Skip to main content

Advertisement

SpringerLink
Log in

Implementation of Routine Postpartum Depression Screening and Care Initiation Across a Multispecialty Health Care Organization: An 18-Month Retrospective Analysis

  • From the Field
  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objectives Postpartum depression (PPD) affects approximately 10–20% of all mothers after giving birth. Adequate screening and follow-up care for the postpartum mother with depression is an essential component of quality care in this population. The purpose of this quality improvement project was to evaluate the quality and quantity of a postnatal PPD screening program and the subsequent initiation of needed PPD treatment in an integrated health system. Methods After implementing a standardized PPD screening process, we conducted an 18-month retrospective study of patient visits that required a PPD screen. Data were abstracted from medical records and analyzed to determine if postnatal PPD screening occurred, what quality of the screening was, and what follow-up measures were taken. Results Within the study timeframe, 28,389 postpartum and well-child visits were eligible for PPD screening. PPD screening occurred at 88% of eligible visits for approximately 5000 unique women. PPD was identified in 8.1% of screened women. Conclusions Of women with PPD, at least 44.8% were prescribed an SSRI and 21.4% attended a visit with a mental health professional, which is consistent with other studies. Screening can be successful through collaboration, although ongoing evaluation and process modification are necessary.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  • Andrews-Fike, C. (1999). A review of postpartum depression. Primary Care Companion to the Journal Clinical Psychiatry, 1(1), 9–14.

    Article  Google Scholar 

  • Committee opinion No. 453 American College of Obstetrics and Gynecology. (2010). Screening for depression: Perinatal Depression. Obstetrics and gynecology, 115, 394–395.

    Article  Google Scholar 

  • Agnafors, S., Sydsjo, G., deKeyser, L., & Svedin, C. G. (2013). Symptoms of depression postpartum and 12 years later: Associations to child mental health at 12 years of age. Maternal and Child Health Journal, 17(3), 405–414.

    Article  PubMed  Google Scholar 

  • American Academy of Pediatrics. (2010). Managing maternal depression before and after birth. Elk Grove Village, IL: American Academy of Pediatrics.

    Google Scholar 

  • Boath, E. H., Pryce, A. J., Cox, J. L. (1998). Postnatal depression: The Impact on the family. Infant Psychologe, 16(7–3), 199–203.

    Article  Google Scholar 

  • Byatt, N., et al. (2015). Depression and anxiety among high risk obstetric inpatients. General Hospital Psychiatry, 36(6), 644–649.

    Article  Google Scholar 

  • Children’s Defense Fund Minnesota. (2011). Zero to three research to policy project: Maternal depression and early childhood full report. St. Paul, MN: Children’s Defense Fund Minnesota.

    Google Scholar 

  • Cooper, P., & Murray, C. (1997). Prediction, detection, and treatment of postnatal depression. Archives of Disease in Childhood, 77, 97–99.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of the postnatal depression: Development of the 10-item Edinburgh postnatal depression scale. British Journal of Psychiatry, 150, 782–786.

    Article  CAS  PubMed  Google Scholar 

  • De Crescenzo, F., Perelli, F., Armando, M., & Vicari, S. (2014). Selective serotonin reuptake inhibitors (SSRIs) for post-partum depression (PPD): A systematic review of randomized clinical trials. Journal of Affective Disorders, 152–154, 39–44.

    Article  PubMed  Google Scholar 

  • Dennis, C. L., & Hodnett, E. D. (2007). Psychosocial and psychological interventions for treating postpartum depression. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD006116.pub2.

    Google Scholar 

  • Earls, M. F. (2010). Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Committee on psychosocial aspects of children and family heath. Pediatrics, 126(5), 1032–1039.

    Article  Google Scholar 

  • Ellsworth-Bower, E. R., & Corwin, E. J. (2012). Nutrition and the psychoneuroimmunology of postpartum depression. Nutrition Research Reviews, 25(1), 180–192.

    Article  Google Scholar 

  • Feldman, R., Granat, A., Pariente, C., & Kanety, H. (2009). Maternal depression and anxiety across the postpartum year and infant social engagement, fear regulation and stress reactivity. Journal of the Academy of Child and Adolescent Psychiatry, 48(9), 919–927.

    Article  Google Scholar 

  • Fergerson, S. S., Jamieson, D. J., & Lindsay, M. (2002). Diagnosing postpartum depression: Can we do better? American Journal of Obstetrics and Gynecology, 186(5), 899–902.

