normal spontaneous delivery and 1000 mL if
WEEK 11: POSTPARTUM
COMPLICATIONS
Recorded lecture by Prof. Laicherry Y. Roman
LEARNING OBJECTIVES
🦖 may occur either early (within the first 24 hours) or
• Describe common deviations from the normal that
can occur during the puerperium
• Assess a woman and her family for deviations from
the normal and during the puerperium
• Recognize expected outcomes for a postpartal
woman experiencing a complication
• Identify areas related to care of women with
postpartal complications that could benefit from
additional nursing research or application of
evidence-based practice.
POSTPARTUM COMPLICATION
Although the puerperium is usually a period of
health, complications can occur. When they do,
immediate intervention is essential to prevent long-
term disability and interference with parent–child
relationships. A woman with a postpartal
complication is at risk from three points of view:
▪ her own health
▪ her future childbearing potential
▪ her ability to bond with her new infant.
→ The family may be disrupted because of an
extended hospital stay that removes the
mother from other family members
I. POSTPARTAL HEMORRHAGE
• Is one of the most important causes of maternal
mortality associated with childbearing, poses a
possible threat throughout pregnancy and is
also a major potential danger in the immediate
postpartal period.
→ The normal blood loss during labor and
delivery is approximately 500 mL if it’s
Page 1 of 10 NCMA217 LEC (MIDTERMS)
it’s a cesarean section.
• Postpartal hemorrhage has been defined as any
blood loss from the uterus greater than 500 mL
within a 24-hour period (Pavone, Purinton, &
Petersen, 2007).
• In specific agencies, the loss may not be considered
hemorrhage until it reaches 1000 mL. Hemorrhage
late (any time after the first 24 hours during the
remaining days of the 6-week puerperium).
→ In NSD, if it’s more than 500 mL within 24-hr.
period, we may consider it as postpartum
hemorrhage. BUT in some specific agency
these blood losses may not be considered
hemorrhage until it reaches 1000 mL
→ Within 24 hrs. – early postpartal hemorrhage
→ After 24 hrs. – late postpartal hemorrhage
→ It’s very important to monitor the client’s
condition, right after 2 hrs. of delivery
because as early as that, pwede nang mag
start mag bleed ang pasyente.
→ Need to monitor their vital signs every 15
minutes, specifically the BP, pulse and
bleeding of the patient. Need to check their
pads or diaper from time to time to monitor
for this bleeding
• The greatest danger of hemorrhage is in the first 24
hours because of the grossly denuded and
unprotected uterine area left after detachment of
the placenta.
→ Kaya right after delivery, admitted pa rin sila
sa hospital after 24 hrs. para ma monitor for
early postpartal bleeding.
→ If within the community, the nurse should do
a home visit to a client who gave birth at
home, 24 hrs after delivery to assess for early
sign of postpartum hemorrhage.
→ How are we going to assess for postpartum
hemorrhage?
→ It is a must for us to assess, uterine
contraction from time to time, check if the
uterus is contracted, because if it’s not then
it may lead to bleeding. Aside on that you
Annotated by: C. Danting
 need to check for the perineal pads for it’s
saturation.
→ If 15 minutes ang pads nya ay soaked. Maybe
you need to consider or double check.
→ It’s very important to weight the perineal
pads, approximately a fully soaked sanitary
pad it’s composed of 50 cc of blood. Why?
Kasi pag ni weigh mo ang perineal pad ang
1g = 1 cc
→ Ex. 50 g = 50 cc blood loss
4 T’S

• TONE: uterine atony

• TISSUE: retained placenta
• TRAUMA: lacerations, uterine rupture
• CLOTTING: coagulopathy
• There are five main causes for postpartal
hemorrhage:
▪ uterine atony
→ inability of uterus to contract after delivery
▪ lacerations
→ possible there’s a perineal laceration or
there’s a tear that needs to be repaired
▪ retained placental fragments
→ as long as there is retained placental
fragments (inunan) continuously, mag
bbleed ang pasyente
▪ uterine inversion
→ baka bumaliktad ang uterus upon delivery,
baka hindi maganda ang pag support sa
uterus upon the delivery of the placenta
▪ disseminated intravascular coagulation.
→ Baka may problem ang client with clotting
UTERINE ATONY
• Uterine atony, or relaxation of the uterus, is the
most frequent cause of postpartal hemorrhage
(Poggi, 2007). The uterus must remain in a
contracted state after birth to keep the open
vessels at the placental site from bleeding.
