PSYCHOTHERAPY IN OBSTETRICS

Pregnancy is often regarded with excitement, but no matter how eagerly a child's birth is anticipated, stress
and other forms of emotional distress are still likely to occur during the challenging period of pregnancy.
Pregnancy issues may be mild or serious, but they can affect the health of the mother or child, put strain on a
romantic partnership, and lead to life changes, both predicted and unpredictable. When concerns that arise
during pregnancy or after birth cause distress or otherwise affect one's mental health, the support of a
therapist or other mental health professional may be helpful.

Challenges associated with pregnancy and birth

Though pregnancy can be challenging for both parents, in many cases the pregnant woman
experiences the greatest amount of strain. A single mother may experience even higher levels of emotional
distress, as single mothers may often lack help and support. These worries may be mild or severe, but the
stress they can cause may lead some women to experience increased physical or mental strain, depression or
poor physical health, all of which may lead to increased risk in childbirth.

Pregnancy can put strain on a partnership, especially when

• A pregnancy was unplanned and partners have different goals

• One partner desires children and the other does not

• Both partners wish to have a child, being unprepared for the child's arrival

Financially or in other ways may still be a cause for concern

• A couple has unaddressed or unsolved relationship issues, their partnership

May be further tested by the varied challenges of childrearing

• One or both partners is ambivalent to the idea of parenthood having a baby

May have a negative impact on the relationship,

• Other strains or stressors are present.

The physical challenges that often accompany pregnancy can also be difficult for many women to cope with.
Morning sickness aches and pains, fatigue, insomnia, and indigestion are just a few of the concerns that a
pregnant woman may face. Women who contract illnesses while pregnant can be more severely affected by
symptoms and may have a greater risk of complications, the most severe of which are birth defects or fetal
death. In order to prevent certain birth defects and food borne illnesses, a physician will typically
recommend certain dietary restrictions to women who are pregnant, such as the avoidance of alcohol and
raw or unpasteurized foods. Beyond these restrictions, some women may find it difficult to eat a variety of
foods, due to morning sickness or other pregnancy-related stomach concerns.

Pregnancy and mental health concerns

While pregnancy often elicits many positive emotions, it can also cause a woman to experience negative
thoughts and feelings. During pregnancy, past family issues, insecurities, relationship difficulties, and
financial issues can become real and immediate concerns. A woman who is expecting may find herself
experiencing mood swings, fear, anxiety, forgetfulness, or body image issues. Women who experienced
depression or anxiety before becoming pregnant may be more likely to experience mental health concerns
during pregnancy. When mental health conditions occur during pregnancy or postpartum, a woman's doctor
will generally be able to provide referrals to mental health professionals as well as immediate health care
and support.

Because some psychotropic medications can have harmful effects on developing fetuses, women who
are taking these medications and discover they are pregnant or intend to become pregnant are advised to
contact their doctor and mental health care provider. In some cases, another medication is prescribed, and in
others, a woman may receive an alternative form of treatment for the duration of the pregnancy, such as
therapy only.

Societal expectations of pregnant women and new mothers may lead many women to experience
anxiety or stress. Well-meaning individuals—family, friends, or even strangers—may criticize the practices,
diet, and weight gain (or lack thereof) of pregnant women and May often offer unsolicited opinions or
advice. Some women may experience irritation, anger, or frustration as a result, but others may come to
doubt their own ability to be good mothers. Soon-to-be parents may turn to parenting books or other sources
of advice and become overwhelmed by conflicting opinions on the best or safest options for delivery.

Symptoms of mental health concerns are the most common complication of childbirth. According to
research:

• Between 15 and 20% of women experience clinically significant anxiety or depression after childbirth.

• Two thirds of mothers diagnosed with severe postpartum depression began experiencing changes in mood
during pregnancy.

• Sixty percent of mothers with moderate postpartum depression had pregnancy complications such as
gestational diabetes.

• Stress experienced during pregnancy, especially posttraumatic stress disorder has been linked to premature
birth, low birth weight, and risky behaviour (such as drinking or smoking) during pregnancy.

• Many women experience “baby blues” or a period of low mood and tearfulness, for a week or two
following childbirth. These feelings generally resolve with the support of one's partner or family. When they
do not resolve or include hopelessness, negative thoughts about oneself or one's baby, or a loss of appetite, a
more serious condition may be indicated.

