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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
Postpartum Mental Health Screening

Introduction

This toolkit summarizes content from the Postpartum Mental Health Screening Evidence Accelerator and the MCHbest database. The peer-reviewed literature supporting this work can be found in the Established Evidence database. Use the resources below as you develop effective evidence-based/informed programs and measures.

Postpartum Mental Health Screening is related to the following topics; see these Accelerators for additional information: Postpartum Visit and Postpartum Contraception Use.

From the MCH Block Grant Guidance. Mental health conditions are common complications during the postpartum period with approximately 1 in 8 women experiencing depressive symptoms following a live birth.1 Mental health conditions are associated with several adverse health behaviors and outcomes, including poorer maternal and infant bonding, decreased breastfeeding initiation, and delayed infant development.2 They are also the leading underlying causes of pregnancy-related deaths.3 Screening for mental health conditions can identify those at risk for depression and increase the provision of treatment or referrals with the potential to reduce other adverse health consequences. Several professional and clinical organizations such as the U.S. Preventive Services Task Force, the American College of Obstetricians and Gynecologists (ACOG), and the American Academy of Pediatrics recommend screening for postpartum depression; ACOG also recommends screening for anxiety symptoms during the postpartum visit.

Goal. To increase the percent of women who receive postpartum depression or anxiety screening.

Note. Access other related measures in this Population Domain through the Toolkits page.

Detail Sheet: Start with the MCH Block Grant Guidance

DEFINITION

Numerator:

Number of women who reported that a healthcare provider asked a series of questions, in person or on a form, to know if they were feeling down, depressed, anxious, or irritable since their new baby was born

Denominator:

Number of women with a recent live birth

Units: 100

Text: Percent

HEALTHY PEOPLE 2030 OBJECTIVE

Related to Pregnancy and Childbirth (MICH) Objective D01: Increase the proportion of women who get screened for postpartum depression (Developmental)

DATA SOURCES

Pregnancy Risk Assessment Monitoring System (PRAMS)

MCH POPULATION DOMAIN

Women/Maternal Health

MEASURE DOMAIN

Clinical Health Systems

1. Accelerate with Evidence—Start with the Science

The first step to accelerate effective, evidence-based/informed programs is ensuring that the strategies we implement are meaningful and have high potential to affect desired change. Read more about using evidence-based/informed programs and then use this section to find strategies that you can adopt or adapt for your needs.

Evidence-based/Informed Strategies: MCHbest Database

The following strategies have emerged from studies in the scientific literature as being effective in advancing the measure. Use the links below to read more about each strategy or access the MCHbest database to find additional strategies.

Chart of Evidence-Linked Strategies and Tools

Evidence-Informed

Evidence-Based

Mixed Evidence

Emerging Evidence

Expert Opinion

Moderate Evidence

Scientifically Rigorous
 

Field-Based Strategies: Find promising programs from AMCHP’s Innovation Hub

Cutting Edge:

Emerging:

Promising:

Best:

2. Think Upstream with Planning Tools—Lead with the Need

The second step in developing effective, evidence-based/informed programs challenges us to plan upstream to ensure that our work addresses issues early and is measurable in “turning the curve” on big issues that face MCH populations. Read more about moving from root causes to responsive programs and then use this section to align your work with the data and needs of your populations.

Move from Need to Strategy

Use Root-Cause Analysis (RCA) and Results-Based Accountability (RBA) tools to build upon the science to determine how to address needs.

Planning Tools: Use these tools to move from data to action

3. Work Together with Implementation Tools—Move from Planning to Practice

The third step in developing effective, evidence-based/informed programs calls us to work together to ensure that programs are implementable and moveable within the realities of Title V programs and lead to improved health outcomes for all people. Read more about implementation tools designed for MCH population change and then use this section to develop responsive strategies to bring about change that is responsive to the needs of your populations.

Additional MCH Evidence Center Resources: Access supplemental materials from the literature

Implementation Resources: Use these field-generated resources to affect change

PRACTICE

The following tools can be used to translate evidence to action to advance this NPM:

  • The National Maternal Mental Health Hotline | MCHB provides 24/7, free, confidential support before, during and after pregnancy. The Blue Dot Project raises awareness on maternal mental health disorders and aims to combat stigma around mental health. Clinician training/education, patient education, and collaboration between care providers are strategies shown to be effective in increasing screening rates.12 Although universal mental health screening might be beneficial, ethical factors such as the presence, or lack of, a systematic referral process should be considered.4,16,17
  • Postpartum Depression Toolkit (AAFP). This toolkit includes materials to assist in the identification/care of postpartum depression.
  • Maternal Depression-Making a Difference Through Community Action: A Planning Guide (MHA). This guide strengthens the capacity of communities to mobilize around postpartum depression.

PARTNERSHIP

The following organizations focus efforts on Postpartum Depression Screening:

References

Introductory References: From the MCH Block Grant Guidance

1 Bauman BL, Ko JY, Cox S, et al. Vital Signs: Postpartum Depressive Symptoms and Provider Discussions About Perinatal Depression - United States, 2018. MMWR Morb Mortal Wkly Rep. 2020;69(19):575-581. Published 2020 May 15. doi:10.15585/mmwr.mm6919a2.

2 Slomian J, Honvo G, Emonts P, Reginster JY, Bruyère O. Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes [published correction appears in Womens Health (Lond). 2019 Jan-Dec;15:1745506519854864]. Womens Health (Lond). 2019;15:1745506519844044. doi:10.1177/1745506519844044

3 Trost SL, Beauregard J, Njie F, et al. Pregnancy-Related Deaths: Data from Maternal Mortality Review Committees in 36 US States, 2017–2019. Atlanta, GA: Centers for Disease Control and Prevention, US Department of Health and Human Services; 2022. https://www.cdc.gov/reproductivehealth/maternal- mortality/docs/pdf/Pregnancy-Related-Deaths-Data-MMRCs-2017-2019-H.pdf

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.