Scenario
Natalie is a 32-year-old woman who delivered a healthy baby girl 12 weeks ago after previously experiencing a stillbirth two years earlier. Although she initially felt joyful and supported, she has recently become withdrawn, anxious, and burdened by guilt that her daughter survived while her son did not. She continues breastfeeding but feels emotionally disconnected from her baby.
Since delivery, her only medical visits have been routine postpartum and pediatric appointments, during which her mental health was not assessed. With no prior psychiatric history and concerns about stigma—reinforced by family comments that she should have “recovered” by now—Natalie has sought help from a psychiatric mental health nurse practitioner due to worsening low mood and anxiety.
Appropriate Resources from Postpartum Support International
For Natalie, who has been diagnosed with perinatal depression, the Edinburgh Postnatal Depression Scale (EPDS) may be an appropriate screening tool at the first visit. The EPDS is a widely used screening tool for depression in postpartum women (Levis et al., 2020). A combination treatment including psychotherapy and pharmacotherapy may be appropriate for the treatment of Natalie, who suffers from postpartum depression. Psychotherapy, such as cognitive behavioral therapy (CBT), can help Natalie identify and change the negative thoughts and behaviors associated with her depression (Chand et al., 2022). Pharmacotherapy, such as antidepressants, may be recommended if Natalie’s symptoms of depression are severe or prolonged.
PMHNP can use the following strategies:
- Education and awareness: the PMHNP can provide Natalie with information about depression after childbirth and its prevalence. She can explain that depression after childbirth is a medical condition, not a weakness or failure, and that many women experience it.
- Community support and matching: PMHNP can help Natalie find a support group for women with postpartum depression or other mothers who are going through similar experiences. Participating in such a group can help Natalie feel less isolated and realize that she is not alone in her struggles.
Find Help is one resource on the Postpartum Support International website that is suited for Natalie. This article lists mental health professionals who specialize in postpartum depression and other maternity-related mental health issues. Natalie can also benefit from Online Support for Moms. She’ll discover online support groups, forums, and chat rooms where she can share her thoughts and seek advice from other women going through similar experiences. This is especially beneficial for Natalie, who feels lonely and distant from her kid.
Collaboration Strategies for Effective Mental Health Screenings
To improve maternal mental health outcomes, the following strategies can be used to collaborate with providers in the community:
- Provider training: Collaborate with physicians, midwives, and other health care providers to provide them with updated information about postpartum depression and other mental health disorders, and train them in the use of screening tools. This will help increase providers’ awareness and confidence in detecting and treating mothers in need of mental health support.
- Integrate screening into routine practice: Collaborate with mental health providers and health facilities to integrate screening for maternal mental health disorders into routine practice. The use of standardized screening tools, such as the Edinburgh Postnatal Depression Scale (EPDS), can help identify and provide early intervention when needed.
References
Chand, S. P., Kuckel, D. P., & Huecker, M. R. (2022). Cognitive Behavior Therapy (CBT). StatPearls Publishing.
Levis, B., Negeri, Z., Sun, Y., Benedetti, A., & Thombs, B. D. (2020). Accuracy of the Edinburgh Postnatal Depression Scale (EPDS) for screening to detect major depression among pregnant and postpartum women: systematic review and meta-analysis of individual participant data. BMJ, 371(371).