Perinatal Mental Health: Preventing Postpartum Psychiatric Illness through Debriefing

Abstract

Problem: Postpartum women often experience psychiatric illnesses, including postpartum blues, depression, psychosis, or anxiety, that frequently go undetected and untreated following the birth of their child. Postpartum illness can result in maternal and infant morbidity and mortality and poor health outcomes. A few structures are in place to assess, evaluate, and debrief postpartum women about their experience on the units, and to provide support services. Purpose: The project aims to implement clinician therapeutic debriefing and counseling post-delivery to trigger early interventions. Early interventions include referrals to social work, the postpartum depression specialist, mental health providers, and follow-up appointments with their OB/GYN. A nurse-led debriefing occurs after the newborn's birth and before discharge by the clinician when completing a postpartum depression screening. Methods: A root cause analysis was conducted with nursing to determine appropriate healthcare clinicians to lead the debriefing and the education necessary for the staff. In the Trauma-Informed Care approach (TIC), gaps in knowledge were identified through staff surveys. An informative recorded presentation was provided to the unit staff on the TIC approach. Results: Of 39 patients who screened positive for anxiety, 13% were provided the intervention by the nurse navigator over the fifteen weeks. Conclusions: The results conclude that clinician therapeutic debriefing improved communication regarding the patient’s history, including trauma and anxiety, and supports nurses to provide appropriate care. The nurses are able to internally communicate the patient’s needs and the patients expressed appreciation for the validation of their thoughts and feelings.