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Depression is very common in women, especially in women of reproductive age. It is estimated that 14%-23% of pregnant women experience depression during pregnancy, and 5%-25% experience depression postpartum.
Ob-gyns, physicians whose primary responsibility is women’s health, can screen women for depression and postpartum depression and help manage its impact on pregnancy.
Here are the key publications and resources for ob-gyns, other women’s health care providers, and patients from the American College of Obstetricians and Gynecologists (ACOG) and other sources.
Resources for Ob-Gyns and Women’s Health Care Providers
Resources for Women and Patients
External Screening Tools
Resources for Ob-Gyns and Women’s Health Care Providers
Committee Opinion: Screening for Perinatal Depression
“Screening for Perinatal Depression,” issued by ACOG in May 2015, concludes that pregnant women should be screened at least once during the perinatal period for depression. Women with risk factors for postpartum depression, including a prior history of depression or anxiety, should be monitored more closely. Although there is limited evidence for the benefit of screening, the consequences of unrecognized and untreated perinatal depression or other perinatal mood disorders can be severe. Several screening tools are discussed and evaluated. Practices should have a referral process in place for women who may require follow-up and treatment.
Practice Bulletin: Use of Psychiatric Medications During Pregnancy and Lactation (members only)
“Use of Psychiatric Medications During Pregnancy and Lactation,” issued by ACOG in April 2008 (reaffirmed 2016), reviews the risks and benefits of treatments for psychiatric illnesses such as depression and anxiety during pregnancy. Medications including selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), and benzodiazepines are reviewed.
Work Group Report: The Management of Depression During Pregnancy: A Report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists (members only)
“Management of Depression During Pregnancy: A Report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists,” issued by ACOG in September 2009 (reaffirmed 2014), addresses the risks of both depression and antidepressant exposure to pregnant women and their babies, and provides guidance on treatment of pregnant women with depression. It concludes that research on the use of antidepressants during pregnancy shows a possible impact on pregnancy outcomes, but the studies have not been able to control for other factors that might be at play.
Coding for Perinatal Depression
Access a list of ICD-10 codes for perinatal depression.
Committee Opinion: Optimizing Postpartum Care
“Optimizing Postpartum Care,” issued by ACOG in June 2016, emphasizes the importance of postpartum care, including proactive formulation of a postpartum care plan and a full assessment of psychological, physical, and social well-being. Early follow-up may be beneficial for women at high risk of complications such as postpartum depression.
ACOG’s Opioids Resource Page
The Opioids Resource Page lists key resources to help providers and patients, including pregnant women, together carefully weigh the risks and benefits when making decisions to initiate opioid treatment.
Resources for Women and Patients
Patient FAQ and Patient Education Pamphlet: Postpartum Depression
“Postpartum Depression,” issued by ACOG in December 2013, discusses the difference between postpartum blues and pospartum depression. It covers the signs, symptoms and causes of postpartum depression, when to seek treatment from a health care provider and the use of antidepressants and talk therapy.
Patient FAQ and Patient Education Pamphlet: Depression
“Depression,” issued by ACOG in June 2012, provides women with information on depression, including causes, signs and symptoms, and treatment options including talk therapy and antidepressants.
Centers for Disease Control and Prevention (CDC)
The CDC has a feature on maternal depression which focuses on depression among women before, during, and after pregnancy. It also includes resources that can help.
Massachusetts Child Psychiatry Access Project
The Massachusetts Child Psychiatry Access Project (MCPAP) created the MCPAP for Moms toolkit to assist front-line perinatal care providers in the prevention, identification and treatment of depression and other mental health concerns in pregnant and postpartum women. MCPAP for Moms, a Massachusetts program, has many national aspects and can serve as a model for many other states to help providers help women with perinatal depression.
National Child and Maternal Health Education Program
The NICHD’s National Child and Maternal Health Program (NCMHEP) created a national campaign Moms’ Mental Health Matters Initiative to educate consumers and health care providers about who is at risk for depression and anxiety during and after pregnancy, the signs of these problems, and how to get help. ACOG is a member of NCMHEP’s Coordinating Committee.
Maternal Mental Health: Perinatal Depression and Anxiety Patient Safety Bundle
This patient safety bundle from the Council on Patient Safety in Women’s Health Care can help facilitate the standardization of processes around screening for, responding to, and reporting perinatal depression and anxiety.
Patient, Family, and Staff Support after a Severe Maternal Event Patient Safety Bundle
This patient safety bundle from the Council on Patient Safety in Women’s Health Care can help facilitate the standardization of processes around supporting patients, their families (including non-family support), and staff after a severe maternal event.
Screening for Postpartum Depression
Maintenance of Certification (MOC) Part IV module is optional and requires American Board of Obstetrics and Gynecology (ABOG) login information. This module requires you to review 10 postpartum charts.
Substance Abuse and Mental Health Services Administration Patient health questionnaire (PHQ-9)
This patient questionnaire can be used to aid in the evaluation of depressive symptoms and diagnosis of a depressive disorder.
UCSF Fresno Center for Medical Education and Research Edinburgh Postnatal Depression Scale (EPDS)
This questionnaire can be used to help evaluate pregnant women and women who have recently given birth.
U.S. Preventive Services Task Force Final Recommendation Statement on Depression in Adults: Screening
The USPSTF recommends screening for depression in the general adult population, including pregnant and postpartum women.
American Psychiatric Association
American Psychiatric Association is the world’s largest psychiatric organization. Its member physicians work together to ensure humane care and effective treatment for all persons with mental disorders, including depression.
Postpartum Support International
Postpartum Support International (PSI) works to increase awareness among public and professional communities about the emotional changes that women experience during pregnancy and postpartum. It has volunteer coordinators in every one of the United States and in more than 36 other countries. Support Helpline: 1-800-944-4PPD (4773)
2020 Mom Project
The 2020 Mom Project is a national call to action that sets forth an aggressive new path for solving what some have called one of the biggest public health concerns of our time: the silent maternal mental health crisis which impacts up to 20% of expecting and new moms.
National Alliance on Mental Illness
NAMI is the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness.
MGH Center for Women's Mental Health
The Center for Women’s Mental Health at Massachusetts General Hospital provides state-of-the-art evaluation and treatment of psychiatric disorders associated with female reproductive function.
Center for Women’s Mood Disorders
The UNC Center for Women’s Mood Disorders provides evaluation and treatment of women with mood disorders that occur during periods of hormonal change.
Women and Infants
Care New England’s Health System’s Center for Women’s Behavioral Health specializes in outpatient care for a wide range of behavioral health issues, including mood and anxiety disorders during pregnancy and the postpartum period.
Substance Abuse and Mental Health Services Administration
SAMHSA is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA's mission is to reduce the impact of substance abuse and mental illness on America's communities.