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Prenatal Visits
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Assessment should begin with
1st prenatal visit |
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Prenatal depression may lead
to
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Preeclampsia |
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Premature delivery |
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Low birthweight
infant |
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Postpartum concerns |
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Pregnancy issues:
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Planned vs.
Unplanned |
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Wanted vs. Unwanted |
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Excited about
pregnancy and baby |
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Tolerating
pregnancy well |
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Getting home ready
for baby's arrival (e.g., getting a crib,
buying baby clothes, car seat, etc.) |
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Planning
(e.g., method of feeding, work leave, etc.) |
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Observe/assess mom and
spouse/partner and family interactions |
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Listen to expressions of
concerns with:
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Self-image |
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Worries about the
pregnancy |
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Changes to life
with baby's arrival |
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Partner/spouse |
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Financial worries |
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Abilities to
parent, fulfill responsibilities |
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Delivery Setting
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Observe/assess mom and infant
interactions and initial bonding |
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Observe/assess mom and
spouse/partner and family interactions |
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Observe/assess mom's interest
in or willingness to initiate feedings |
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Postpartum Unit
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Observe/assess ongoing mom
and infant interactions
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Does mom make eye
contact, hold & cuddle the baby, does she talk
with the baby? |
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Does the baby
respond to mom in a positive way, make eye
contact, establish an eating pattern? |
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Observe/assess parenting
skills
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Point out her
positive skills, assist with the others |
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Observe mom for signs/symptoms
of the mild transient "baby blues," or
the more concerning postpartum depression or psychosis
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Listen: to
the mom, to the spouse/partner, to the family--as
they adjust to this life change |
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Stress to
spouse/partner and/or family that mom "is not
a bad person, bad wife or bad mother" because
she is experiencing these feeling |
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Educate the patient and the
family to the signs/symptoms to watch for following
discharge
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Encourage the
patient and family to seek medical/psychological
help |
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Stress there is NO
stigma in seeking help |
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Be persistent--if
you feel mother is not getting help, continue to
follow-up with the her doctor |
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Talk with mom's physician
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Consider a Social
Service consult and/or Home Health Nurse visit,
PRN |
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Encourage a
referral, PRN |
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Postpartum Office Visit
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Evaluate postpartum transition
to assure not the basis for anything going on with mom |
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Provide time to talk and
listen to mom:
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How is she feeling? |
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How is she coping
with a new baby in the household? |
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Is she eating and
sleeping as expected? |
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Is she making plans
to resume normal activities--see friends, return
to work, spend time with spouse/partner? |
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Is she paying attention
to personal grooming and dress? |
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Again, consider a Social
Service consult and/or referral as indicated |
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Postpartum emotional changes--from the
"baby blues" to psychosis--are much more common than
accepted
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Yet, many women are never
screened nor treated |
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