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When one considers that every year in the United States approximately 6 million pregnancies occur and that up to 20% of women develop postpartum depression, the far reaching implications of this devastating illness are readily apparent. However, in many areas women are not routinely screened for postpartum depression even though there is documented evidence of the potential for negative implications for the mother, infant, and family. The National Guideline Clearinghouse, which provides evidence-based practice guidelines, strongly supports identification and screening for depressive symptoms in the postpartum period. They also support postpartum depression education for all nurses who provide care to new mothers.

Unfortunately, all women are not routinely screened for postpartum depression. This is compounded by the fact that hospitals providing obstetrical services, often do not provide detailed patient education related to postpartum depression.  

Recognizing the need to provide comprehensive postpartum care to women in our community, a postpartum depression education and screening project was developed and implemented in a large Midwest metropolitan region. The goals for this project were to increase the awareness of postpartum depression and to incorporate screening into routine postpartum care. This would allow earlier recognition and treatment of postpartum depression optimizing mother, baby, and family wellness.

The project received overwhelming support by both local hospitals, which together average approximately 420 deliveries per month. This support was mirrored in the obstetrical out-patient community as over 70% of the obstetrical practices agreed to participate in the project. The community based project had three distinct components. The first component of the project involved the development of a postpartum depression patient education guide. This guide was developed and adopted by two large metropolitan hospitals to be included in all postpartum patient discharge packets. The information is reviewed with all patients prior to discharge, offering an opportunity for further discussion or questions. The second component was implementation of staff development training for the nurses involved in mother/baby care at both hospitals. The content included in staff development training included postpartum depression  definition, signs and symptoms, incidence, risk factors, negative consequences, evidence based practice guidelines, and nursing’s role in patient education. Approximately 250 nurses completed the postpartum depression education. A computer-based education module and written materials were developed to facilitate the training process.

Building upon the commitment to improve postpartum depression screening, the third aspect of the project branched into area out-patient obstetrical practices. Eight of eleven obstetrical practices in the metropolitan region adopted the EPDS screening instrument for postpartum depression to use at the 4 to 6 week postpartum visit.

Implementation of the postpartum depression screening and education program began in May 2009 and has continued to receive overwhelming support within the regional healthcare community. This presentation will review strategies used to implement a community based postpartum depression education and screening program which could be adapted to benefit women in other communities.