Puerperal Psychosis is a group of illnesses which occur following childbirth. It is characterized by delusions, hallucinations and impaired perception of reality and usually becomes evident within the first 3 months postpartum.
Risk factors include a fall in oestrogen and progesterone levels, previous puerperal psychosis, history of bipolar (manic – depressive) disorders, stressors such as lack of social support, obsessive personality and family history of mood disorders.
The following information is a part of a lecture I attended while in Midwifery School, I am sure you will find it very interesting as it may clarify any doubts you might have about Puerperal Psychosis;
Nature of the Disorder
- Postpartum psychosis is considered an emergency because of the risk of suicide.
- The psychotic woman may experience delusions or hallucinations that support her perceptions that the infant should not be allowed to live (e.g. the baby is evil)
- She may contemplate suicide because she believes the child would be better off with no mother than a “crazy mother”
Clinical Manifestations
- Strange behaviors
- Confusion
- Fear and distress
- Restlessness
- Insomnia
- disorientation
Prevention and Early Recognition
- Adequate antenatal and psychiatric history
- Counseling to woman, spouse and family
- Refer to support groups
- Teach how to recognize signs of problems
- Need for home help
- EMERGENCY HOSPITALIZATION IS INDICATED ON RECOGNITION
- Treatment is directed at the specific type of psychotic symptoms displayed.
- Psychotherapy may take a number of forms e. g. supportive, analytical, behavioral and conjoined and or group therapy
- Many drugs used in treating postpartum psychiatric conditions are contraindicated in breastfeeding woman
- Use of antipsychotic medications
Care of the Infant
Infant may be separated in the initial stage based on the state of the mother (e. g. suspected infanticide)
Prognosis
With prompt treatment the prognosis is good, but it is likely that further episodes of the illness will occur throughout the woman’s life and there is a high risk of recurrence in subsequent pregnancies.
