psychological changes in puerperium

1. WELCOME

2. PSYCHOLOGICAL
CHANGES
DURING PUERPERIUM

4. PSYCHOLOGICAL CHANGES DURING
PUERPERIUM :-
1. Adjustment to all the new changes, new
roles
2. Postpartum blues
3. Cultural influences
4. Attachment

5. PSYCHOLOGICAL ADAPTATION DURING
POSTPARTUM:-

6. REVA RUBIN

7. RUBIN’S STAGES OF MATERNAL
PSYCHOLOGICAL ADAPTATION:-

8. 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.

9. 2-TAKING HOLD PHASE (DEPENDENT TO
INDEPENDENT PHASE):-
 Last from the 3rd to 10th 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.

10. 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.

11. MATERNAL CONCERNS & FEELINGS
DURING POSTPARTUM PERIOD:-
 Abandonment
 Disappointment
 Bonding( attachement)

12. POSTPARTUM DISORDERS:-

13. 1- Postpartum blues (Baby Blues)

14. 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.

15. 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

16. 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.

17.  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.

18. 2- Postpartum depression

19. 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.

20. 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

21.  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.

22. 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.

23.  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.

24. 3,Postpartum Psychosis

25. NURSING INTERVENTION TOWARD
PSYCHOLOGICAL CHANGES &
DISORDERS DURING POSTPARTUM
PERIOD:-

26. 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

27. The thought of harming myself has
occurred to me.
Yes, quite often
Sometimes
Hardly ever
Never
EXAMPLE-QUESTION 10

28. SUMMARY
 Psychological changes
 Adaptation
 Maternal concerns
 Postpartum disorders
 Nursing interventions
 Patient education

29. RECAPITULATION

30. ASSIGNMENT

31. conclusion

32. 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

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

34. THANKS ALOT