A review of research and nursing management of mental health problems in pregnancy and motherhood

Abstract

In this article, the authors explore the risks pregnant women experiencedue to mental illness and intimate partner violence (IPV) and discussthe nursing role involved in the management of their care. For manywomen, pregnancy is a time of hopeful anticipation, yet for others,pregnancy reflects a new or an ongoing struggle with mental illness. Thesequelae of untreated mental illness can be as severe as infanticide,maternal suicide, lack of maternal attachment, and inability to parent.Newborns whose mothers misuse alcohol and drugs are at risk of fetalalcohol spectrum disorders and neonatal addiction syndrome. Women wholive with IPV risk their physical and mental well-being as well as thesafety of their newborn. Implications for practice include the use ofassessment tools early and during the treatment trajectory; otherwise,mental illness and IPV in pregnancy would go undetected/untreated.Identifying postpartum depression early is key toward providing timelycare for both the mother and infant; yet, few obstetric practices use adepression assessment tool such as the Edinburgh Postnatal DepressionScale. During the initial intake assessment, the Edinburgh PostnatalDepression Scale can provide the means of early treatment throughtargeted assessment. Further implications include specialized servicesfor substance-misusing pregnant women whose issues are different andseparate from those of men, integration of services to address theirmultifaceted needs, and educating nurses to the reality of comorbidityas the norm rather than the rare occurrence, with a truly holisticapproach that diminishes stigma.