Can Screening for Depression During Pregnancy and After Birth Help New Parents?

What you need to know

• Depression during pregnancy and after birth can significantly impact both parent and child health
• Currently there isn’t clear evidence that routine depression screening questionnaires improve outcomes beyond regular care
• Healthcare providers should still have ongoing discussions about mental health and wellbeing with patients

The Importance of Mental Health During Pregnancy and After Birth

Having a baby is often portrayed as a joyous time, but for many people, pregnancy and the first year after birth can bring significant emotional challenges. Depression during this period is common, affecting around 8-9% of individuals. When left unaddressed, it can impact not just the parent’s wellbeing, but also infant development, parent-child bonding, and family relationships. This raises an important question: what’s the best way to identify and support people experiencing depression during this sensitive time?

Understanding Depression Screening

Depression screening involves having all patients complete a standardized questionnaire, typically at specific points during pregnancy or after birth. The questionnaire includes questions about mood, energy levels, sleep patterns, and other symptoms. Based on the total score, healthcare providers determine who may need additional mental health evaluation.

Common screening tools include the Edinburgh Postnatal Depression Scale (EPDS) and the Patient Health Questionnaire (PHQ). These tools ask questions like “Have you felt sad or miserable?” and “Have you had trouble sleeping?” Patients scoring above a certain threshold are considered “screen positive” and referred for further assessment.

What the Research Shows

Surprisingly, there is very limited research on whether this type of routine screening actually helps improve outcomes. The task force found only one relevant study, conducted in Hong Kong with 462 participants. While this study showed some potential benefits, the evidence was considered very low quality, meaning we can’t be confident in the results.

Potential Benefits and Drawbacks

Screening might help identify some cases of depression that would otherwise go unnoticed. However, it also has potential drawbacks:

• False positives: For every 100 people screened, about 5 would be incorrectly identified as potentially having depression
• Resource use: Screening takes time away from other aspects of care
• Access issues: Follow-up mental health services aren’t always readily available
• Unnecessary referrals: Some people with temporary symptoms might be referred for treatment they don’t need

What This Means for You

If you’re pregnant or have recently had a baby, you don’t necessarily need to complete formal depression screening questionnaires at every visit. However, your healthcare provider should:

• Ask about your emotional wellbeing
• Discuss any mental health concerns you have
• Be attentive to signs of depression
• Take action if you show symptoms or express concerns

Don’t hesitate to bring up feelings of sadness, anxiety, or overwhelm with your healthcare provider. These conversations are an important part of your care.

Conclusions

• Healthcare providers should have regular conversations about mental health rather than relying solely on screening questionnaires
• More research is needed to determine if routine screening provides benefits beyond standard care
• The focus should be on creating an environment where patients feel comfortable discussing mental health concerns