→ Ideally, dapat ang uterus mag contract, mag
compress ang blood vessels thus mag
prevent ang bleeding
Page 2 of 10 NCMA217 LEC (MIDTERMS)
• If the uterus suddenly relaxes, there will be an
abrupt gush of blood vaginally from the
placental site. If the vaginal bleeding is
extremely copious, a woman will exhibit
symptoms of shock and blood loss.
→ Pag nagkaroon ng shock and blood loss,
client’s bleeding and circulation will be
affected
• This can occur immediately after birth or more
gradually, over the first postpartum hour, as the
uterus slowly becomes uncontracted.
→ How are we going to measure the amount
of blood loss of the mother and paano
masasabi na nag bleed?
→ You need to check yung vaginal bleeding,
gaano kalakas ang vaginal bleeding ano ang
estimated amount of blood loss na nakikita
sa saturated pad or diaper.
→ You need to count for the perineal pads na
nassaturated per hour. We advise the
mother to change pads every four hours but
it depends especially for the first 24 hours
nan aka diaper, for how long ba sya na
ssaturated
• It is difficult to estimate the amount of blood a
postpartal woman has lost, because it is difficult
to estimate the amount of blood it takes to
saturate a perineal pad. The amount is between
25 and 50 mL.
Annotated by: C. Danting
• By counting the number of perineal pads
saturated in given lengths of time such as half-
hour intervals, you can form a rough estimate of
blood loss. Five pads saturated in half an hour is
obviously a different situation from five pads
saturated in 8 hours.
• Weighing perineal pads before and after use and
then subtracting the difference is an accurate
way to measure vaginal discharge: 1 g of weight
is comparable to 1 mL of blood volume.
→ It’s very important to weigh the perineal
pads or diaper of the patient before you
throw it away. We need to measure it first
since it’s part of the client’s output.
• Palpate a woman’s fundus at frequent intervals
postpartally to be certain that her uterus is
remaining in a state of contraction. This is the
best measure for preventing early hemorrhage.
→ Masasabing contracted pag matigas, parang
may ulo ng bata, kapag nag palpate at
parang walang bilog doon baka nag rerelax
uterus, you need to check it from time to time
• Factors that predispose to poor uterine tone or
any inability to maintain a contracted state are:
▪ Deep anesthesia or analgesia
▪ Labor initiated or assisted with an oxytocin
agent
→ Oxytocin promotes uterine contraction
especially if it’s given in early part of the
labor. Pwedeng mapagod ang uterus, pag sa
latent phase pa lang nag bigay, continuous
lang ang contraction. But when the uterus is
already time for contraction during
postpartum, pagod na ito thus nag relax na
siya.
▪ Maternal age greater than 35 years
→ Ideal for pregnancy and delivery is 18 to 35
▪ High parity
→ Uterus is like a garter naiistretch sya during
pregnancy and after delivery and babalik sya
sa pregnancy state. Kung maraming beses
na syang na stretch and bumalik, most
probably nagkakaroon na ng problem ang
Page 3 of 10 NCMA217 LEC (MIDTERMS)
muscle for contraction. Mostly G5,6,7 they’re
at risk of uterine atony.
▪ Previous uterine surgery
→ Ex. Myomectomy or previous C.S section,
magkakaroon ng scar = magkakaroon ng
problem sa certain part ng uterus na mag
contract, it can predispose to poor uterine
contractility
▪ Prolonged and difficult labor
→ During labor the uterus is contracting, if it’s
prolonged and difficult mas mahaba pa sya
sa usual time, mostly mapapagod na ang
uterus mo mag contract.
▪ Possible chorioamnionitis Secondary
maternal illness (e.g., anemia)
→ Kapag may anemia, kaunti ang blood flow
and oxygen level na ddeliver sa blood vessels,
nagkaka problem ang muscle na mag
contract
▪ Prior history of postpartum hemorrhage
→ If on your previous delivery, you have
postpartum hemorrhage or uterine atony,
most probably next deliveries will be the
same.
▪ Endometritis
→ Baka may infection doon sa
endometrium/uterus kaya nag kaka problem
with uterine contraction
▪ Prolonged use of magnesium sulfate or
other tocolytic therapy
→ Tocolytic agent – used to relax the uterus
especially during pregnancy kapag
threatened for abortion or nag ppremature
uterine contraction, hindi pwede mag
contract especially pag preterm lalo na ung
nag ttake ng isoxsuprine, pinaparelax ang
uterus, pineprevent mag contract, para hindi
mag lead into preterm labor.
