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Postpartum psychosis — RCPSC EM MCQ

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HardPsychiatric emergenciesPostpartum psychosisRCPSC EM

Ten days after delivery, a parent has severe insomnia, believes the baby is possessed and hears a voice commanding cleansing of the child. What is the most appropriate immediate management?

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Correct answer: D — Arrange hospital care with infant protection and psychiatric assessment

The best answer is “Arrange hospital care with infant protection and psychiatric assessment”. Postpartum psychosis is a medical emergency with risk to the parent and infant. The infant must be protected, urgent psychiatric assessment and pharmacological treatment are needed, and hospitalization is usually required. Sleep hygiene and family counselling can be supportive later but cannot replace immediate safety planning and specialist care.

Reference: Public Health Agency of Canada: Maternity and Newborn Care—Postpartum Care: https://www.canada.ca/en/public-health/services/publications/healthy-living/maternity-newborn-care-guidelines-chapter-5.html