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The Role of Maternal & Child Health Nurses in Peri natal Depression

The Role of Maternal & Child Health Nurses in Peri natal Depression. 26/6/609 Sue Williams- Emch Nurse- Glen Eira City Council. Referral to Maternal & Child Health Service. Voluntary Service Birth notification sent to Local Govt. from hospital 72 Local Govt. areas in Victoria

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The Role of Maternal & Child Health Nurses in Peri natal Depression

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  1. The Role of Maternal & Child Health Nurses in Peri natal Depression 26/6/609 Sue Williams- Emch Nurse- Glen Eira City Council

  2. Referral to Maternal & Child Health Service • Voluntary Service • Birth notification sent to Local Govt. from hospital • 72 Local Govt. areas in Victoria • Home visit offered to all mothers. • Invited to attend M& CH centre • Transfers between centres. • Outreach programs

  3. Client exposure • 95% mothers attend M & CH service in first 12 months. • Home visit • Developmental checks- 2wk, 4wk,8wk, 4 months, 8 months, 1 year, 2 year, 3 1/2 years • Open sessions • New Parent Group

  4. Qualifications • Division one nurse • Midwife • Advanced Diploma in Family and Community Nursing- Maternal & child health • Additional post grad qualification- eg- Health education, Infant Mental Health

  5. Knowledge of Mental Health issues • Component of Initial training • Regular Professional Training • Becoming routine part of Maternal & Child Health program- Screening tool • Clinical Supervision

  6. Maternal Awareness of PND • Media • Ante-natal classes • Information pamphlets in early post partum period • Discussion at New Parent group • Regular use of EPDS in consultation • Mandatory introduction of a Screening tool

  7. Differential Diagnosis • Normal reaction • Baby ‘Blues • Adjustment Disorder • Postpartum Anxiety • Post partum Psychosis • Relapse of previous mental illness- OCD, Bipolar disorder, Anxiety Disorder, PTSD, Depression, Schizophrenia, Personality disorders.

  8. Symptoms in the Infant • Regulatory Disorder-eg. sleep & feeding issues • Gaze avoidance • Failure to thrive • Dissociation- excess sleep • Infant Depression • Bonding & attachment issues

  9. Considerations in referral Pathways • *****Safety of the baby • Consultation with the mother • Severity of symptoms • Social & extended family supports • EPDS- score • Access to services.

  10. Possible referral pathways • No referral- monitoring by M&CH nurse • Enhanced Maternal & Child Health Nurse • GP- medication, mental health plan- counseling, ATAPS, monitoring • Psychiatrist • Specialist Services- Alfred CAMHS, Perinatal & Infant Mental Health Service • Private counseling • Group Therapy • Complimentary therapies • CAT team • Child Protection- mandatory reporting • Supported Playgroups

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