Depression Screening Algorithm for Obstetric Providers
The Edinburgh Postnatal Depression Scale (EPDS) should be administered:
- during initial intake of first obstetrics visit
- during visit following glucose intolerance test
- if high-risk* patient, two weeks postpartum
- at six weeks postpartum visit
EPDS Score
Score < 10
Score > 10
Positive Score on Question 10
Does not suggest depression
Clinical staff educates woman about the importance of emotional wellness. Provide information about community resources (e.g., support groups) to support emotional wellness.
Suggests patient is depressed
Assess to determine most appropriate treatment (refer to the Assessment of Depression Severity, Treatment Options by Depression Severity, and Discussing Antidepressant Use with Perinatal Patients documents). Always consider comorbid psychiatric illnesses (e.g., psychosis, substance use) and medical cause of depression (e.g., anemia, thyroid disorders).
Suggests patient may be at risk of self-harm or suicide
Do NOT leave woman/baby in room alone until further assessment or treatment plan has been established. Immediately assess further:
- In the past two weeks, how often have you thought of hurting yourself?
- Have you ever attempted to hurt yourself in the past?
- Have you thought about how you could harm yourself?
Document assessment and plan in medical record. If there is a clinical question, locate your regional MC3 phone number and give us a call.
Contact clinical support staff to arrange follow-up care if needed. Give woman information about community resources (e.g., support groups) and encourage woman to engage in social supports. If woman is already in treatment, ensure follow up appointment is scheduled.
If antidepressant medication is indicated:
- Screen for bipolar disorder (refer to Bipolar Depression Screen)
- Refer to Antidepressant Treatment Algorithm
- Offer psychotherapy
ALWAYS DISCUSS ALL SUPPORT/TREATMENT OPTIONS INCLUDING PSYCHOEDUCATION, COMMUNITY, AND PSYCHOSOCIAL SUPPORTS
* High-risk = women with a history of depression or a positive EPDS Score, or those taking or who have taken psychiatric medications.
This resource has been adapted with permission from the MCPAP for Moms Pediatric Toolkit for Postpartum Depression.
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