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Screening and Referral Recommendations in Postpartum Depression
Experts discuss that while standardized screening tools are important for detecting perinatal mood and anxiety disorders, true identification often relies on provider intuition, meaningful dialogue, and cross-specialty collaboration—especially in pediatric settings—to ensure timely support for both parent and child.
In clinical practice, standardized screening tools like the Edinburgh Postnatal Depression Scale are essential for identifying perinatal mood and anxiety disorders (PMADs), but they are not foolproof. Patients may underreport symptoms out of fear, shame, or a desire to avoid further questioning. Minimizing symptoms is common, especially among those who believe they should be grateful or coping better. In these situations, scores may not reflect the provider’s experience of the patient in person. Subtle signs—such as a flat affect, visible distress, lack of eye contact with the baby, or expressions of isolation—can indicate deeper issues not captured by formal screening.
Effective identification often depends on a provider’s ability to build rapport and engage in open-ended conversations. Asking questions like “How are you really doing?” or inquiring about their mental and emotional well-being in a conversational tone can reveal more than checkboxes on a form. Taking the time to sit at eye level, pause from routine tasks, and truly listen can encourage patients to open up. These moments are especially important in postpartum care, where mothers often feel invisible as focus shifts entirely to the infant’s health. Meaningful dialogue can uncover distress in patients who might otherwise go unnoticed.
There is also growing recognition of the role pediatricians and other frontline providers play in identifying PMADs. Since mothers attend frequent pediatric visits but far fewer postpartum checkups, pediatricians are well-positioned to screen and refer when needed. Clinics integrating maternal mental health screeners into pediatric appointments are helping to bridge gaps in care. While pediatricians may not treat these conditions, their awareness and willingness to refer are crucial. Ultimately, it is a shared responsibility across specialties to ensure parents receive timely support, recognizing tha
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