Pregnancy outcomes, early separation, and psychiatric relapse experienced by South African women with peripartum psychosis: a descriptive exploration

Afr J Reprod Health. 2020 Dec;24(4):58-68. doi: 10.29063/ajrh2020/v24i4.7.

Abstract

The peripartum is associated with increased incidence of severe mental illness (SMI), a greater occurrence of psychotic symptoms and psychiatric admissions. This study aimed to describe the psychiatric, medical and psycho-social risk factors affecting South African mothers who experienced peripartum psychosis. Using a prospective, descriptive design, we conducted a detailed interview and supplementary information was collected by review of clinical records. The study examined the accounts of forty mothers who experienced peripartum psychosis between 6 and 18 months postpartum. Descriptive statistics for demographic and clinical variables were completed with SPSS for Windows, version 25. Pregnancies were predominantly unplanned and more than half of participants reported prenatal substance use. Medical or psychiatric problems during pregnancy were common and the majority of dyads experienced periods of early separation. Socio-demographic factors exacerbated the challenges this group of women at high risk face, in providing nurturing care to their infants. Results highlight the need for close follow-up for women with SMI, with particular attention to substance screening and psychosocial stressors. Integrated maternal and infant mental health services are recommended.

Keywords: Peripartum psychosis; mother-infant separation; postpartum relapse; pregnancy outcome; prenatal substance use.

MeSH terms

  • Adult
  • Female
  • Humans
  • Mother-Child Relations
  • Mothers / psychology*
  • Peripartum Period / psychology*
  • Postpartum Period / psychology*
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / psychology*
  • Prospective Studies
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / epidemiology*
  • Recurrence
  • Risk Factors
  • Substance-Related Disorders
  • Young Adult