Postpartum Depression
LEARNING ACTIVITY MODULE
SOUTHEASTERN LOUISIANA UNIVERSITY
SCHOOL OF NURSING
N 481
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N481 MODULE: Postpartum Depression
PURPOSE:
To provide the student an opportunity to recognize risk factors and symptoms of
postpartum depression and role-play therapeutic interventions with families.
RATIONALE:
While the baby blues can affect as many as 80 % of new mothers, postpartum depression
maybe present if symptoms continue past a couple of weeks. It can have long-term
implications for both the mother and infant. The nurse is responsible for assessing and
identifying women at risk, recognizing the symptoms of postpartum depression and
taking definitive steps to intervene.
OBJECTIVES:
1.
2.
3.
4.
Identify ways to screen women for risk of postpartum depression by performing a
brief screening or using a validated assessment tool.
Recognize symptoms and verbal or nonverbal communication that may indicate a
problem.
Practice therapeutic responses to women displaying post partum depression.
Demonstrate interest and a caring attitude in role-played scenarios.
RESOURCES:
REQUIRED READINGS:
Lowdermilk, D., & Perry, S. (2012). Maternity & women’s health care. (10th ed.). St.
Louis, Mo: Mosby Elsevier.
Ch 22 Transition to Parenthood
RECOMMENDED READINGS:
Beck, C.T. Postpartum Depression, It isn’t just the blues. AJN 2006;106(5):40-50.
STUDENT LEARNING ACTIVITIES:
1.
2.
3.
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Discuss personal clinical experiences with postpartum depression
Role-play selected scenarios
Discuss effectiveness of the nurse during role-play of selected scenarios
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Background Information
Postpartum depression (PPD) can affect about 20% of new mothers. Symptoms can be
mild or severe and often go undiagnosed or unreported. Although the cause is unknown,
there are strong indicators that can help identify women at risk for PPD. These include:
Depression during pregnancy
Prenatal anxiety
Stressful life events
Feelings of isolation, lack of social support
Personal or Family history of depression
Poor marital relationship or single mother
Mothers of premature infants or deliver multiple infants
Screening:
PPD risk: Postpartum Depression Predictors Inventory-Revised by C Beck,
2002. (see recommended reading)
PPD: The Edinburgh Postnatal Depression Scale (EPDS)
The Postpartum Depression Screening Scale ((PDSS)
Symptoms of PPD
Less interest in surroundings
Loss of usual emotional response toward her family
Unable to feel love or pleasure
Sees the infant as demanding and herself as inept
Feelings of guilt, shame, unworthiness, loss of slef
Fatigue, irritability, difficulty concentrating and making decisions
Weight changes
Sleep disturbances
Anxiety attacks
Role-playing Exercises
Scenario # 1
Roles: Nurse; 24 yr. old patient in bed with infant
22 year old Rosanna C. is a new mom, has delivered a healthy, 7 lb 12 oz infant
boy 2 days ago and is ready for discharge. As you come into the room to give her the
discharge papers, you find her sitting in bed still in the hospital gown, legs spread apart
and the infant placed on the bed between her knees. Rosanna has her elbows on her
thighs, with her hands on the sides of her face and is looking at the baby. She makes the
comment “I don’t think he likes me.”
Roll play various responses and evaluate:
1) What is your response?
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2)
3)
4)
5)
Is your response helpful?
What nursing attitude and language will be most effective?
What other information do you want to know?
What additional actions should the nurse take?
Scenario # 2
Roles: Nurse; 24 yr. old patient on telephone
Maria H. is a 24 year old who delivered her 3rd child 4 weeks ago and has called her OB
office crying. She says “I just don’t know what’s wrong with me. I’m exhausted and just
want to sleep all day! The kids are driving me crazy and I yell at them all the time. I’m
such a bad mother. I think my husband is having an affair and planning on leaving me.
The nurse tells her, “It sounds like you are just having a case of the baby blues and
everything will be ok. I’m sure your husband loves you and it just seems that way now
because you are so tired. I’ll see if the doctor can order you something to help you
sleep.”
1) What comments that Maria makes are concerning and why?
2) Are the nurse’s responses appropriate? What would be a more therapeutic
response?
3) What additional actions should the nurse take?
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