Case scenario: Postpartum Depression

Sheela was a 30 year-old mother of four children who had been married for eight years. She
lived with her husband and in-laws in a small village. She had given birth to her fourth child
three months previously. Her pregnancy and labor had been uneventful, and an untrained
traditional midwife helped conduct the home delivery. Because pregnancy was viewed in her
village as a normal occurrence that did not require any medical attention, Sheela did not
receive any antenatal or postnatal care.

For a month after the birth , Sheela felt normal, but then she began to exhibit unusual
behavior. She became reclusive and stopped speaking to anyone at home, losing interest in
her daily activities and ceasing to care for her children. The rest of the people in her family,
however, were busy with their own lives and seemed indifferent to her condition.

One day, when all of her family members had gone to the fields to work, Sheela set herself on
fire and walked out of the house covered in flames. Some neighboring men saw her and
smothered the flames with blankets, and one of them ran to get her family from the fields.
They called an auto rickshaw to take her to the hospital, where Sheela was admitted to the
burns unit. She had sustained 63% superficial and deep burns. Eight days after admission,
she died of shock and septicemias.
A. Current State B. Goals and Concerns

Sheela
C. Actions and D. Evaluation
Intervention
A. Current State
Patient’s individual Situation
 Sheela set herself on fire while her family was working on the
fields. She walked out of the house engulfed in flames. She had
sustained 63% superficial and deep burns.

Background
 Sheela is a 30 – year old, mother of four children who had been
married for 8 years. She had given birth to her fourth child 3
months previously by an untrained traditional midwife on their
home.
Demographics
 She lived with her husband and in-laws in a small village. Pregnancy
was viewed in her village as a normal occurrence that did not require
any medical attention.

Functioning
 For a month after birth, Sheela felt normal but then she began to
exhibit unusual behavior. She became reclusive and stopped speaking
to anyone at home, losing interest in her daily activities and ceasing
to care for her child. Her condition was not viewed by the family as
different due to their busy life.
Medications Used
 No medications used.

Usual Treatment
 She did not receive any postnatal care.
The Heath-care team member involved

 Emergency Nurse  Physical & Occupational Therapist

 Emergency Physician
 Plastic Surgeon
 Rehab Nurse (burn care)
 Psychiatrist
 Bedside Nurse
 Pharmacist
 Dietician
 Case Manager
 Social Worker
 Vocational Counselor
 Infection Disease Specialist
 Respiratory Therapist
B. GOALS AND CONCERNS
General Goal
 Help the patient return to the highest
level of function and interdependence
possible, while improving the overall
quality of life- physically, emotionally,
socially and mentally.
Specific Goal
For the Patient
A. To show decreased symptoms of
postpartum depression.
B. To display timely healing of burn wounds
and perform activities of daily living.
Specific Goal

For the Family

To correctly understand the current
condition and provide holistic support to Mrs.
Sheela.
Specific Goal

For the Team

To provide interventions to improve
psychological health and regain
functionality of the body.
C. Action and Intervention