→ If prolonged ang use, nasanay na ang uterus
na mag relax, thus pag time nya na mag
contract medyo nahihirapan na.
→ You need to assess for the bladder – baka full
bladder and walang room for the uterus to
Annotated by: C. Danting
 contract. After delivery catheterize ang
patient. Pinapaihi after delivery.
→ Ibang patient na nag bleed after delivery,
pag dinala sa room naka catheter pa sila to
continuously empty the bladder para
continuous contracted ang uterus.
THEREAPEUTIC MANAGEMENT FOR UTERINE ATONY
1. BIMANUAL MASSAGE
• If fundal massage and administration of
oxytocin or methylergonovine are not effective
in stopping uterine bleeding, a sonogram may
be done to detect possible retained placental
fragments. The woman’s physician or nurse-
midwife may attempt bimanual compression.
With this procedure, the physician or nurse-
midwife inserts one hand into a woman’s vagina
while pushing against the fundus through the
abdominal wall with the other hand.
→ Kapag nagkakaroon ng profuse bleeding ang
patient, we need to check the bleeding and
promote uterine contraction like fundal
massage, administer medication like
oxytocin or methergine. Sometimes applying
cold compress above the uterus. Kapag hindi
pa rin naging effective sometimes ang
ginagawa, chinecheck baka may natirang
placental fragments, ultrasound to assess.
Kapag wala naman, ginagawa ang bimanual
massage/compression
→ Fist tinutulak ang uterus and ang isang hand
nasa ibabaw ng abdomen (fundus)
→ It’s pushed against the fundus and the
abdominal wall to compress the blood vessel
and thus it will promote uterine contraction
Page 4 of 10 NCMA217 LEC (MIDTERMS)
2. PROSTAGLANDIN ADMINISTRATION
• Prostaglandins promote strong, sustained
uterine contractions. Intramuscular injection of
prostaglandin F22 is another way to initiate
uterine contractions.
• Carboprost tromethamine (Hemabate), a
prostaglandin F2a derivative, or
methylergonovine maleate (Methergine), an
ergot compound, given intramuscularly, are
second possibilities. Rectal misoprostol, a
prostaglandin E1 analogue, may be
administered rectally. Hemabate may be
repeated every 15 to 90 minutes up to 8 doses;
methylergonovine may be repeated every 2 to 4
hours up to 5 doses.
→ Carboprost – bawal sa px na merong asthma
or DOB and cardiovascular diseases. We
need to assess for the respiration and pulse
of our client. It also promotes uterine
contraction. Kadalasan nag ppoop sila.
→ Methergine – need to check px vital signs
especially the BP. It’s contraindicated to px
that’s hypertensive.
→ Kapag hindi pa rin effective nag bibigay ng
Rectal misoprostol to promote uterine
contraction
• The usual dosage of oxytocin is 10 to 40 U per
1000 mL of a Ringer’s lactate solution. When
oxytocin is given intravenously, its action is
immediate
→ Hinahalo siya mostly with D5LR, minimix sya
sa IV fluid na yon and ina administer natin
with our client
→ We need to thoroughly assess the client from
time to time.
3. BLOOD REPLACEMENT
• Blood transfusion to replace blood loss with
postpartal hemorrhage may be necessary. Make
certain that blood typing and cross-matching
were done when the woman was admitted and
that blood is available.
→ Pag bumaba ang hemoglobin and
hematocrit ng px because of severe blood
Annotated by: C. Danting
 loss, doctor order blood replacement to
replace blood loss
• Women who experience postpartal hemorrhage
tend to have a longer than average recovery
period, because the physiologic exhaustion of
body systems can interfere with their recovery.
Iron therapy may be prescribed to ensure good
hemoglobin formation. Activity level,
exertion,and postpartal exercise may be
restricted somewhat.
→ For iron therapy of the patient, inform that
their stool is going to be black tarry, mas
effective ang iron pag tinetake with VIT. C.
postpartal exercises may be restricted or
limited.
→ Bakit nililimit ang activity level or exertion
because mababa ang hemoglobin and
hematocrit, ang oxygen delivery system
magkaka problem due to severe blood loss.
• Monitor her temperature closely in the
postpartal period, to detect the earliest signs of
developing infection.
4. HYSYERECTOMY OR SUTURING
• Usually, therapeutic management is effective in
halting bleeding. In the rare instance of extreme
uterine atony, sutures or balloon compression
may be used to halt bleeding (Nelson & O’Brien,
2007).
