Peripartum cardiomyopathy is often associated with severe heart failure occurring towards the end of pregnancy or in the months following birth with debilitating, exhausting and frightening symptoms requiring person-centered care. The aim of this study was to explore women's experiences of health care while being diagnosed with peripartum cardiomyopathy.
Qualitative interviews were conducted with 19 women with peripartum cardiomyopathy in Sweden, following consent. Data were analysed using qualitative content analysis. Confirmability was ensured by peer-debriefing, and an audit trail was kept to establish the credibility of the study.
The main theme in the experience of health care was, 'Exacerbated Suffering', expressed in three subthemes; 'not being cared about', 'not being cared for' and 'not feeling secure.' The suffering was present in relation to the illness with failing health symptoms, but most of all in relation to not being taken seriously and adequately cared for by healthcare professionals. Women felt they were on an assembly line in midwives' routine work where knowledge about peripartum cardiomyopathy was lacking and they showed distrust and dissatisfaction with care related to negligence and indifference experienced from healthcare professionals. Feelings of being alone and lost were prominent and related to a sense of insecurity, distress and uneasiness.
This study shows a knowledge gap of peripartum cardiomyopathy in maternity care personnel. This is alarming as the deprecation of symptoms and missed diagnosis of peripartum cardiomyopathy can lead to life-threatening consequences. To prompt timely diagnosis and avoid unnecessary suffering it is important to listen seriously to, and respect, women's narratives and act on expressions of symptoms of peripartum cardiomyopathy, even those overlapping normal pregnancy symptoms.
Do associations between maternal anxiety symptoms and offspring mental health remain after comparing differentially exposed siblings? Participants were 17,724 offspring siblings and 11,553 mothers from the Norwegian Mother and Child Cohort study. Mothers reported anxiety and depressive symptoms at 30 weeks' gestation, and 0.5, 1.5, 3, and 5 years postpartum. Child internalizing and externalizing problems were assessed at ages 1.5, 3, and 5, and modeled using multilevel analyses with repeated measures nested within siblings, nested within mothers. Maternal pre- and postnatal anxiety were no longer associated with child internalizing or externalizing problems after adjusting for maternal depression and familial confounding. Maternal anxiety when the children were in preschool age, however, remained significantly associated with child internalizing but not externalizing problems.
With regard to experiences described in the literature, and the particular psychotherapeutic and paedagogic effects on mother and child in the inpatient treatment setup presented in this paper, we give an account of the preliminary deliberations and preconditions arising from this particular setup. Prognostically unfavourable aspects of joint admission and treatment are also presented. Finally, previous experiences are discussed, and suggestions for improvement of care for mentally ill mothers and their infants or toddlers are made, taking into consideration the facilities existing in England and Denmark.
Psychiatric morbidity in the Arctic has not been extensively studied. Seasonal variations in climate, light and darkness are unique for these areas and impose special kinds of strains on the population. Three case-histories focusing on snow-wandering as a parasuicidal act are presented. One of them bears some resemblance to the Arctic hysteria described among Eskimoes. Reasons for choosing snow-wandering as an alternative to other kinds of suicide are discussed and a hypothesis is suggested. The psychological and physiological factors as explanations for post snow-wandering amnesia are discussed.
Confusion persists regarding relative psychological risks associated with term deliveries and induced abortions. One reason for the scarcity of comparative findings is the lack of epidemiological data on post-abortion and post-partum admissions to psychiatric hospital. While such admissions are not separately tracked in United States health statistics, they are measurable events, reflective of severe psychological stress associated in time with delivery and abortion, and probably less subject to diverse interpretation than are individual consultations with clinical practitioners in their offices. The paper reviews what is known from published international research about post-abortion and post-partum admissions to psychiatric hospitals and discusses comparative findings obtained from computer linkages of Danish national registers. Admissions to psychiatric hospital were tracked for a three-month period after either delivery or abortion for all women under age 50 and then compared with the three-month admission rate to psychiatric hospitals for all Danish women of similar age. The major finding is that for never-married and currently married women, the post-pregnancy-related risk of admission is about the same-around 12 per 10 000 abortions or deliveries. Higher psychiatric admission rates were noted for separated, divorced and widowed women having abortions or carrying to term.