PMH-C Risk Factors 5 — Questions and Answers
Question 1: In assessing PMAD risk, which of the following questions most directly screens for a key modifiable social risk factor?
- How many prenatal visits have you attended?
- Do you have people you can count on for emotional support? (Correct answer)
- Have you taken childbirth education classes?
- What is your planned infant feeding method?
Correct answer: Do you have people you can count on for emotional support?
Social support is one of the most important modifiable risk factors for PMAD, and directly assessing its presence or absence guides intervention.
Question 2: A client is a single parent by choice with no co-parent. The most clinically relevant PMAD risk in this scenario is:
- Hormonal differences in single mothers
- Reduced instrumental and emotional support, and sole responsibility for infant care (Correct answer)
- Higher rates of birth complications in single mothers
- Reduced access to prenatal care
Correct answer: Reduced instrumental and emotional support, and sole responsibility for infant care
Single parenting without a co-parent increases PMAD risk primarily through reduced support and the burden of sole caregiving responsibility.
Question 3: Which statement best characterizes how race and ethnicity function as PMAD risk factors?
- Race itself is a biological cause of PMAD
- Racial disparities in PMAD are driven by racism, discrimination, and inequitable access to care (Correct answer)
- PMAD rates are equal across all racial and ethnic groups in the US
- Ethnicity affects PMAD risk only through dietary differences
Correct answer: Racial disparities in PMAD are driven by racism, discrimination, and inequitable access to care
Racial and ethnic disparities in PMAD rates reflect the impact of structural racism, discrimination, and inequitable healthcare access, not biological race.
Question 4: A client with a previous cesarean section who strongly desired a vaginal birth experienced a repeat cesarean. This is a risk factor for PMAD because:
- Cesarean sections alter postpartum hormone levels significantly
- Unmet birth expectations and perceived loss of control are associated with PMAD and birth trauma (Correct answer)
- Cesarean deliveries always require longer recovery and this causes depression
- Repeat cesarean patients receive less postpartum nursing support
Correct answer: Unmet birth expectations and perceived loss of control are associated with PMAD and birth trauma
When birth outcomes significantly diverge from desired plans, feelings of failure, loss of control, and grief can contribute to postpartum depression and PTSD.
Question 5: A client is a healthcare worker who experienced significant occupational stress and moral injury during the COVID-19 pandemic before and during her pregnancy. This functions as a PMAD risk factor through:
- Exposure to hospital-acquired infections during pregnancy
- Cumulative trauma, burnout, and moral injury increasing vulnerability to PMAD (Correct answer)
- Shift work causing hormonal disruption only
- Mandatory vaccination exposure during pregnancy
Correct answer: Cumulative trauma, burnout, and moral injury increasing vulnerability to PMAD
Occupational trauma and moral injury constitute significant cumulative stress that increases vulnerability to perinatal mood and anxiety disorders.
Question 6: Adolescent mothers (under age 18) face elevated PMAD risk primarily due to:
- Immature hormonal systems that cannot regulate postpartum changes
- Developmental stage challenges, social stigma, disrupted education, and reduced support (Correct answer)
- Higher rates of pregnancy complications than adult women
- Shorter labor duration causing psychological distress
Correct answer: Developmental stage challenges, social stigma, disrupted education, and reduced support
Adolescent mothers face elevated PMAD risk due to developmental vulnerabilities, social stigma, disrupted life trajectories, and often limited family support.
Question 7: Which of the following best describes how substance use history functions as a PMAD risk factor in the perinatal period?
- Substance use history only increases risk if use continues during pregnancy
- Substance use history often reflects underlying mental health vulnerabilities and trauma, elevating PMAD risk even in recovery (Correct answer)
- Past substance use has no impact on perinatal mental health if the person is currently sober
- Substance use history increases obstetric risk but not psychiatric risk
Correct answer: Substance use history often reflects underlying mental health vulnerabilities and trauma, elevating PMAD risk even in recovery
Substance use history often signals underlying trauma, anxiety, or depression, and these root vulnerabilities continue to elevate PMAD risk even during sobriety.
PMH-C Risk Factors 5
In assessing PMAD risk, which of the following questions most directly screens for a key modifiable social risk factor?