→ Also called as “Balloon Tamponade”
→ Yung catheter usually may balloon, it’s filled
with a sterile water and ni clamp sa dulo para
di lumabas ang water.
→ Balloon will be compressed inside the uterus;
it’s compressing the blood vessel to prevent
bleeding. If it’s still not effective the last
resort is ligation or hysterectomy
→ It might lead to death pag hindi na stop ang
bleeding
• Embolization of pelvic and uterine vessels by
angiographic techniques may be successful. As a
last resort, ligation of the uterine arteries or a
hysterectomy may be necessary.
• Open lines of communication between the
couple and health care providers that allow a
Page 5 of 10 NCMA217 LEC (MIDTERMS)
family to vent its feelings are most helpful to a
couple in this crisis.
LACERATIONS
• Small lacerations or tears of the birth canal are
common and may be considered a normal
consequence of childbearing. Large lacerations,
however, can cause complications.
• They occur most often:
▪ With difficult or precipitate births
→ Pag mabilis masyado ang pag labor, it may
lead to laceration
▪ In primigravidas
→ Because of the passageway of the fetus, it’s
quite narrow
▪ With the birth of a large infant (9 lb)
→ Sa mga diabetic mothers; macrosomic baby,
it may lead to cervical or vaginal laceration
▪ With the use of a lithotomy position and
instruments
1. CERVICAL LACERATIONS
• Lacerations of the cervix are usually found on
the sides of the cervix, near the branches of the
uterine artery. If the artery is torn, the blood loss
may be so great that blood gushes from the
vaginal opening. Because this is arterial
bleeding, it is brighter red than the venous blood
lost with uterine atony.
Annotated by: C. Danting
 → Upon assessment na check mo na lower and
upper uterime segment ay contracted
naman. Kapag nag internal examination,
makikita laceration ang cervix, usually sa
anterior or posterior, it needs to be repaired
or else bleeding will continue
• An indwelling urinary catheter (Foley catheter)
THERAPEUTIC MANAGEMENT
• Repair of a cervical laceration is difficult,
because the bleeding can be so intense that it
obstructs visualization of the area. Be certain
• Lacerations of the perineum usually occur when
that a physician or nurse-midwife has adequate
space to work, adequate sponges and suture
supplies, and a good light source.
• If the cervical laceration appears to be extensive
or difficult to repair, it may be necessary for the
woman to be given a regional anesthetic to relax
the uterine muscle and to prevent pain
vaginal pack or packing. Nag iinsert ng gauze
sa loob ng vagina para mag bigay ng
pressure sa suture line and to prevent further
bleeding. Need naka note na ang certain
client na yon ay may vaginal pack para
matanggal in 24 hrs. and para ma assess.
→ Kahit naka vaginal pack, need pa rin I check
ang uterine contraction dahil baka nag
bbleed naman siya sa loob.
→ Vaginal pack dapat matanggal bago umuwi
→ Do not forget to document and endorse to
other nurses.
may be placed at the same time, because the
packing causes pressure on the urethra and can
interfere with voiding.
3. PERINEAL LACERATIONS
a woman is placed in a lithotomy position for
birth, because this position increases tension on
the perineum
→ We have 4 degrees of laceration – 1st, 2nd,
3rd and 4th degree laceration

2. VAGINAL LACERATIONS
• Although they are rare, lacerations can also
occur in the vagina. They are easier to assess
than cervical lacerations, because they are
easier to view.
THERAPEUTIC MANAGEMENT

• Because vaginal tissue is friable, vaginal

lacerations are also hard to repair. Some oozing
often occurs after a repair, so the vagina may be
packed to maintain pressure on the suture line.
If packing is inserted, document in a woman’s
nursing care plan when and where it was placed,
so you can be certain it will be removed after 24
→ 1st degree tear – affects the perineal skin
to 48 hours or before discharge.
→ 2nd degree tear – affects the perineal skin and
→ Repaired by suturing perineal muscles
→ Kapag may vaginal laceration ang patient,
→ 3rd degree tear – affects the perineal skin,
pagkatapos I repair, nilalagyan siya ng
perineal muscles and external anal sphincter
Page 6 of 10 NCMA217 LEC (MIDTERMS) Annotated by: C. Danting
 → 4th degree tear – affects the perineal skin,
perineal muscles, external and internal anal
THERAPEUTIC MANAGEMENT
• Perineal lacerations are sutured and treated as
an episiotomy repair. Make certain that the
degree of the laceration is documented, because
women with fourth degree lacerations need
extra precautions to avoid having repair sutures
loosened or infected.
