Working as a post-partum nurse doesn't mean just taking care of the physical needs of mothers and newborns. As more awareness is being raised about post-partum depression, many healthcare organizations are taking steps to include post-partum depression screening in the nurse's assessment process.

Nurses first assess for risk factors for post-partum depression. Reviewing medical and mental health history is critical. Patients with a history (or family history) of depression, post-partum depression with a previous pregnancy, abuse, anxiety, stress, and other mental disorders place the new mom at risk for post-partum depression. Low socioeconomic status, lack of support, and high levels of stress in the home are also risk factors.

Assessment also includes the new mom's affect and the way she interacts with the newborn and even others. Mothers with post-partum depression may exhibit outward signs and symptoms such as irritability, crying, lack of motivation, sleeping too much (or not sleeping), and appearing "withdrawn." Nurses must be aware of these symptoms before discharge and take appropriate action.

Some healthcare organizations have implemented questionnaires for mothers in the post-partum period which serve as a tool to measure the risk or degree of post-partum depression. Based on the results, appropriate interventions are initiated such as social work or psychiatric referral. In some cases, new mothers are started on medications to get them through the post-partum period.

One of the most powerful tools nurses have when assessing for signs and symptoms of post-partum depression is education. Mothers need to know that post-partum depression is common, and nothing to be ashamed about. Teaching patients about the symptoms to look for and when and how to seek help is essential for not just their health, but the health of their newborn. Being on the front lines, post-partum nurses can help heal the physical as well as the mental/behavioral health of childbirth.

Amanda Bucceri Androus, RN, BSN
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