The impact of a policy of universal perinatal depression screening

Perinatal depression remains a leading cause of maternal morbidity and mortality along with its significant adverse effects on neonatal outcomes, infant attachment, and childhood neurocognitive development. Unfortunately, despite these well-documented risks, a minority of women suffering from perinatal depression receive appropriate care. Research has demonstrated multiple barriers to mental health care service utilization during the perinatal period, but an optimal approach to care has yet to be established. One controversial area within the field of perinatal mental health is that of universal depression screening. Proponents argue that screening is essential given the public health importance of perinatal depression, the relative ease of screening, and the availability of interventions to improve health if depression is identified. Opponents point to the costs and potential harms of screening along with a lack of scientific evidence to support any health benefits. Despite this ongoing debate, the American College of Obstetricians and Gynecologists (ACOG) has recently revised its policy, now recommending for depression screening in the perinatal setting. To ensure continued delivery of quality health care, it is critical that after implementation of any new health policy, the effectiveness of the policy’s implementation is evaluated. The objective of this study is to evaluate the impact of a policy of universal perinatal depression screening. With a policy change advocating for universal perinatal depression screening that preceded but paralleled that of ACOG’s recent guideline change, we are uniquely poised to examine the longitudinal impact of a universal perinatal depression screening policy on screening adherence and mental health service utilization. Results of this study will guide obstetric practice nationwide and will poise SMFM to become leaders in the area of perinatal mental health.