Women diagnosed with postnatal psychosis experience auditory or visual hallucinations, delusions, rapid mood swings, perplexed thinking and their risk of suicide increases substantially. However, one of the most insidious consequences of postnatal psychosis is the disruption to the mother-child bonding process that can lead to lifelong psychological problems for both the mother and the child.
One in two of every 1,000 women who give birth are affected by postnatal psychosis. Based on the annual number of births in Australia, that works out at approximately 600 Australian women each year.
Although the condition has been described in medical literature since the time of Hippocrates, health outcomes for women diagnosed with postnatal psychosis are compromised because of a lack of awareness about the condition. A recent systematic review shows that women are reluctant to disclose any symptoms of psychosis following birth because they are afraid that they will be seen as failures and that the State will take their babies from them. This is not an unrealistic fear.
They were not supported until the symptoms became so severe that they were scheduled into public mental health facilities and separated from their babies.
The women we interviewed for our research described how they knew they were experiencing symptoms of postnatal psychosis. However, when they sought help from healthcare professionals they were turned away. They were not supported until the symptoms became so severe that they were scheduled into public mental health facilities and separated from their babies. Often the women are cared for by staff that do not have adequate knowledge of the condition and do not understand the implications of separating a mother from her child so soon after birth.
Postnatal psychosis is an easily treatable condition that responds well to antipsychotic medication. If the condition is recognised early, admission to public mental health facilities can be prevented and the women do not need to be separated from their babies. However, the situation is made difficult because there is no national policy guiding the treatment and care of postnatal psychosis. Best practice is when a woman is treated in a Mother Baby Unit where specialist nurses trained in both mental health and maternal and infant care support the mother to care for her baby while she recovers. But while there are publically funded mother-baby beds in Victoria, South Australia, Western Australia and Queensland, there are no publicly funded mother-baby beds in NSW, the ACT or the NT.
Raising awareness about postnatal psychosis is a very important issue for the health of new mums, their babies and their families. To properly care for women who are experiencing psychosis after childbirth, we need to make sure that healthcare professionals can recognise this condition early so that treatment can begin before the situation reaches crisis point.
We also need greater public awareness and understanding so that any new mother who believes that she is experiencing the symptoms of psychosis can seek help in the knowledge that she will be treated with the dignity and respect she deserves.
Dr Diana Jefferies (RN, PhD Member of ACMHN) is a lecturer in the School of Nursing and Midwifery at Western Sydney University.