The Periscope Project exists to increase health care clinician’s capacity to support behavioral health needs of pregnant and postpartum women. Whether you are looking for specific information on managing treatment of depressive and/or anxiety symptoms with antidepressants or just looking to learn more about the broad topic of perinatal psychiatry, The Periscope Project can help.
15% of pregnant and postpartum women will struggle with mental health conditions.
Screening for Perinatal Depression and Anxiety
Why screen for depression?
National standard of care recommendations now includes recommendations for screening for mental health during the pregnancy and postpartum period.
In May 2015, the American College of OB/GYN guidelines were updated to include recommendations that:
- “Clinicians screen patients at least once during the perinatal period for depression and anxiety symptoms using a standard, validated tool.”
- “Coupled with appropriate follow-up and treatment”
- “Systems should be in place to ensure follow-up for diagnosis and treatment”
In January 2016, the US Preventative Services Task Force:
- “Recommends screening for depression in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.”
In October 2010, the American Academy of Pediatrics:
- “The primary care pediatrician, by virtue of having a longitudinal relationship with families, has a unique opportunity to identify maternal depression and help prevent untoward developmental and mental health outcomes for the infant and family. Screening can be integrated, as recommended by Bright Futures and the AAP Mental Health Task Force, into the well-child care schedule and included in the prenatal visit.”
When to Screen
- Ideally once per trimester, at least once prenatally.
- When there is a concern about the patient’s ability to function by the patient or the family.
- When there is a subsequent pregnancy before 12 months postnatal, screen at least once per trimester.
- Between 2-4 weeks postpartum.
- Between 8-12 weeks postpartum.
- Between 9-12 months postpartum.
- Rescreen at any time there is a concern about the patient’s ability to function by the patient or family.
Talking to your patients after screening
Even if a patient completes a screening tool with no concerning responses, it allows providers an opportunity to begin discussion about how she is doing emotionally. Asking the patient questions like; “How are handling the transition to motherhood?” or “Are you enjoying the baby?” Normalizing the screening process and follow-up questions will create an environment where the patient may be more comfortable disclosing to you what she is experiencing. Patient may be embarrassed of her feelings or afraid of the consequence if she tells you how she’s feeling. Create an environment of openness and trust with your pregnant or postpartum patient.Watch the Conversations Starters video for tips on discussing the screening tool with patients.
Call The Periscope Project with questions or concerns about screening tools and results.