Postpartum depression

A Research Proposal on Postpartum Depression: Outline: I. AbstractII. Introduction -Statement of Problem -Literature Review III. Methodology.IV. Findings and data analysis V. Summary/Conclusion Abstract: Postpartum depression refers to some unexplained feeling of sadness experienced by some mothers after giving birth. A mother may feel lonely, annoyed, and afraid. She can also develop a dislike for her baby. These feelings form the basis of this analysis. In essence, the paper will seek to establish why they occur, their possible causes, symptoms, their effects and possible treatment, if any. The first part will present a psychological literature relating to postpartum depression, analyzing at least 7 articles on this subject. The second section will explore the methodology to deploy for this research and materials needed. The final section explores findings and conclusions thereof. 1.0 Introduction: 1.0.1Statement of Problem: What is postpartum depression? What are the causes of this condition? Is it easy or difficult to diagnose? Is it treatable? What are the available remedies for postpartum depression and what effects does it pose to women and families involved? Does postpartum depression affect a mother`s long term role attainment? This research will be seeking to answer these questions as we address the main hypothesis which is postpartum depression can be predicted in advance. 1.2 Literature Review: After pregnancy, a mother may experience some mood disturbances in form of low self esteem, guilt, hate, and feeling of failure among others. This condition, which may last for two or more weeks, has also been termed by some as "baby blues", and is what we have called postpartum depression (PPD). In the ordinary sense, we expect that one of a mother`s happiest moments should be after having a child. Contrary to this, however, a mother may exhibit signs of depression, which, depending on the length of time it may take to subside, may cause adverse effects both to the mother and the family at large. According to Wong 2006: 10-15% of women experience postpartum depression, typically with the classic symptoms of depression, sadness, crying, withdrawal, and sleep disorders. One is likely to either fear causing harm to her baby and may contemplate committing suicide in some cases. This condition after delivery, in many occasions, goes undiagnosed. This has been attributed to the fact that a mother wants to avoid embarrassment. She may feel guilty or fear to share willingly about her sensitively distressful feelings. Up to 40% of the cases go unnoticed (p. 102). It is thus important that every effort should be made to prevent postpartum depression. Victims of PPD should be accorded essential and reasonable care. There is need for awareness creation and sensitization activities aimed at helping the mother and baby that may be affected by PPD. Nurses have a significant part to play and this goes as far as helping their patients to identify PPD symptoms and seek medical attention, or giving proper necessary care to those already diagnosed. It is important for instance that nurses educate their patients of the risk factors to look for so that they can avoid or prevent PPD. "A nurse who identifies and addresses these issues early on is able to assist the new mother with seeking treatment, supporting her and being empathetic to her feelings" (Castine, 2007).Quite a number of factors are associated with causes of PPD and may be a result of social cultural, biochemical and psychological factors. Specific examples include; general fatigue from delivery, hormonal imbalance/variation, and a mother`s behavior with relation to baby needs and cultural practices. The mother`s history during pregnancy should be understood by a nurse in order to help diagnose PPD. For instance, a nurse may want to establish if the mother suffered any form of depression including prenatal anxiety and stressful situations during pregnancy. Other risk factors to look for include; problems in marriage, menstrual cycle problems, history of mental problems, drug abuse and any other socio economic malpractices. There are some tools such as Beck`s Postpartum Depression Checklist and Edinburgh Postnatal Depression Scale which can be deployed to screen for risk factors (Creehan, 2007). After pregnancy, a mother should be given continued care and support, alongside her baby. Otherwise, if attention shifts to the baby and the mother feels no one cares, she will be at risk of getting depressed. As Watt observed, when community focuses their support to the mother, PPD prevalence declines (Watt, 2002). This research will therefore seek to establish in detail what other attention should be accorded to women by the caregivers and family. In addition, the particular role they play in preventing postpartum depression will be highlighted. Whereas postpartum depression is a manageable and treatable condition, many cases usually go unidentified. If diagnosed, it is necessary to help the mother access medical attention. Various medical measures that have been suggested to help manage PPD include both psychotherapy and pharmacological. In some cases, antidepressants such as Tegretol or Depakote have been applied. "A Psychotherapist focuses on the patient`s fears and concerns regarding her new tasks and roles as well as monitoring for suicidal or homicidal thoughts" (Wong, 2006). It has also been observed that self-care goes along way in helping a mother after delivery, and can actually help to prevent PPD. Cheng (2006) writes Motherhood is very involving and can be crushing, if for instance there is potential conflict between the woman`s relationship and their financial status. Everything is new, and taking care of your own child is exciting and frightening at the same time. These women often have responsibilities they feel that they must do on their own including cooking, cleaning and caring for the infant while trying to recover from giving birth. In order to relieve everyday stresses incurred by the new mother; she must learn to perform self-care (p. 123). Diagnosis for PPD seems to be a primary factor that goes along way to help either prevent or provide treatment for the affected individuals. This research will therefore seek to identify and explain in detail why it is difficult to diagnose or rather why many cases go unnoticed and if there is something to be done to manage such occurrences in future. There are a number of observations regarding this issue. One of the arguments is to do with the time period taken by a mother at hospital after delivery. For normal delivery, it is 48 hours. For cesarean delivery, it is 96 hours (Datar &Sood, 2006). Even though this time frame is sufficient for the mother and baby to receive basic care at the hospital while keeping the costs at minimum, it is not sufficient enough to allow for PPD assessment. According to Gjerdingen & Center (2003); The first postpartum check-up takes place six weeks after birth during which the providers will perform a physical examination and discuss any concerns the new mother is having. Many women suffering from postpartum depression feel embarrassed and choose not to share their feelings. After the six-week check-up, the focus turns to the infant, without further follow up for the mother (p. 190) Women are likely to keep to themselves their experiences due to fear of embarrassment. Since the mother ordinarily anticipate a lot of changes after delivery, she might not be certain if her condition is unusual (Epperson, 1999). It may be even more complicated for a mother who has never delivered before. Such a mother, having mixed feelings may not make decision to conduct professional help she has no idea how to confront the situation. Even for those who may be aware of PPD, the general tendency to remain in a state of denial makes it difficult to diagnose and hence failure to find remedy in time. Following the review above, this research will be seeking to test the hypothesis that postpartum can be predicted in advance. In the next section, we explore the methodology that the research will use for this end. 1.3 Methodology: 1.3.1 Sampling Procedure: The research intends to use randomly selected samples of respondents for interviews, which will be done through questionnaires. This research will involve a set of respondents comprising of pregnant mothers with a few days to delivery date, mothers who have just delivered, practicing doctors and nurses. To be able to test the main hypothesis, that is, PPD can be predicted in advance, this research will use the same group of women to respond to all questions in three different phases. The first set of questionnaires will be administered to a sample of pregnant women with less than a week to delivery. The second set of questions will be administered to the same group of women three days after delivery. The final set of questions will be administered to the same group three weeks after delivery. This control measures are aimed at ensuring consistency in the process. This will help to establish if there are constant/common predominant patterns that tend to lead to PPD. The data will then be critically and carefully analyzed in order to draw valuable conclusion. 1.3.2 Data Collection Procedure: This research will make...