.org/10.5498/wjp.v7.i2.77

Davis WN, Raines C, Indman P, Meyer BG, Smith A History and purpose of postpartum support international. J Obstet Gynecol Neonatal Nurs. 2018; 47:(1)75-83 https://doi.org/10.1016/j.jogn.2017.10.004

de Witte LD, Snijders G, Litjens M Are infectious agents involved in the pathogenesis of postpartum psychosis?. J Affect Disord. 2018; 229:141-144 https://doi.org/10.1016/j.jad.2017.12.069

Degner D Differentiating between ‘baby blues’, severe depression, and psychosis. BMJ. 2017; 359 https://doi.org/10.1136/bmj.j4692

Derickson R, Fishman J, Osatuke K, Teclaw R, Ramsel D Psychological safety and error reporting within Veterans Health Administration hospitals. J Patient Saf. 2015; 11:(1)60-66 https://doi.org/10.1097/PTS.0000000000000082

The Mental Capacity Act 2005: Code of Practice.London: TSO; 2007

Di Florio A, Jones L, Forty L Mood disorders and parity—A clue to the aetiology of the postpartum trigger. J Affect Disord. 2014; 152-154:334-339 https://doi.org/10.1016/j.jad.2013.09.034

Dias MC, Jones I Perinatal Psychiatry. Medicine. 2016; 44:(12)720-723 https://doi.org/10.1016/j.mpmed.2016.09.006

Doucet S, Letourneau N, Blackmore ER Support needs of mothers who experience postpartum psychosis and their partners. J Obstet Gynecol Neonatal Nurs. 2012; 41:(2)236-245 https://doi.org/10.1111/j.1552-6909.2011.01329.x

England C The healthy low birth weight baby, 16th edn. In: Marshall J, Raynor M (eds). Edinburgh: Churchill Livingstone, Edinburgh; 2014

Franks WLM, Crozier KE, Penhale BLM Women's mental health during pregnancy: A participatory qualitative study. Women Birth. 2017; 30:(4)e179-e187 https://doi.org/10.1016/j.wombi.2016.11.007

Fusté M, Pauls A, Worker A Brain structure in women at risk of postpartum psychosis: an MRI study. Transl Psychiatry. 2017; 7:(12) https://doi.org/10.1038/s41398-017-0003-8

Ganjekar S, Dcruz M, Thippeswamy H, Sutar R, Prakash A, Chandra PS Autoimmune disorders and postpartum psychosis: case report with a comprehensive topical review. Personalized Medicine in Psychiatry. 2018; 7-8:1-6 https://doi.org/10.1016/j.pmip.2018.02.001

Glangeaud-Freudenthal NMC, Howard LM, Sutter-Dallay AL Treatment—Mother-infant inpatient units. Best Pract Res Clin Obstet Gynaecol. 2014; 28:(1)147-57 https://doi.org/10.1016/j.bpobgyn.2013.08.015

Kalanithi P When Breath Becomes Air.New York (NY): Random House; 2016

Kent A Psychiatric disorders in pregnancy. Obstetrics, Gynaecol Reprod Med. 2011; 21:(11)317-322 https://doi.org/10.1016/j.ogrm.2011.09.002

Lawson A, Murphy KE, Sloan E, Uleryk E, Dalfen A The relationship between sleep and postpartum mental disorders: A systematic review. J Affect Disord. 2015; 176:65-77 https://doi.org/10.1016/j.jad.2015.01.017

Mannion A, Slade P Psychotic-like experiences in pregnant and postpartum women without a history of psychosis. Schizophr Res. 2014; 160:(1-3)118-123 https://doi.org/10.1016/j.schres.2014.10.003

Maternal Mental Health Alliance. Home. 2018a. http://www.maternalmentalhealthalliance.org/ (accessed 11 January 2019)

Maternal Mental Health Alliance. Free online training. 2018b. http://www.maternalmentalhealth.org.uk/resources/training/

Maternal Mental Health Alliance. Maps. 2018c. https://maternalmentalhealthalliance.org/campaign/maps/ (accessed 11 January 2019)

National Institute for the Prevention of Cruelty to Children and Royal College of Midwives. Specialist perinatal mental health midwives: what they do and why they matter.London: RCM; 2013

Murray-Davis B, Marshall M, Gordon F What do midwives think about interprofessional working and learning?. Midwifery. 2011; 27:(3)376-381

Nahar A, Kondapuram N, Desai G, Chandra PS Catatonia among women with postpartum psychosis in a Mother-Baby inpatient psychiatry unit. Gen Hosp Psychiatry. 2017; 45:40-43 https://doi.org/10.1016/j.genhosppsych.2016.12.010

