Depression Screening Works and Now It Can Work for Pregnant and Postpartum Women
By Amalia Corby-Edwards, MS (Senior Legislative and Federal Affairs Officer, APA Public Interest Directorate)
You may not have heard much about this, but something just happened that could positively impact millions of women and their families. The U.S. Preventive Services Task Force (USPSTF) just included pregnant and postpartum women in the new depression screening guidelines.
Psychologists know that depression is common during pregnancy and after birth. Approximately one in seven women experience depression in the year after their child is born, and many of the symptoms begin during pregnancy. In addition to its psychological harms, perinatal depression is linked with pregnancy risks such as preeclampsia, preterm birth, and low birth weight. It is also linked to outcomes which can negatively affect children, including stopping of breastfeeding, family discord, and child abuse and neglect (AAP 2010).
Depression screening works. While health care providers may not always be able to prevent the onset of depressive symptoms, they can reduce the risks of perinatal depression by screening pregnant and postpartum women and referring them to an appropriate treatment provider. Thanks to the new guidelines issued in January 2016, screening for these women will begin to be incorporated into routine medical care.
The USPSTF is an independent panel of national experts in prevention and evidence-based medicine. The Task Force makes evidence-based recommendations on clinical preventive services, including screenings. Surprisingly, previous 2002 and 2009 USPSTF depression screening guidelines applied to all adults with the exception of pregnant women, citing a lack of evidence for this population.
The Task Force chose to revisit the body of evidence again in 2014, and made their research plan available for public comment. APA weighed in, emphasizing the need for a fresh look at the balance of the harms and benefits of screening pregnant and postpartum women. APA and other supporters of women’s reproductive health enthusiastically welcomed the inclusion of pregnant and postpartum women in the revised 2016 USPSTF depression screening guidelines.
Yet, much work remains. Meeting the mental health needs of parents is essential, because it is so closely linked to the well-being of their children. Congress and the federal government should take a leading role. For example, the Melanie Blocker Stokes MOTHERS Act, which authorized support and education on postpartum depression and psychosis, was included in the 2010 health reform law (PL 111-148), but it has never been funded. Again in 2015, Congress introduced a number of bills focused on maternal mental health and substance use disorders, and even passed the Protecting our Infants Act of 2015 (PL 114-91), which addresses prenatal opioid exposure. Yet there has been no additional funding allocated for these issues, rendering the laws toothless.
APA’s Public Interest Directorate continues to educate congressional and federal agency staff on the importance of these issues. You can help us! Contact your Senators and Representatives to advocate for funding for these and other programs that address maternal mental health through APA’s Federal Action Network.
American Academy of Pediatrics (AAP). (2010). Incorporating recognition and management of perinatal and postpartum depression into pediatric practice. Pediatrics, 126(5), 1032-1039.
Image courtesy of Flickr user Frank de Kleine via Creative Commons