• A diet high in fluid and a stool softener may be
prescribed for the first week after birth to
prevent constipation and hard stools, which
could break the sutures.
• Any woman who has a third- or fourth-degree
laceration should not have an enema or a rectal
suppository prescribed or have her temperature
taken rectally, because the hard tips of
equipment could open sutures near to or
including those of the rectal sphincter
RETAINED PLACENTAL FRAGMENTS
• Occasionally, a placenta does not deliver in its
entirety; fragments of it separate and are left
behind. Because the portion retained keeps the
uterus from contracting fully, uterine bleeding
occurs. To detect the complication of retained
placenta, every placenta should be inspected
carefully after birth to see that it is complete.
→ Wala bang kulang sa placenta? Kumpleto ba
ang cotyledon
• Retained placental fragments may also be
detected by ultrasound. A blood serum sample
that contains human chorionic gonadotropin
hormone (hCG) also reveals that part of a
placenta is still present.
→ Assess by ultrasound
→ Manually removed by the doctor
→ Checking of blood serum level (+) = placental
fragments are present
Page 7 of 10 NCMA217 LEC (MIDTERMS)
THERAPEUTIC MANAGEMENT
• Removal of the retained placental fragment is
necessary to stop the bleeding. Usually, a
dilatation and curettage (D&C) is performed to
remove the placental fragment.
→ Dilatation and curettage or “raspa”
• Methotrexate may be prescribed to destroy the
retained placental tissue
II. UTERINE INVERSION
• Uterine inversion is prolapsed of the fundus of
the uterus through the cervix so that the uterus
turns inside out. This usually occurs immediately
after birth.
→ It usually happens when hindi sinusupport
yung placenta upon delivery. That’s why it’s
very important to perform Brandt Andrews
maneuver. We need to support the placenta
while delivering or else pag binigla, pag hila
ng placenta pwedeng sumama yung fundus
at babaliktad ang uterus
III. DISSEMINATED INTRAVASCULAR COAGULATION
• Disseminated intravascular coagulation (DIC) is a
deficiency in clotting ability caused by vascular
injury. It may occur in any woman in the
postpartal period, but it is usually associated
with premature separation of the placenta, a
missed early miscarriage, or fetal death in utero.
III. UTERINE SUBINVOLUTION
• Subinvolution is incomplete return of the uterus
to its prepregnant size and shape. With
subinvolution, at a 4- or 6week postpartal visit,
the uterus is still enlarged and soft. Lochial
discharge usually is still present.
• Subinvolution may result from a small retained
placental fragment, a mild endometritis
(infection of the endometrium), or an
accompanying problem such as a uterine
myoma that is interfering with complete
contraction.
Annotated by: C. Danting
 THERAPEUTIC MANAGEMENT
• Oral administration of methylergonovine, 0.2
mg four times daily, usually is prescribed to
improve uterine tone and complete involution.
If the uterus is tender to palpation, suggesting
endometritis, an oral antibiotic also will be
prescribed.
V. MASTITIS
• Mastitis (infection of the breast) may occur as
early as the seventh postpartal day or not until
the baby is weeks or months old (Reddy et al.,
2007).
• The organism causing the infection usually
enters through cracked and fissured nipples.
→ That’s why it’s very important to clean the
baby’s mouth especially sa nag bbreast feed
na mother
→ Time to time need I clean ang mouth ni baby
by towel with sterile water para matanggal
ang microorganisms since the mouth can be
an area for multiplication of microorganism,
pwede itong pumasok sa fissured nipples
during breast feeding
→ Need rin linisin ang nipples with cloth and
warm water
• Therapeutic Management:
▪ Treatment consists of antibiotics
▪ Breastfeeding is continued, because keeping
the breast emptied of milk helps to
preventgrowth of bacteria.
→ Need I empty ang milk sa infected na breast
to prevent growth of bacteria
Page 8 of 10 NCMA217 LEC (MIDTERMS)
VI. EMOTIONAL AND PSYCHOLOGICAL
COMPLICATIONS
• Breastfeeding A Woman Whose Child Is Born
with an Illness or Is Physically Challenged
• Most women say during pregnancy they do not
care about the sex of their child so long as the
child is born healthy. This can make them feel
cheated when this one requirement is not met.
They can feel angry, hurt, and disappointed.
They may feel a loss of self-esteem: they have
given birth to an imperfect child, and so they see
themselves as imperfect.
