Midwives' role in screening for antenatal depression and postnatal depression

Abstract

This is an educational paper which aims to inform midwives of tools available to help them make appropriate provisional diagnosis of perinatal depression. A second aim of the paper is to increase midwives' awareness of the relatively newer diagnosis of antenatal depression (AND). Of additional clinical importance, midwives need to recognise that postnatal depression (PND) may be a continuation of AND. To date, screening for AND has received relatively little attention compared with PND, with the evidence-base supporting that the impact can be as severe. It is important for midwives to know that screening for AND can be undertaken using valid and reliable psychometric self-report depression screening questionnaires which have known validity characteristics and threshold cut-off scores. There are several of these tools available to help midwives make the decision about whether or not to refer the women to the mental health team. Current practice in the UK involves the midwife asking an initial short two-item ‘Whooley Question’ screen which, if indicates depression, can be followed up by the women completing a self-report depression screening questionnaire. To highlight their availability, a selection of valid and reliable psychometric self-report depression screening questionnaires are discussed herein, with it being important for midwives to develop a toolkit that can be given to women at clinics, in pamphlets, online or embedded into mobile applications.

Midwives’ descriptions of strategies and requirements when following up pregnant women at risk of developing perinatal depression - a qualitative study

“…Midwifery students need a better understanding of the complexities of mental health and risk factors for developing problems (29,30). Martin et al (31,32) claim that the large focus on physical health in midwifery education is detrimental to the level of knowledge and self-confidence needed to deal with women with challenges related to mental health. They point to a possible need to adjust the midwifery education curriculum, which is also supported by Jarrett (29,30), who believes that a review of the current midwifery education is needed.…”

Postpartum Depression

“…The Edinburgh Postnatal Depression Scale is a shorter, 10-question screening tool that can be completed in approximately 5 minutes by patients or providers [ 11 , 18 , 19 ]. Although there are no universally accepted cutoff markers diagnostic for depression in this scale, a score of greater than 12 is frequently considered to be indicative of probable PPD and requires further patient evaluation [ 11 , 18 , 19 , 24 ].…”

Data of the MAternal Mood Assessment (MAMA) survey for healthcare professionals: A pilot study on midwives in Italy

“…Understanding the problem and personal attitudes towards it, which can lead to prejudiced emotional reactions, are two components of stigma [ 5 , 6 ].…”