Collaborative Role of Providers for Screening, Diagnosis, and Referrals in Postpartum Depression

EP: 1.Defining Postpartum Depression

EP: 2.Recognizing and Differentiating Postpartum Depression

EP: 3.Impact on Quality of Life in Postpartum Depression

EP: 4.Risk Factors for Postpartum Depression

Now Viewing

EP: 5.Collaborative Role of Providers for Screening, Diagnosis, and Referrals in Postpartum Depression

EP: 6.Screening and Referral Recommendations in Postpartum Depression

When addressing perinatal mood and anxiety disorders, a significant challenge is recognizing and managing these conditions within primary care or general obstetrics settings, where providers may lack specialized training in mental health. Perinatal psychiatry is a relatively new and evolving subspecialty, and questions remain about whose responsibility it is to provide comprehensive care—whether it should be obstetricians, psychiatrists, or both. Often, primary care ends up managing complex cases due to gaps in comfort or resources among specialists. Therefore, fostering collaboration and educating providers on when and how to refer patients is crucial to ensure holistic care.

To improve early identification and treatment, primary care and obstetric providers are encouraged to become familiar with validated screening tools, such as the Edinburgh Postnatal Depression Scale and the Patient Health Questionnaire. These tools are designed for use during pregnancy and postpartum, accounting for typical physiological changes that may affect symptoms like sleep and appetite. Screening should occur multiple times throughout pregnancy and postpartum to catch emerging symptoms. However, screening alone is insufficient without follow-up protocols, as many clinics struggle with underutilization of screening results and inadequate action plans.

Referral to psychiatric specialists is recommended for patients with a history of bipolar disorder, psychosis, psychiatric hospitalization, or those who do not respond to initial therapy or medication. The Mood Disorder Questionnaire is also a vital screening tool to identify potential bipolar disorder, which is important to rule out before starting antidepressants due to risks of triggering mania. Strengthening the capacity of obstetric providers to recognize and manage common perinatal mental health conditions, while knowing when to involve specialists, improves outcomes and prevents serious complications for both patients and their families.