POSTPARTUM DEPRESSION
POSTPARTUM DEPRESSION
Postpartum depression (PPD) is a mood disorder that
affects some women after childbirth. Mothers with PPD
can experience feelings of extreme sadness and anxiety,
which can make it difficult to complete daily activities
and could have significant consequences for both the
mother and family
SYMPTOMS
▪ Severe mood swings
▪ Intense irritability and anger
▪ Feelings of shame, guilt or inadequacy
▪ Withdrawal from family and friends
▪ Difficulty bonding with the baby
▪ Overwhelming fatigue
▪ Insomnia
▪ Loss of appetite
▪ Loss of interest in sex
THE BABY BLUES
The “Baby Blues” is a lot more common than PPD, and
the symptoms of this condition usually happen in the first
Annotated by: C. Danting
 few days following childbirth, and are a lot less serious
than PPD and normally don’t need treatment
SYMPTOMS
▪ Sadness
▪ Changes in sleeping and eating patterns
▪ Reduced libido
▪ Crying episodes
▪ Impatience
▪ Restlessness
▪ Irritability
▪ Anxiety
POSTPARTAL DEPRESSION
• Almost every woman notices some immediate (1
to 10 days postpartum) feelings of sadness
(postpartal “blues”) after childbirth. This
probably occurs as a response to the
anticlimactic feeling after birth and also
probably is related to hormonal shifts as the
levels of estrogen, progesterone, and
gonadotropin-releasing hormone in her body
decline or rise (Baker, 2008).
→ During postpartum as much as possible
bumabalik ang body natin into prepregnancy
state. That’s why mabilis din ang shifting ng
ating hormones especially during pregnancy
nagkaroon ng shifting ng estrogen,
progesterone and gonadotropin-releasing
hormone binabalik during prepregnancy
state, it affects the mood of the postpartum
mother
• The sensations of overwhelming sadness can
interfere with breastfeeding, child care, and
Page 9 of 10 NCMA217 LEC (MIDTERMS)
returning to work. In addition to an overall
feeling of sadness, a woman may notice extreme
fatigue, an inability to stop crying, increased
anxiety about her own or her infant’s health,
insecurity (unwillingness to be left alone or
inability to make decisions), psychosomatic
symptoms (nausea and vomiting, diarrhea), and
either depressive or manic mood fluctuations.
→ Fatigue – si mother ang nag aalaga doon sa
kanyang baby, pwede napupuyat sa
madaling araw
• Depression of this kind is termed postpartal
depression and reflects a more serious problem
than normal “baby blues”
• Risk factors for postpartal depression include a
▪ history of depression
▪ a troubled childhood,
▪ low self-esteem,
▪ stress in the home or at work,
▪ lack of effective support people.
→ Pag severe and prolonged, tinatawag na
siyang postpartal depression
• A woman may need counseling and possibly
antidepressant therapy to integrate the
experience of childbirth into her life
POSTPARTUM PSYCHOSIS
• A woman with postpartal psychosis usually
appears exceptionally sad. By definition,
psychosis exists when a person has lost contact
with reality. A psychosis is a severe mental
illness that requires referral to a professional
psychiatric counselor and antipsychotic
medication.
→ Parang nawawala sa sarili, kung ano ano
ang sinabi, maybe you need to refer to a
professional psychiatric counselor
• A woman with a postpartal psychosis may deny
that she has had a child and, when the child is
brought to her, insist that she was never
pregnant.
→ Yung iba sinasaktan ang baby kapag nakaka
experience ng postpartal psychosis. It’s very
important to ensure the safety of the baby as
Annotated by: C. Danting
 well as the mother during this period, and
macheck agad siya ng professional
psychiatric counsellor and mabigyan ng
appropriate medication
• A psychosis is a severe mental illness that
requires referral to a professional psychiatric
counselor and antipsychotic medication.
• While waiting for such a skilled professional to
arrive, do not leave the woman alone, because
her distorted perception might lead her to harm
herself. Nor should you leave her alone with her
infant.
→ Kasi hindi natin alam kung ano ang pwede
nyang gawin, pwede siya mag form ng threat
sa sarili nya or to the newborn as well with
the family because of her distorted
perception.
→ We need a thorough assessment for as to
determine if the mother is experience a
postpartum psychosis, kung sobrang sad, di
na nagbibigay ng eye contact, kung anoa no
na sinasabi nya, baka kailangan na I assess
and refer medical professionals.

Page 10 of 10 NCMA217 LEC (MIDTERMS) Annotated by: C. Danting