Week of 2.12.18

Post Partum Depression is a very real and unfortunately very prevelant condition and warrants carefull attention on both the part of the care giver, parents to be and their relatives or significant other. Teaching sessions on the possibility of developing this condition, how to manage it and signs to look for, should be part of the regimen for both pre natal and anti-natal care. It should also involve relatives and significant other, so that they too can monitor the new mother and note any signs that may denote such a condition. No one wants to self diagnose themself with a mental disorder, so particular cues or behaviors maybe be brushed aside or downplayed. Hence the need for family involvement. The events that took place when Ms. Porten tried to seek medical help for a perceived problem is unfortunate, but these events are bound to occur when you have a healthcare system that seems to prioritizes protection against litigation above patient care. I totally understand the initial nurse may have had a genuine concern for the babies well being, but could she not have gotten a doctor or in house psychiatrist to do a risk evaluation first? Or at least explain to the mother first that she has done nothing wrong and willl receive the treatment she needs, but some protocols have to be followed first? It’s not always what you do, but how you do it. It’s not always what you say, but how you say it.

Post Partum depression is not an uncommon condition to come across, and in this case what seems to have happened is that the nurse was merely alarmed once the patient mentioned that she hit herself and thought she sometimes was squeezing her baby too tight. The nurse was probably on the look out for possible psychosis and then her main priority became to ensure patient safety and infant safety by admitting her. No one is really to blame for what happened in my opinion. Protocols, however uncomfortable they are, are in place to ensure patient safety and provide quality care. I agree with some of the above comments where relatives and significant others should attempt to monitor and comfort a mother during this time, especially when such symptoms start to emerge.

First of all I would like to say kudos to Jessica Porten for acknowledging her symptoms and taking action to improve her mental health. From my understanding of the article the hospital staff could have handled the situation more delicately. That being said, suing the hospital would not have been the correct response. I believe she was right as to forego legal action against the hospital; speaking as a person with a very limited knowledge on similar legal matters, what would have even been her case? The nurse identified a potential threat to the Ms Porten’s child after she admitted having violent thoughts and “squeezing the baby too tight”. Granted calling the police was quite extreme and uncalled for, I do agree with the hospital’s protocol in that she should have been isolated from her baby. However I can sympathize with Ms. Porten in that the length of time it took to finish sorting out the situation should by no means have taken 10 hours especially when dealing with an emotionally distressed mother and her baby. I have both sympathy for the mother and to some degree agree with the hospital’s protocol.

There’s a valid argument on both sides. The nurse did what she thought was best in protecting the baby, and according to California laws, she did nothing wrong.Although calling the police will deter other mums from seeking help. I agree with the confinement of Jessica Porten but she should have been given medical help since that’s what she came for.kudos to her for not suing the hospital after the ordeal she went through. Looking at this from a different perspective, if they had sent Porten back home and she had harmed her baby unintentionally, who would take the blame. I agree with Jessica Porten that new bills should be passed protecting both the mother and the baby and also mothers should be encouraged to seek help for any postpartum depression and help should be given to them, both medically and legally.

Post-Partum Depression


“A Nurse Called the Cops on a New Mom Who Wanted Depression Treatment”


I really sympathized with Ms. Porten’s feelings and situation, however, I also can understand why the nurse report the patient. Although, the situation that Ms. Porten lived was not easy I can see that this story have a happy ending. Unfortunately, perinatal depression affects one in seven women, it is for this reason that the American College of Obstetrics and Gynecologist (ACOG) recommends all pregnant women to be screened at least once during the perinatal period. Around 8-15% of women develop postpartum depression following birth, and 0.1-0.2% can progress to postpartum psychosis, which in both conditions there is a significantly increased risk of suicide and infanticide. In reference to this article, we need to have more information to have the complete picture of what is really happening with this patient. We need to know if this patient complete her follow up appointment that is usually 4 weeks post-delivery with her OB/GYN, what was the assessment at that time, and if the pertinent screening test (questionaries) were administered to assess postpartum blues, postpartum depression, or postpartum psychosis so we can understand what is really going on with Ms. Porten. In the big picture, we cannot get blind with only one part of the story, because there is usually 2 or more side of the story. In addition, I really can understand that the nurse was following the protocol of the clinic and she did what she needs to do at that time, and in the other side that nurse maybe avoid a tragedy, because we really cannot read minds or see what is really going on in the mind of a patient. I can understand that Ms. Porten had a really hard time during this whole situation, and as she said; “… the whole thing made her feel like a criminal”, but also maybe the course of action of that nurse avoid a tragedy and avoid to Ms. Porten to become a really a criminal or even worst lost her baby because the mind is very powerful and sometimes it trick us. I really don’t think the nurse, the medical staff or the physicians acted to cause harm to either the mother or the baby. For the other hand, I think they acted in the best interest of the patient to ensure the mother’s and the baby’s safety. I can understand what the nurse did because when you have a patient saying; “I describe maybe hitting myself or squeezing the baby too tight”, this is not a game and there is an explicit thought from the patient to harm herself or the baby and legally the medical staff is obligated to report the incident obviously to avoid the patient carry out the plans to harm herself or the baby. It is a life threating emergency and it needs to be attended seriously. Finally, I a previously mentioned that the mind is very powerful and it sometimes can trick us especially in an individual that is not mentally stable, and the medical staff cannot predict the future to see which patient is going to result in a homicidal or suicidal. We never will know, not even Ms. Porten what could have happened if the nurse did not call the cops. What I do know is that is better safe than sorry, especially in this type of situation where the life of an innocent baby that cannot defend herself could be in danger. Yes, maybe there are better ways to handle the situation or better protocols to follow, but medical staff are also human being that are not perfect and we also should look at the result of this situation instead of always criticized the system. What I am very sure from what I have learned in this field is that life threating thoughts to self or other always should be taken seriously specially when we are taking about a baby, because we never know when the patients are ready to actively performs those thoughts. Finally, I think that Ms. Porten should look forward for help because depression is not easy, and it does exist and it can really impair the person’s life. Also, her physician should be involved in provided her the different groups, associations and helps that exist to better her quality of life.