PPD Nursing: What You Need to Know About Postpartum Depression

• PPD nursing is an area of concern as a postpartum nurse. 
• Positive outcomes start with a postpartum nurse screening for PPD and advocating for proper treatment.
• A postpartum nurse plays an integral role in screening for PPD. 

Discussion around mental health has been on the rise recently. Growth and continued discussions need to be an ongoing effort to advance the impact on mental health care. Mental health in general can have many negative stigmas surrounding it, but this can be especially true for postpartum depression (PPD).

After delivery, there is a huge shift in hormones during a short time span and the introduction of a major life change. Sprinkle in some anxiety, fear, and sleepiness to the mix and it can create the perfect postpartum depression recipe. The role of postpartum nursing is to be on the lookout for signs and symptoms of PPD.

Understanding Baby Blues vs. PPD in PPD Nursing

With the lengthy list of changes in the postpartum period, becoming overwhelmed can be expected. Mom is experiencing changes in her physical, mental, and social health. 

Baby blues is known as experiencing any of the following symptoms from time immediately after delivery and up to two weeks postpartum. 

• Mood Swings 
• Pulling away from family and friends 
• Decrease in interest/enjoyment in activities that used to provide them 
• Memory issues 
• Difficulty concentrating or being decisive  
• Low energy or motivation 
• Too much sleeping or eating/ too little sleeping or eating  
• Feelings of being a bad mother 
• Crying frequently 
• Feelings of worthlessness, guilt, sadness, hopelessness, moodiness, restlessness, or being overwhelmed 
• Disconnected from the baby including losing interest or feeling like it’s someone else’s baby 

When the above list continues past the two-week mark, is when the transition from baby blues to PPD occurs. 

General aches and pains can also be associated with depression, but the cause of these should always be explored regardless of the time frame they are experienced. 

At any point in time after delivery, thoughts of hurting themselves or the baby should always be immediately acted upon, never waiting to see if the thoughts subside. 

PPD Nursing Recognizing PPD in Moms

Introduction of postpartum depression in the prenatal period can help initiate discussions and education on awareness of the topic.  

Discussions can lead to the establishment of a baseline. A baseline can gather tons of insightful information including past medical history, family history, and prenatal thoughts of the pregnancy and the unborn newborn.  

Thorough education during the hospital stay is critical to continue to build upon screenings and recognition of postpartum depression.  

All patients regardless of history, prenatal screening, or current emotional state should receive education on signs and symptoms to monitor upon discharge.  

The education provided should also be discussed with the birth partner and family members within the new mom’s close support group. Patient support members will typically recognize these symptoms and frequency more accurately and quicker than the patient will.  

The support member’s acknowledgment and encouragement for the new mom to reach out to their health care provider is crucial in obtaining efficient treatment. New moms may feel ashamed to feel this way and reaching out sometimes is difficult, so their support group is key.  

Additional postpartum depression screenings should be done at the clinic postpartum visit, which creates continued assessment and follow-up care. Further monitoring by the newborn provider at the newborn appointments can create extra checkpoints.  

Properly identifying postpartum patients when entering the ER produces additional spot-checks.  

When possible, having continuation of care throughout the prenatal, intrapartum, and postpartum periods, can build and reinforce recognition and allow for prompt treatment. 

PPD Nursing Advocate

Encouraging new moms to take care of themselves seems simple, but sometimes they feel discouraged to do so. Providing the tips below can make it seem more acceptable, when stated by a healthcare provider: 

• Sleep when the baby sleeps and rest as much as possible 
• Ask for help and do not take on everything! 
• Discuss feelings with family, friends, other moms, or support groups 
• Do not strive for perfection 
• Make alone time for yourself and/or your partner 
• Visit friends and family 
• Avoid additional major life changes in conjunction with having a baby 

Many women fear discussing postpartum depression with their healthcare provider, due to concerns around medication. Fears of medication interactions with breastfeeding or effects with increased sleepiness. Discussing that medications, which have no interactions with breastfeeding, are available for prescription and safe for momma and baby. 

Another non-clinical treatment option includes open discussion about one’s feelings. Educating new moms that postpartum depression can be treated through talk therapy can be very encouraging. 

Alternatives to not expressing symptoms of depression to a healthcare provider can be detrimental leading to self-harm, harming the newborn, long-term complications, or regret of missed bonding. 

The Bottom Line

Postpartum depression is real and deserves support. Early intervention starts with the discussion long before delivery. The responsibility of PPD nursing is to recognize the signs and symptoms of postpartum depression and encourage patients to seek the treatment that is desperately needed.

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