Postpartum depression: standardization of the referral and screening process

Abstract

Approximately 6.5% to 20% of women will experience postpartum depression (PPD), which can have lasting negative effects on both mother and newborn. Universal screening of women for PPD is recommended; however, less than 20% of women undergo guidelines- consistent screening during pregnancy or postpartum. Early identification of PPD through consistent screening, follow-up, and referral can improve maternal outcomes. This project aimed to standardize each part of the process to improve PPD outcomes in a women's health and newborns unit in Western Montana providing comprehensive obstetrics/gynecology, maternal- fetal medicine focusing on high-risk pregnancy and births. The standardized process required RNs to screen all patients with the EPDS (Edinburgh Postnatal Depression Scale), with scores 13 or greater generating an automatic referral to social work. After receiving the referral, social workers follow up with the patient, addressing concerns, providing education to the patient, and referring to additional resources. Following the implementation of the standardized process, the unit saw an increase in EPDS screening rates from 78% to 92%. Seventy-one percent of patients (5 out of 7) who screened positive on the EPDS received a follow-up by the social worker. Postpartum awareness and education materials identifying signs and symptoms of PPD were provided for all patients and families. Having a plan in place for a positive EPDS screen facilitates effective referral and follow-up treatment for women suffering from postpartum depression allowing for the appropriate intervention.