Sunday, June 28, 2009
Hall A (San Diego Convention Center)
Kristi L. Rietzel, BSN, RN , Mother Baby Unit, Hoag Hosptial, Newport Beach, CA
Postpartum depression is one of the most common complications of childbirth. Major or minor postpartum depression can affect 10 to 20 percent of new mothers within the first three months after birth (Beck, 2008). Maternal depression affects the mother’s ability to emotionally and cognitively interact with her infant and family. Many women are reluctant to disclose symptoms of depression and seek treatment regardless of the amount of contact with health professionals.  Due to the fact that depression has a profound and devastating impact on the health of mothers and babies, a multidisciplinary method was used to screen postpartum patients for postpartum depression prior to discharge from their hospital stay. Current evidence supports the significance of postpartum screening for early detection and treatment.  The Edinburgh Postnatal Depression Scale (EPDS) is used to screen all postpartum patients with a live birth.  This assessment tool has been identified as the most common, useful assessment screen for postpartum depression.  The Edinburgh Screen is completed by the patient as close to discharge as possible.  Completing a depression assessment just before discharge from the hospital is a reliable method of identifying possible depression in the immediate postpartum period.  The bedside nurse totals the completed screening tool and notifies the physician and social work for scores of 13 or greater for appropriate interventions and referrals.  The healthcare team is aware of subtle signs of depression and teaches mothers the necessity of rest and acceptance of help to help minimize risk or prevent the escalation of depression.   A Social Worker and a Women’s Wellness Center RN make follow-up phone calls within 2 weeks of discharge to discuss coping techniques, support available, and offer a monthly postpartum depression support group. Since implementing the program, 3 percent of new mothers have been identified as high risk for postpartum depression. By using the EPDS after delivery, those at high risk for developing postpartum depression were able to obtain appropriate follow-up care. By getting these mothers into treatment programs and/or community programs sooner, the experience of motherhood can be restored as previously imagined.  Work is still in progress to ensure that high risk mothers are taking the Edinburgh Postnatal Depression Scale again at 2 and 6 weeks after delivery at primary care givers’ offices.