Table 1:

Recommendations on screening for depression in pregnant and postpartum populations

OrganizationRecommendation
Canadian Task Force on Preventive Health Care (current guideline, 2022)The task force recommends against instrument-based depression screening using a questionnaire with cut-off score to distinguish “screen positive” and “screen negative” administered to all individuals during pregnancy and the postpartum period (up to 1 year after childbirth) (conditional recommendation, very low–certainty evidence).
Canadian Task Force on Preventive Health Care (2013)12For adults in subgroups of the population who may be at increased risk of depression,* we recommend not routinely screening for depression (weak recommendation; very-low-quality evidence).
Registered Nurses’ Association of Ontario (Canada)31Routinely screen for risk of perinatal depression, using a valid tool, as part of prenatal and postpartum care.
US Preventive Services Task Force (United States)10Screening for depression is recommended in the general adult population, including pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up.
UK National Screening Committee (United Kingdom)32A systematic antenatal and postnatal population screening program for mental health problems is not recommended.
National Institute for Health and Care Excellence (England)9
  • At a woman’s first contact with primary care or her booking visit, and during the early postnatal period, consider asking the following depression identification questions as part of a general discussion about a woman’s mental health and well-being: During the past month, have you often been bothered by feeling down, depressed or hopeless? During the past month, have you often been bothered by having little interest or pleasure in doing things?

  • If a woman responds positively to either of the depression identification questions, is at risk of developing a mental health problem, or there is clinical concern, consider using the EPDS or the Patient Health Questionnaire as part of a full assessment or referring the woman to her general practitioner or, if a severe mental health problem is suspected, to a mental health professional.

Scottish Intercollegiate Guidelines Network (Scotland)33Enquiry about depressive symptoms should be made, at minimum, on booking in and postnatally at 4–6 weeks and 3–4 months. The EPDS or the Whooley Questions34 may be used in the antenatal and postnatal period as an aid to clinical monitoring and to facilitate discussion of emotional issues.
Centre of Perinatal Excellence (Australia)35Use the EPDS to screen women for a possible depressive disorder in the perinatal period. Complete the first antenatal screening as early as practical in pregnancy and repeat screening at least once later in pregnancy. Complete the first postnatal screening 6–12 weeks after birth and repeat screening at least once in the first postnatal year. Arrange further assessment of perinatal woman with an EPDS score of 13 or more.
  • Note: EPDS = Edinburgh Postnatal Depression Scale.

  • * Subgroups of the population who may be at increased risk of depression include people with a family history of depression, traumatic experiences as a child, recent traumatic life events, chronic health problems, substance misuse or Indigenous origin.