Brief reportAcceptability of routine screening for perinatal depression☆
Introduction
Postnatal depression (PND) affects 13% of women who give birth (O'Hara and Swain, 1996), with potential long-term family mental health consequences (Murray and Cooper, 1997). A majority of women with PND do not seek treatment, because of factors such as stigma, and unrealistic perceptions of motherhood (McIntosh, 1993, Whitton et al., 1996). Studies have shown that detection of PND increases with routine use of a screening tool (Evins et al., 2000) and with training health professionals become aware of the issue and offer relevant management (Lumley, 2005, Seehusen et al., 2005). There is, however, an ongoing debate about the acceptability of routine screening (Shakespeare et al., 2003).
The beyondblue Australian PND Program introduced routine antenatal screening across Australia, and in corresponding communities postnatally. This article reports on the acceptability of this screening.
Section snippets
Methods
The screening program operated 2002–2005, with ethics approval received from 43 maternity hospitals/area health services across Australia, (Buist et al., 2005). Part of an end evaluation is presented here.
Postnatal women
Of the 1460 postnatal women surveyed, 860 women (59%) completed the experience of screening questionnaire, 507 women completing at least part of all questionnaires. Demographics are in Table 1.
Almost all women (n = 830, 97.2%) reported receiving an explanation for the use of the EPDS; details are in Table 2. Overall, 47 women of the 709 women (6.6%) who completed an EPDS on the postal survey had an EPDS of ≥ 13. Whilst over 90% found it easy to complete, discomfort was significantly related to an
Discussion
Most women involved in routine perinatal screening found the EPDS easy to complete (93%) and experienced no discomfort (85%), in keeping with the 90% reported by Matthey et al. (2005).
Shakespeare et al. (2003) concluded based on a qualitative study of 39 women that the EPDS is unacceptable, because women wanted to talk about issues. The training of the health professionals in this sample emphasized this and might have improved the acceptability.
Of those women who were distressed by the
Conclusions
There have been many criticisms and calls for concern over routine perinatal depression screening. This sample, taken from an Australia wide screening program, suggests the following two outcomes:
- 1)
That screening (antenatal and postnatal) is generally acceptable to both women and health professionals, providing there is appropriate support for women who screen positive.
- 2)
The primary health care professionals providing screening need ongoing training and clinical supervision.
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This project was funded by beyondblue: the national depression initiative.