Assessment and Interventions for Perinatal Depression.

As per the Registered Nurses’ Association of Ontario: 

Nurses, health organizations and parents now have the latest evidence-based recommendations to help them with a mental health illness that is prevalent, and yet largely undetected and untreated.

Perinatal depression (a term used to describe depression that can occur before or after childbirth) is one of the most common illnesses experienced by women who are pregnant or postpartum. Research shows that between 10 and 14 per cent of women develop some type of mood disorder as result of pregnancy. Symptoms can include: frequent crying, trouble sleeping, fatigue or low energy levels, changes in appetite, increased anxiety, and difficulty feeling a connection with a developing baby or child. Unlike the so-called baby blues, which is considered normal, the symptoms of those experiencing perinatal depression are much more serious and last for more than a few weeks.

The focus of this guideline is on the screening, assessment, prevention, interventions and evaluation of persons with depression symptoms during pregnancy and in the first year following childbirth.

The guideline was developed using a systematic review of evidence and consultation with a interdisciplinary 14-member panel led jointly by Dr. Angela Bowen and Dr. Phyllis Montgomery, a professor of nursievng at Laurentian University in Sudbury. Their work was supported by RNAO’s guideline research and development team, which has produced 54 best practice guidelines being implemented in Ontario and around the world.

Guideline recommendations are provided at the following three levels:

  • Practice Recommendations relate to the screening and assessment of depression symptoms and include the implementation of effective preventive and non-pharmacological treatment interventions, including those focusing on psychosocial and psychological supports.
  • Education Recommendations include ongoing professional development to enhance nurses and the interprofessional team’s knowledge and skills in mental health services and supports for perinatal depression.
  • Organization and System Policy Recommendations have been developed to address the importance of comprehensive and coordinated mental health services and supports for perinatal depression to support care strategies provided by nurses and the interprofessional team.

The following research questions were established to guide the systematic review:

  1. In the area of perinatal mental health, what are effective screening and assessment strategies for identifying symptoms of depression during pregnancy and postpartum for up to one year after childbirth?
  2. In the area of perinatal mental health, what are effective interventions for persons experiencing depression during pregnancy and postpartum for up to one year after childbirth?
  3. What education and training in perinatal depression are required to ensure the provision of effective assessment and interventions among nurses within the scope of their practice?
  4. How do health-care organizations and the broader health-care system ensure optimal prevention, assessment, and interventions for perinatal depression?