Depression during pregnancy and the postpartum period—Infographic

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Depression in pregnancy and the postpartum period is a serious issue.

The Canadian Task Force on Preventive Health Care recommends against universal screening for depression using standardized tools, such as questionnaires with a cut off, with all pregnant and postpartum people (up to 1 year after birth)

What does this mean for clinicians?

Do ask patients about their well-being as part of usual care
Do practice good clinical judgment to detect potential depression

We recommend against using a standardized tool to screen every patient

Do remain vigilant for depression
Do use clinical judgment to decide on further steps

Depression Rates:

8% in pregnant and 9% postpartum people vs. 8% in nonpregnant people ¹

Usual care vs screening:

Usual Care	Screening
Ask about well-being Individual, conversation-based Clinical judgement determines next steps if depression is suspected	Uses a medical test or tool with everyone to identify people who might have a disease or health problem Uses a standardized questionnaire with cut off score with every pregnant or postpartum patient Questionnaire score determines next steps Not for people with symptoms

Takeaway:

Depression is a serious issue – Ask patients about their well-being at visits
Don’t use a screening tool with a cutoff score to detect depression with every patient
Continue to use clinical judgement and remain vigilant to depression

Why?

The evidence supporting instrument based screening over usual care is very uncertain.
Implementing a universal screening program that has no proven benefit uses resources and takes away from other health concerns

Depression resources:

1 Vesga-López O, Blanco C, Keyes K, et al. Psychiatric disorders in pregnant and postpartum women in the United States. Arch Gen Psychiatry 2008;65:805-15.