• Postpartum psychosis is rare but serious: The condition is characterized by delusions, rapid mood swings,
and paranoia and carries a 5% rate of suicide and a 4% rate of infanticide. Symptoms generally appear
suddenly, within two weeks after giving birth.

Impact of birth on emotional health

1. Emotionally and physically fatigued

2. Lowered immune system

3. Increased irritability

4. And stress

5. Difficult to cope with pain and fatigue

Therapy for pregnancy and birthing concerns

Psychotherapy refers to a range of treatments that can help with mental health problems, emotional
challenges, and some psychiatric disorders. Psychotherapy is a collaborative treatment based on the
relationship between an individual and a psychologist. Grounded in dialogue, it provides a supportive
environment that allows you to talk openly with someone who’s objective neutral and nonjudgmental. In
psychotherapy, psychologists apply scientifically validated procedures to help people develop healthier,
more effective habits. There are several approaches to psychotherapy —including cognitive- behavioural,
interpersonal and other kinds of talk therapy — that help individuals work through their problems.

Psychotherapy -- also called talk therapy, therapy, or counselling -- is a process focused on helping you heal
and learn more constructive ways to deal with the problems or issues within life.

Signs that need therapy it include

1. A person’s problems don't seem to get better despite your efforts and help from family and friends.

2. A person finds it difficult to concentrate on work assignments or to carry out other everyday activities.

3. A person worries excessively, expect the worst or are constantly on edge.

4. A person’s actions, such as drinking too much alcohol, using drugs or being aggressive, are harming you
or others

Types of psychotherapy

• Behaviour therapy

• Cognitive therapy

• Dialectical behaviour therapy

• Interpersonal therapy

• Psychodynamic therapy

• Cognitive-behavioural therapy

• Family therapy

• Group therapy

• Supportive

• Deep

• Directive

• Non directive

Approaches to psychotherapy

• Individual therapy

• Group therapy

• Marital/couple therapy
• Family therapy

• Long term

• Short term

• Therapy for children and adolescents

APPLICATION OF THE PSYCHOTHERAPY IN CLINICAL SETUP

INTRODUCTION

Pregnancy is often regarded with excitement, but no matter how eagerly a child’s birth is
anticipated.
When concerns that arise during pregnancy or after birth cause distress or otherwise affect one’s mental
health, the support of a therapist or other mental health professional may be helpful.

PATIENT PROFILE

NAME Mrs. GOWRI

AGE 27 years

SEX female

AREA guindy

OCCUPATION home maker

INFORMANT mother

HISTORY OF PRESENT ILLNESS

MRS.GOWRI, 27 years old got admitted in emergency obstetrical and gynaecological

care, saidapet as she is pregnant. Her previous 2 delivereries are LSCS. She is having fear of LSCS again.
So she was depressed and also her husband and mother in law wants male child as her first 2 babies is girl.
So she was depressed.

SIGNS AND SYMPTOMS IDENTIFIED

 Sleeplessness
 Irritation
 Poor self-care
 Depression
 FAMILY THERAPY

INTRODUCTION
Psychotherapy (psychological therapy or talking therapy) is the use of psychological methods, particularly when
based on regular personal interaction with adults, to help person change behaviour and overcome problems in
desired ways. Psychotherapy aims to improve an individual's well-being and mental health, to resolve or mitigate
troublesome behaviours, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social
skills. 
Family therapy, also referred to as couple and family therapy, marriage and family therapy, family
systems therapy, and family counselling, is a branch of psychotherapy that works with families and couples
in intimate relationships to nurture change and development. It tends to view change in terms of the systems of
interaction between family members.

Techniques

Family therapy uses a range of counselling and other techniques including:

Structural therapy - identifies and re-orders the organisation of the family system

Strategic therapy - looks at patterns of interactions between family members

Systemic/Milan therapy - focuses on belief systems

Narrative therapy - restoring of dominant problem-saturated narrative, emphasis on context, separation of

the problem from the person

Transgenerational therapy - transgenerational transmission of unhelpful patterns of belief and behaviour

IP scope model and Interceptive Interviewing

Communication theory

Psycho education

Psychotherapy

Relationship counselling

Relationship education

Systemic coaching

Systems theory

Reality therapy

The genogram

CONCLUSION
So far, i understand how psychotherapy helps in the management of DEPRESSION with the help of
FAMILY THERAPY
REFERENCE
R.SREEVANI, “A GUIDE TO MENTAL HEALTH AND PSYCHIATRIC NURSING” 4th EDITION,
JAYPEE PUBLICATIONS LTD.,