Postpartum Depression Information and Resources
Postpartum Psychosis
Postpartum psychosis is a rare, but potentially life-threatening progression of postpartum depression. It affects up to two of every 1,000 postpartum women. It may be characterized by hallucinations, delusions and thoughts of both suicide and infanticide. Emotional lability is common, and these women may appear normal at times, decompensating at times when they are not scheduled to see their primary providers. Once again, the community health nurse (CHN) is in a much better position to assess home functioning. Evidence of postpartum psychosis requires immediate psychiatric referral and may require hospitalization.
The hospitalization of a new mother creates incredible strain upon the entire family. A priority is ensuring that the infant is being cared for and is safe. Keeping the mother and baby together is ideal, but many inpatient psychiatric facilities are not equipped or staffed to absorb the care of a newborn infant. Breastfeeding may not be possible for a period of time. Depending upon the family constellation, other family members will have varying abilities to assist. If the mother is single and without social support, foster care of the infant may be indicated. In the presence of an extended family network, other family members may be able to assume temporary care. The woman herself desperately needs support through this ordeal, and family members may need assistance in understanding the disorder and being able to provide encouragement and assistance throughout this crisis. Even after hospital discharge, family follow-up is necessary. There is a high incidence of recurrence associated with postpartum psychosis, both again during the postpartum period as well as later. Long-term counseling may be required.