Prevention of postpartum depression at an OB/GYN clinic: a translational research project using group interpersonal psychotherapy

Abstract

Between one in eight to ten mothers in the United States experience frequent postpartum depressive symptoms. Postpartum depression has a wide range of negative effects on a woman's psychological and social functioning, as well as her family's. Sufficient evidence indicates that an interpersonal psychotherapy group therapy intervention may help prevent postpartum depression in childbearing women. Unfortunately, many obstetrician and gynecologist clinics are not utilizing collaborative-care models that address such mental health needs. The purpose of this project was to (a) translate current best evidence into practice, (b) design and implement an interpersonal psychotherapy group intervention at one Colorado obstetrician and gynecologist clinic, and (c) evaluate the impact of the intervention based on the Edinburgh Postnatal Depression Scale scores at the beginning of the project and at six weeks postpartum. An evidence table was created to evaluate the current best evidence for preventing postpartum depression. A Colorado clinic was selected for its convenient location and sufficient patient population. An intervention was created based on the description of interventions utilized in the randomized-controlled trials that were included in the evidence table. Four women were recruited for the group intervention and only one woman completed the intervention and post-assessment tools. This woman had a clinically significant improvement in her depression scale from pre-intervention to post-intervention. An unanticipated difficulty was the low attendance rate or follow through with the intervention. This project highlights the need for more comprehensive services to prevent and treat postpartum depression. Psychiatric nurse practitioners are optimally placed to coordinate and/or deliver the services in coordination with obstetrician and gynecologist clinics.