Elsevier

Women's Health Issues

Volume 25, Issue 6, November–December 2015, Pages 703-710
Women's Health Issues

Original article
Examining the Screening Practices of Physicians for Postpartum Depression: Implications for Improving Health Outcomes

https://doi.org/10.1016/j.whi.2015.07.003Get rights and content

Abstract

Purpose

Postpartum depression (PPD), the most common complication of childbirth, remains largely undetected by providers. Pediatricians, obstetricians/gynecologists, and family practitioners have a responsibility to identify PPD as the condition has long-term adverse effects on their patients.

Methods

Using PubMed and PsycInfo databases, this review explores and summarizes studies on the screening practices of physicians.

Findings

The prevalence and method of screening their patients for PPD was low and variable among the three types of physicians. Pediatricians were the least likely to screen compared with obstetricians/gynecologists and family practitioners. However, the majority of all physicians felt it was within their professional purview to screen for PPD and were willing to learn more about PPD detection.

Conclusions

Screening rates can increase if physicians are educated about PPD and trained on the ease of routinely using a validated tool to identify PPD. This is critical, because more detection can lead to improved access to treatment, and the long-term detrimental impact that untreated PPD has on a mother and her children might be mitigated.

Section snippets

Methods

This literature review was conducted using PubMed and PsycInfo searches for articles published between 2003 and 2013 with the following key words: attitude, beliefs, clinic, depression, family, identify, maternal, obstetric, pediatric, physician, postpartum, practice, primary care, provider, recognition, routine, and screening. The resulting 169 studies were further narrowed down to 90 by limiting the results to research carried out within the United States.

Results

There was little consistency in how the various surveys measured similar outcomes, but some results, when appropriate, were merged. For example, if three different studies ask quantitatively how often the provider screens for PPD, the average of those results are presented.

Discussion

This study's hypotheses were found to be true with the majority of physician groups reporting low use of screening instruments for PPD, and the lowest rate of screening being among pediatricians. Although the majority of physicians in all three specialties consistently reported throughout the studies that they feel responsible for recognizing PPD, their screening practices were largely contradictory to their beliefs. This paradox between beliefs and behaviors could be owing to many physicians

Implications for Practice and/or Policy

Assessing for depression is a critical element of postpartum care (American College of Obstetricians and Gynecologists, Committee on Obstetric Practice, 2015, Beeghly et al., 2003, Sit and Wisner, 2009). PPD screening should be incorporated into the standard of care for postpartum patients and at well-child pediatric visits, particularly at the first visit when the prevalence of maternal depression is the greatest (American College of Obstetricians and Gynecologists, Committee on Obstetric

Melissa Goldin Evans, MsPH, a third-year Community Health Sciences PhD student at the Louisiana State University Health Sciences Center School of Public Health, has research interests in health disparities within issues of preventative women's health.

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    Melissa Goldin Evans, MsPH, a third-year Community Health Sciences PhD student at the Louisiana State University Health Sciences Center School of Public Health, has research interests in health disparities within issues of preventative women's health.

    Stephen Phillippi, PhD, is the Program Chair of Behavioral Community Health Sciences at the Louisiana State University School of Public Health and the Director of the Institute for Public Health and Justice.

    Rebekah Elizabeth Gee, MD, MPH, MSHPR, FACOG, is an assistant professor in the LSU Schools of Public Health and Medicine and is the Medicaid Medical Director of Louisiana.

    Funding statement: The authors have no conflicts of interest that would make a reader, reviewer, or editor feel misled or deceived. Specifically, there are no personal, commercial, political, academic, or financial conflicts of interest.

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