DescriptionPurpose: The purpose of this project was to identify early signs of postpartum depression in women during a third trimester prenatal visit. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen women both prenatally and at the six-week postpartum visit. Women who had a positive screen for depression were referred to mental health services.
Methodology: This Quality Improvement project was conducted at an outpatient obstetrics and gynecology private practice in Northern New Jersey. A chart review was performed on the medical records of women who had delivered in the 3 months prior to the project implementation, this included the scores on the Edinburgh Postnatal Depression Scale (EPDS) which is done routinely at the six-week post-partum visit. Next, an educational presentation was provided to the staff on the importance of screening for prenatal depression during the third trimester of pregnancy using the EPDS, as well as during the post-partum visit. During implementation of this project which lasted 12 weeks, the office staff provided the EPDS to all adult pregnant women between the gestational ages of 36-40 weeks before being seen by their Ob/Gyn. The provider scored their scale and discussed the results with the patient. When necessary, patients were referred to mental health services. Chart reviews were then conducted on these patient records.
Results: The results were not statistically significant when using the EPDS prenatally (n=9) and therefore no difference was seen in the postpartum results in postimplementation period. Three patients screened positive for depression in the preimplmentation group (n=10). Use of the EPDS during pregnancy in the postimplementation group identified one person at risk for depression who was no longer depressed, at the post-partum visit and one person who had a mild to moderate depression risk in the postpartum period but was not at risk for depression prenatally. While not significant, the results made the provider more aware of the mental health of her patients.
Implications: This change in practice could provide useful information to providers. They could identify women at risk for post-partum depression and address their psychological well-being before they give birth. Identifying and addressing this risk prior to the birth of their child may reduce their risk for postpartum depression by providing mental health care prior to the postpartum period.