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 experience due to mental illness and intimate partner violence (IPV) and discuss the nursing role involved in the management of their care. For many women, pregnancy is a time of hopeful anticipation, yet for others, pregnancy reflects a new or an ongoing struggle with mental illness. The sequelae 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 fetal alcohol spectrum disorders and neonatal addiction syndrome. Women who live with IPV risk their physical and mental well-being as well as the safety of their newborn. Implications for practice include the use of assessment 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 timely care for both the mother and infant; yet, few obstetric practices use a depression assessment tool such as the Edinburgh Postnatal Depression Scale. During the initial intake assessment, the Edinburgh Postnatal Depression Scale can provide the means of early treatment through targeted assessment. Further implications include specialized services for substance-misusing pregnant women whose issues are different and separate from those of men, integration of services to address their multifaceted needs, and educating nurses to the reality of comorbidity as the norm rather than the rare occurrence, with a truly holistic approach that diminishes stigma.