Impact of Pregnancy on the Patient

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Pregnancy can be one of the most exciting times in a woman's life or one of the worst. Even a woman who experiences joy from becoming pregnant may suffer anxiety during her pregnancy. ''Will the baby be normal?'' ''How will I tolerate labor?'' ''How will the baby change my life?'' ''I've put on so much weight. Will I ever be able to take it off?'' These are just a few of the many questions commonly asked by pregnant women, and these issues cause much of their anxiety. Anxiety over body image is common as pregnancy progresses.

Pregnancy may worsen an existing psychiatric illness, and pregnancy and the postpartum period can be stressful enough to induce a psychiatric illness. It has been estimated that one per five pregnant women experiences some sort of mental health problem during pregnancy. In addition, a severe psychotic episode occurs in 1 to 2 women per 1000 live births.

Depression is common during pregnancy;almost 15% of all pregnant women suffer some degree of depression during pregnancy, and 8% suffer depression during the postpartum

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period. Postpartum depression, or the postpartum blues, may be related to the diminishing of excitement after delivery, the loss of sleep during labor, anxiety about the ability to care for the child, perineal pain, feeding difficulties, and concern about appearance. Fortunately, postpar-tum depression is usually self-limited and remits within a week. Women at greatest risk for the development of postpartum depression are those with an unwanted pregnancy and those with marital difficulties. Sympathetic reassurance and support can help a woman return to her baseline state.

In previously psychotic patients, depression or schizophrenia is likely to occur during the postpartum period. Confusion, paranoid delusions, and disorientation may result. An important symptom is an aversion to the infant. Because child abuse by this group of patients is common, their symptoms must be identified quickly.

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Getting to Know Anxiety

Getting to Know Anxiety

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