New Changes in Depression Screening Before and After Pregnancy
Ten percent of new mothers will experience a major depressive disorder. Is your doctor talking to you about depression?
Recently, the United States Preventive Services Task Force recommended updated depression screening guidelines for adults. Within these recommendations, a specific group of the population was called out, a segment that had never received this attention before: women who are pregnant or in the postpartum period. Growing evidence – and growing efforts by states, medical organization and women’s health advocates – have shown that the issue of depression, and not just postpartum depression, is much larger and more serious than previously documented or treated. This call to action was also prompted by evidence that shows success when women receive an accurate diagnosis and treatment, and the benefit to not only mothers, but also their children.
The Task Force is made up of an independent panel of experts appointed by the Department of Health and Human Services. Recommendations around depression screening were last made by the Task Force in 2009; at that time, there was no mention of screening during or after pregnancy. In the past, the question of whether screening did more harm than good to women – and if it was wrong to screen women without proper referrals and access to treatment – halted the call for formal recommendations. Now, with mental health services more widely available, that concern is less of a barrier. Screening tools are also being seen as a way to prompt vulnerable, important discussions of feelings and mental health – opening the door to conversations that were feared, in the past, to perhaps only instigate more anxiety among women. When it comes to screening tools, The Edinburgh Postnatal Depression Scale was recommended by the panel.
The need for widespread screening and treatment is crucial: according to the Task Force, roughly nine percent of pregnant women and 10 percent of new mothers will experience a major depressive disorder. In addition to the negative effects maternal depression can have on a woman’s older children,
Depression that begins in pregnancy can lead to poor prenatal health and adverse birth outcomes.
Many health insurers and health systems follow the recommendations of the Task Force, so the impact of the panel is significant. So far, New Jersey is the only state that requires screening, but several other states have laws in place that encourage screening, treatment, and education. This will hopefully now become the norm.
Questions and complications still remain: will appropriate referrals be given? Will women receive the treatment they need? Which care providers are best suited to screen women, and how will they be compensated? But, ultimately, this formal call to action and recognition is a move in the right direction for the health of women – and families – nationwide. When a mother is healthy and thriving, her children also have the opportunity to thrive and be well.
The recommendation statement made by the US Preventive Services Task Force can be found in JAMA, the Journal of the American Medical Association.