Study: Screen For Underdiagnosed Postpartum Depression Through First Year After Birth
Postpartum depression is vastly underdiagnosed. A new study concludes that women are not being screened often enough — or at all — for the disorder.
Researchers at the University of Pittsburgh Medical Center found that women should be screened for postpartum depression several times, at the end of their pregnancy and throughout the first year after giving birth.
“Screening is one of the most important things we can do to detect at risk women,” according to Dr. Erin Smith, senior resident at the Western Psychiatric Institute and Clinic at the University of Pittsburgh Medical Center and one of the authors of the study. “One screen might miss a vulnerable woman who, on a certain day, seems fine but really hasn’t been doing well.”
Smith said she was interested in looking into postpartum depression because she saw so many women being diagnosed with the disorder, as well as depression during pregnancy, which isn’t uncommon.
“Between 10 and 15 percent of all women will have a new episode of depression during pregnancy or in the initial year postpartum,” she said.
She and other researchers looked at all of the available research on postpartum depression, from the ways women are screened, to when and where they’re screened. They determined that we need more screening, more often, and that it can be done in just about any situation — including at a pediatricians’ office when mother go in for their baby's checkups.
Smith said there are social and individual factors that contribute to the underdiagnosing of postpartum depression, including the stigma that comes with having a mental health problem and the pressures women face when having a baby. Then, there are practical barriers to treatment for disorders like this, like transportation and mental health care coverage.
“The push nationally and internationally is for universal screening in a standardized way, and that often takes place in primary care, pediatric or obstetric clinics,” she said.
The most widely used screening tool is a questionnaire called the Edinburgh Postnatal Depression Scale, said Smith. It asks some basic questions that point to the main symptoms of depression. Smith thinks it does wonders to reduce the stigma surrounding postpartum depression and normalize it.
“Like, ‘Hey, this is just like your blood pressure, you heart rate,’” she said. “I think about postpartum depression the same way as I would discuss diabetes or high blood pressure. It can happen and it’s treated and people get better.”
When it comes to treatment, Smith said that looks different for different women. It can be anything from talk therapy to, in more severe cases, a combination medication and therapy.
“Sometimes all they need is to know … they didn’t make this up, they’re not a bad person, they’re not a bad mom,” said Melissa Beauchamp, a nurse and the community education coordinator for Dignity Health Chandler Regional Medical Center and Mercy Gilbert Medical Center. She runs a support group for pregnancy and postpartum that meets every week in Gilbert.
Beauchamp said women think having a baby will be all “butterflies and rainbows,” but the reality is often different.
“They’re primed that they’re supposed to enjoy this time, and it’s a special time, and it’s a wonderful time, and it is all of those things, but it’s a lot of hard work,” Beauchamp said. “And I think we sometimes don’t paint a realistic enough picture of life with a newborn.”
Women are often scared to come to a support group, said Beauchamp. However, once they do, they often realize the one thing they need most: “I’m not the only one,” she said.
“That alone is huge. It’s not going to fix it, it’s not going to make it go away, but the fact that you’re not the only woman on the face of the earth with these kind of feelings is a huge relief to them,” said Beauchamp.