Depression Screening in Perinatal Care

Purpose: This project aimed to increase obstetric healthcare providers’ willingness to administer depression screenings during pregnancy and increase depression screening practice frequency to provide a pathway in compliance with the ACOG and USPSTF recommendations.Background: Previous undiagnosed depressive episodes have been associated with postpartum depression resulting in serious concerns that affect the mother and the baby. There are multifactorial symptoms associated with pregnancy requiring depression screening during pregnancy using a universal tool. A lack of training and confidence in treating or referring patients that limit depression screening are barriers associated with the underdiagnosis of depression. There are also varying practices in the frequency of screening amongst providers. To satisfy the ACOG and USPSTF recommendations, screening for depression should occur at least once during pregnancy. Methods: Using a pretest/posttest design among a single group of obstetric healthcare providers in Arizona, participants were given a survey before and following an evidence-based educational intervention on perinatal depression screening using the patient health questionnaire-9 (PHQ-9). The pretest and posttests evaluated the participants’ current and future depression screening practices, knowledge of perinatal depression, understanding of the PHQ-9 depression screening tool, expertise level in administering the PHQ-9, the comfort level of administering the PHQ-9, and willingness to implement depression screening into practice in perinatal patients during pregnancy. Results: Seven participants completed the quality improvement project. Key findings indicated an increase in the participants' knowledge of perinatal depression, the expertise and comfort of administering and interpreting the PHQ-9, treating depression during pregnancy, and the number of participants who plan to always screen for depression during pregnancy in the future. Conclusions: The results of this study illustrate the need for additional training in utilizing universal depression screening tools. Through evidence-based training, barriers can be avoided. To provide holistic care, multifactorial symptoms of depression during pregnancy must be addressed using universal depression screening tools. As research has shown a link between previous episodes of depression and postpartum depression, it would be reasonable to screen for depression at every visit during pregnancy