The Wicked Doctor

52: Postpartum Psychosis

Postpartum Psychosis (PP) is a severe, but treatable, form of mental illness that occurs after having a baby. It can happen ‘out of the blue’ to women without previous experience of mental illness. There are some groups of women, women with a history of bipolar disorder for example, who are at much higher risk. PP normally begins in the first few days to weeks after childbirth. It can get worse very quickly and should always be treated as a medical emergency. Most women need to be treated with medication and admitted to hospital.

Of the women who develop a postpartum psychosis, research has suggested that there is approximately a 5% suicide rate and a 4% infanticide rate associated with the illness. This is because the woman experiencing psychosis is experiencing a break from reality. In her psychotic state, the delusions and beliefs make sense to her; they feel very real to her and are often religious. Immediate treatment for a woman going through psychosis is imperative.

It is also important to know that many survivors of postpartum psychosis never had delusions containing violent commands. Delusions take many forms, and not all of them are destructive. Most women who experience postpartum psychosis do not harm themselves or anyone else. However, there is always the risk of danger because psychosis includes delusional thinking and irrational judgment, and this is why women with this illness must be quickly assessed, treated, and carefully monitored by a trained healthcare perinatal mental health professional.

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She slept soundly on the hospital bed with contraptions connected to her body . Her face was pale and lifeless as the cardiac monitor beeped together with her heartbeat.

What happened to this girl?

I fell asleep with my head on the side of the bed while waiting for her to wake up. All I knew was her  name that was on the school ID inside her wallet which I found in her bag. She's a doctor in the making but now she's a patient lying on a hospital bed.

I woke up when I felt something on top of my head, like a hand was stroking my hair. I raised my head to look at her face while still trying to wake my brain. I smiled sheepishly as she stared at me.

She's pretty.

I immediately stood beside the bed and ransacked my brain for the most plausible excuse I could possibly find.

"Are you ok now? I'm sorry I was such an idiot and I panicked before calling for help." Her hand fell on the bed and immediately found its way to her abdomen. Her eyes were questioning and she paled even more.

I tried to hide my emotions, pity and guilt are probably showing on my face right now.

"My baby..... Where's my baby? What happened to my baby?"

I heaved a sigh before trying to pacify her. She rashly removed the IV from her hand and with one hand, disconnected the leads from her chest and removed the blood pressure cuff from her arm. I hurriedly pressed the call bell to get the attention of the nurses on duty. Without a delay, they were in the room to help me hold her back. They probably knew even before I pressed the bell because they will be alerted if the connections are removed.

Maybe she remembers something. She drifted in and out of consciousness when I brought her here. She must have remembered her time in the procedure room.

I held her down on the bed as I talked to her while the nurse injected something on her left arm. Her right hand is still bleeding from the IV which she pulled earlier.

"Sir, at this moment she cannot handle the emotional stress caused by the miscarriage so I suggest we break it to her gently. I think she knows what happened to her body and her baby. She just had a panic attack this time and we need to keep her here for her to recover, probably for counselling too." He gave me a fleeting look. I thanked the doctor before he left the room.