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Need of psychological assessment

Antenatal period is having various psychological changes. These changes are due to family circumstances, reaction to pregnancy, hormonal changes and sometimes due to neurochemical changes. Assessing mother from all dimensional aspect is required .

Postnatal and antenatal depression is a focus of considerable clinical and research attention, but little is known about the patterns of anxiety across this period.

Collection of history at the first visit of pregnancy is a crucial for understanding the psychological state as well as categorizing high risk mothers.
History of Socio economic background such as low income, inadequate housing, less than high school education, a physically strenuous or stressful work environment, inadequate nutritional status are important.
Psychological aspect of history includes inadequate personal, family and friends support, ineffective coping mechanisms, ambivalence about the pregnancy and baby, family history of abuse, and feelings of chronic stress and anxiety. Personal history like use of tobacco, illicit drug use, alcohol abuse, inadequate exercise are health behaviors that place women at risk for an adverse antenatal process
. Antenatal visits are modified according the woman need and physiopsychological health. While assessing the psychological state one must consider the socio cultural aspect also. History family history of psychiatric illness, maternal life events, domestic violence, history of sexual, physical or emotional abuse, family preference for a male child and teen pregnancy should be included. History from her partner, family, friends, and neighborhood are also taken as these people influence a woman's psychological health and responses to a diagnosis of disorder.
Most psychological and physical abuse experienced by pregnant women remains undetected by health professionals. Even when the symptoms are recognized, it can be difficult to get help. Good rapport between healthcare professionals and women is essential to collect all aspect of history. These are some barrier which prevents antenatal mother to seek psychologist of psychiatrist help. Kingston et al. stated that Personal and stigma-related barriers influence pregnant women's responses to psychological health screening. Women's most common barriers are: significant others normalizing their emotional difficulties; desiring to handle psychological health problems on their own; preferring to discuss feelings with significant others; and not knowing what emotions were 'normal'


Varieties of treatment options are available for mothers during pregnancy like social support, life style change, talk therapy and finally medications .Antenatal clinics should have facility for diagnosis, and treatment. Health education on antenatal care must be an integral part of treatment approach. Occupational system also play a crucial role should be included in educating mother on emotional effect. With appropriate rapport Counselors can treat patients with other health team member. Once diagnosis of psychiatric disorder is confirmed during pregnancy quick referral for evaluation and treatment must be initiated . Obstetrician plays a central role in treating pregnant mother with whom mother feel more trust during pregnancy as well as in postnatal period. Provision for telephone helpline services or on-line support group with professional assistance may be helpful in decreasing isolation, provide answers to family query, and serve as a forum for sharing experiences


Even we witnessed tremendous advance in patients care system, all these considered instrumental treatment, if psychological aspect of care not included. 'Care' is treatment including emotional attachment with patient. Being in a novel professional our aim should be 'care' rather than 'treatment'. When we care for pregnant mother we care for two live and live without psychological consideration is completely materialistic.

In health care setting, patient's emotional aspect is neglected. The challenge for health care providers is to recognize the importance of understanding individualized psychological care to pregnant women.

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