After a period of brief silence I am back again to ask for your
thoughts/wisdom/help. I am taking a mental health nursing course at the
University of Alberta and have to come up with a topic for a paper on ethics
in mental health nursing.

Considering my interest in maternal-fetal health (with a heavy emphasis on
lactation/breastfeeding), I am gravitating toward a discussion of paternalism
vs. autonomy related either to reproductive rights or support of an expressed
desire to breastfeed in the depressed patient. I have a long-standing
depressive condition in mind but the professor immediately suggested exploring
postpartum psychosis or depression as a focus for my research. Ever the
stubborn and rebellious person, I did a literature search on the
pharmacological management of depression (in general) in the pregnant and
breastfeeding woman but I have not been able to find any other information
related to nonpharmacological tx's or why it would be important for healthcare
providers to support BF mothers with depression. I get the distinct feeling
(especially from the professor) that if babies can be sustained on formula
that BF support is considered a non-issue. However, I would think that it
would be devastating to express a desire to breastfeed and have it completely
swept away due to an underlying medical OR psychological condition.

The paper requires me to restrict myself to a discussion of ethics and the
relationship to mental health nursing practice so I have to be careful to
ground my research and my discussion in nursing care within a mental health
setting. That being said, I am not restricted to discussing an issue that is
unique to a hospital setting (i.e., the patient in a mental health facility).
Possible topics include: (1) consideration of the BF dyad in the treatment of
depression and PPD, (2) rights of the mother vs rights of the fetus/child in
the tx of psychiatric conditions, (3) reproductive rights of mentally ill
female patients in their childbearing years, (4) infant safety (i.e., rooming
in) considerations in cases of suspected PPD/psychosis, etc. Have any of you
dealt with/supported a patient in these types of situations? Are there
standard protocols re: BF by depressed or mentally ill patients in your
hospitals/states/etc.? I do not give up easily when something interests me but
I am not sure if I am biting off far more than I can chew.

Thank you in advance for any help.

Dru Antoniuk
BA, MA, current BScN student, local lactivist, and mom of two wonderful little
girls

P.S. I am still working on revisions and additions to my paper on teen BF. I
hope to send some more info to the list after my mental health practicum (~
July).

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