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Universal screening for postpartum depression: an inquiry into provider attitudes and practice
Rachel Delatte1, Hongyuan Cao, Samantha Meltzer-Brody
1Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. rdelatte@unch.unc.edu
Obstetric providers acknowledge responsibility for screening postpartum depression (PPD) using the Edinburgh Postnatal Depression Scale (EPDS), but documentation rates remain low. Despite confidence in diagnosis, consistent EPDS score recording is lacking in clinical practice.
Area of Science:
- Reproductive Health
- Mental Health
- Clinical Practice
Background:
- Postpartum depression (PPD) is a significant concern affecting maternal well-being.
- Early detection and intervention are crucial for managing PPD.
- The Edinburgh Postnatal Depression Scale (EPDS) is a widely used screening tool.
Purpose of the Study:
- To evaluate the implementation of the EPDS for PPD detection in an academic medical center.
- To assess obstetric providers' knowledge, attitudes, and practices regarding PPD screening and treatment.
- To identify barriers and facilitators in the routine use of the EPDS.
Main Methods:
- Retrospective chart review of 512 patients for demographic, medical, and psychiatric data.
- Validated email survey distributed to 47 obstetrical providers at the University of North Carolina.
- Analysis of documentation rates of EPDS scores and patient counseling.
Main Results:
- EPDS scores were documented in only 39% of patient visits.
- Counseling on EPDS scores or depression occurred in 35% of visits.
- 94% of surveyed providers expressed confidence in diagnosing PPD and all felt responsible for screening.
Conclusions:
- A significant gap exists between obstetric providers' perceived responsibility and actual documentation of EPDS use.
- Despite high confidence, routine implementation of the EPDS for postpartum depression screening is suboptimal.
- Further strategies are needed to improve consistent EPDS documentation and patient counseling in clinical practice.