Antenatal and postnatal mental health: clinical management and service guidance [CG192].London: NICE; 2014

National Library of Medicine. Drugs and Lactation Database (LactMed). 2018. http://www.toxnet.nlm.nih.gov/newtoxnet/lactmed.htm (accessed 11 January 2019)

Noonan M, Doody O, Jomeen J, Galvin R Midwives' perceptions and experiences of caring for women who experience perinatal mental health problems: an integrative review. Midwifery. 2017; 45:56-71 https://doi.org/10.1016/j.midw.2016.12.010

Norhayati MN, Nik Hazlina NH, Asrenee AR, Wan Emilin WMA Magnitude and risk factors for postpartum symptoms: A literature review. J Affect Disord. 2015; 175:34-52 https://doi.org/10.1016/j.jad.2014.12.041

Standards for medicine management.London: NMC; 2007

The Code: Professional standards of practice and behaviour for nurses and midwives.London: NMC; 2018

Perry A, Gordon-Smith K, Di Florio A Adverse childhood life events and postpartum psychosis in bipolar disorder. J Affect Disord. 2016; 205:69-72 https://doi.org/10.1016/j.jad.2016.06.061

Posmontier B The role of midwives in facilitating recovery in postpartum psychosis. J Midwifery Womens Health. 2010; 55:(5)430-437 https://doi.org/10.1016/j.jmwh.2010.02.011

Postpartum Support International. Postpartum Psychosis. 2018. http://www.postpartum.net/learn-more/postpartum-psychosis/ (accessed 11 January 2019)

Perinatal mental health services: Recommendations for the provision of services for childbearing women [CR197].London: RCP; 2015

Spitzer RL, Kroenke K, Williams JBW, Löwe B A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166:(10)1092-1097

Thippeswamy H, Paul P, Purushottam M, Philip M, Jain S, Chandra PS Estrogen pathway related genes and their association with risk of postpartum psychosis: A case control study. Asian J Psychiatr. 2017; 26:82-85 https://doi.org/10.1016/j.ajp.2017.01.014

Tinkelman A, Hill EA, Deligiannidis KM Management of new onset psychosis in the postpartum period. J Clin Psychiatry. 2017; 78:(9)1423-1424 https://doi.org/10.4088/JCP.17ac11880

Toxbase. Home. 2018. http://www.toxbase.org (accessed 11 January 2019)

VanderKruik R, Barreix M, Chou D The global prevalence of postpartum psychosis: a systematic review. BMC Psychiatry. 2017; 17:(1) https://doi.org/10.1186/s12888-017-1427-7

Wyatt C, Murray C, Davies J, Jomeen J Postpartum psychosis and relationships: their mutual influence from the perspective of women and significant others. J Reprod Infant Psychol. 2015; 33:(4)426-442 https://doi.org/10.1080/02646838.2015.1027181

Zijlmans MAC, Riksen-Walraven JM, de Weerth C Associations between maternal prenatal cortisol concentrations and child outcomes: A systematic review. Neurosci Biobehav Rev. 2015; 53:1-24 https://doi.org/10.1016/j.neubiorev.2015.02.015

Postpartum psychosis and management: a case study

02 February 2019
17 min read
Volume 27 · Issue 2

Abstract

Postpartum (or puerperal) psychosis is an acute mood disorder requiring close specialist care. It is a disorder that is rare and poorly understood, but has devastating consequences. This work retrospectively describes the case study of a young woman who suffered postpartum psychosis following the birth of her first child. A critical appraisal of the care received follows this, focusing specifically on the postnatal period when she was most affected. It was found that critical information was not unearthed at the initial booking appointment, nor were her presenting symptoms recognised in a timely manner; detailing a need for greater training among midwives and care givers regarding early recognition and referral for postpartum psychosis.

Postpartum (or puerperal) psychosis is a severe mood disorder characterised by acute onset manic or affective psychosis (Dias and Jones, 2016), usually within 2 weeks after childbirth (Norhayati et al, 2015). This may overlap with depression and often fluctuates before full recovery is achieved (Dias and Jones, 2016). Symptoms include agitation, insomnia, and thought processes that are eccentric, deviated and disorganised, with delusions and hallucinations, the content of which revolves around the neonate's safety (VanderKruik et al, 2017). Postpartum psychosis is considered a psychiatric emergency due to its high risk of suicide and infanticide (Nahar et al, 2017). It also increases the risk of later developing non-gestational psychosis (particularly bipolar disorder) and postpartum psychosis after a subsequent pregnancy (VanderKruik et al, 2017). It is the most severe mental illness of the perinatal period, defined as the period between pregnancy and 1 year after the birth (Dias and Jones, 2016).

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • Unlimited access to the latest news, blogs and video content

  • Monthly email newsletter