    Article  PubMed  Google Scholar 

  • Gavin, N. I., Gavnes, B. N., Lohr, K. N., Meltzer-Brody, S., Gartlehner, G., & Swinson, T. (2005). Perinatal depression: A systematic review of prevalence and incidence. Obstetrics & Gynecology, 106(5 part 1), 1071–1083.

    Article  Google Scholar 

  • Gaynes, B.N., Gavin, N., Meltzer-Brody, S., et al. (2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes. Evidence Report Technology Assessment (Summary), 119, 1–8.

    Google Scholar 

  • Gibson, J., et al. (2009). A systematic review of studies validating the Edinburgh postnatal depression scale in antepartum and postpartum women. Acta Psychiatrica Scandinavica, 119(5), 350–364.

    Article  CAS  PubMed  Google Scholar 

  • Gjerdingen, D. K., & Yawn, B. P. (2007). Postpartum depression screening: Importance, methods, barriers, and recommendations for practice. Journal of the American Board of Family Medicine, 20(3), 280–288.

    Article  PubMed  Google Scholar 

  • Gress-Smith, J. L., Luecken, L. J., Lemery-Chalfant, K., & Howe, R. (2012). Postpartum depression prevalence and impact on infant health, weight and sleep in low-income and ethnic minority women and infants. Maternal and Child Health Journal, 16(4), 887–893.

    Article  PubMed  Google Scholar 

  • Heneghan, A. M., Mercer, M., & DeLeone, N. L. (2004). Will mothers discuss parenting stress and depressive symptoms with their child’s pediatrician? Pediatrics, 113(3 Part 1), 460–467.

    Article  PubMed  Google Scholar 

  • Kahn, R. S., Wise, P. H., Finkelstein, J. A., Bernstein, H. H., Lowe, J. A., & Homer, C. J. (1999). The scope of unmet maternal health needs in pediatric settings. Pediatrics, 103(3), 576–581.

    Article  CAS  PubMed  Google Scholar 

  • Liberto, T. L. (2012). Screening for depression and help-seeking in postpartum depression during well-baby pediatric visits: An integrated review. Journal of Pediatric Health Care, 26(2), 109–117.

    Article  PubMed  Google Scholar 

  • Manca, D. (2015). Do electronic medical records improve quality of care? Canandian Family Physician. 61(10):846–847.

    Google Scholar 

  • Margolis, K. L., Solberg, L. I., Crain, A. L., Whitebird, R. R., Ohnsorg, K. A., Jaeckels, N., et al. (2011). Prevalence of practice system tools for improving depression care among primary care clinics: The DIAMOND initiative. Journal of General Internal Medicine, 26(9), 999–1004.

    Article  PubMed  PubMed Central  Google Scholar 

  • Pearlstein, T., & Steiner, M. (2008). Premenstrual dysphoric disorder: Burden of illness and treatment update. Psychiatry Neuroscience, 33(4), 291–301.

    Google Scholar 

  • Yawn, B., Olson, A. L., Bertram, S., Pace, W., Wollan, P., & Dietrich, A. J. (2012). Postpartum depression: Screening, diagnosis, and management programs 2000 through 2010. Depression Research and Treatment. doi:10.1155/2012/363964.

    PubMed  PubMed Central  Google Scholar 

  • Zhong, Q., Gelange, B. R., et al. (2015). Using the patient health questionnaire (PHQ-9) and the Edinburgh postnatal depression scale (EPDS) to assess suicidal ideation among pregnant women in Lina, Peru. Archives Women’s Mental Health, 18, 783.

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by a grant from the Park Nicollet Foundation.

Author information

Authors and Affiliations

  1. Park Nicollet Health Services, 15800 95th Ave. N., Maple Grove, MN, 55369, USA

    April Lind

  2. Park Nicollet Institute, 3800 Park Nicollet Boulevard, St. Louis Park, MN, 55416, USA

    Sara Richter, Cheryl Craft & Alice C. Shapiro

Authors
  1. April Lind
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sara Richter
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Cheryl Craft
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alice C. Shapiro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to April Lind.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lind, A., Richter, S., Craft, C. et al. Implementation of Routine Postpartum Depression Screening and Care Initiation Across a Multispecialty Health Care Organization: An 18-Month Retrospective Analysis. Matern Child Health J 21, 1234–1239 (2017). https://doi.org/10.1007/s10995-017-2264-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-017-2264-5

Keywords

Search

Navigation