Going to the doctor while you’re pregnant can seem like a never-ending round of tests. Everything seems to get poked, pricked, prodded and measured—except one. Few obstetrical care experts screen new and expectant mothers for anxiety and/or depression. This is surprising because warning signs for postpartum depression are often detectable during pregnancy and a great deal can be done to reduce, or even prevent, flare-ups after delivery.
Thanks to COPE (Centre for Perinatal Excellence), Australia has just issued new perinatal mental health guidelines. They are based on the best scientific evidence and represent the highest standard of care. Everything a clinician should do to care for the emotional health of pregnant and new mothers is included in these guidelines.
As an external reviewer for the guideline, I was thoroughly impressed with the background research that was done and the recommendations that were made. Here are some highlights:
· All pregnant women and new mothers should be screened for anxiety and depression.
· Mothers should be checked for risk factors that might make them more vulnerable to depression or anxiety, including having anxiety or depression in the past, experiencing difficulties with your partner, not having at least one meaningful relationship that offers support, having experienced high stress in the past year.
· On the preventive front, healthy diet, physical activity, mindfulness and relaxation practices, and social support (having a friend!) can help women stay emotionally healthy during pregnancy and postpartum.
· On the treatment side, there is enough scientific evidence now to recognize online therapies as legitimate forms of help. Some that I’ve found to have the best evidence include MoodGym, MyCompass, and ThisWayUp.
· As in the previous version of the guideline, recommendations are given for the 5-8 percent of women who may benefit most from antidepressants.
Bottom Line: Few doctors and nurses in North America offer anxiety and depression screening as part of regular prenatal or new mother care. Here are four questions that you can ask yourself. If you say “yes” to any one of these questions, please speak to your health-care provider and share your responses.
1. During the past month, have you often been bothered by feeling down, depressed or hopeless?
2. During the past month, have you often been bothered by little interest or pleasure in doing things?
3. Over the past two weeks, have you been bothered by feeling nervous, anxious or on edge?
4. Over the past two weeks, have you been bothered by not being able to stop or control worrying?