Use of the Postpartum Depression Screening Scale in a collaborative obstetric practice.

Postpartum depression is a clinical depressive episode that occurs in 13% to 20% of women after birth or miscarriage. This illness has potentially devastating consequences for both mother and infant, and is thought to be highly underreported and under-diagnosed. Our study examined the use of the Postpartum Depression Screening Scale (PDSS) in a high-volume collaborative obstetric and midwifery practice. The prevalence of women with a positive screen for major postpartum depression in our study was 16%, which is consistent with other studies. An additional 20% of the participants had symptoms that indicated a potential postpartum depression. Obstetric clinicians were willing to use the PDSS, and 15 of 20 clinicians actively participated in the study. Women who had a positive screen at 6 weeks after birth were more likely to have not completed a high school education, be unpartnered, be exclusively bottle feeding, and have a history of depression. Two variables were statistically significant predictors of screening positively with the PDSS following logistic regression: history of depression (risk ratio, 4.8; 95% confidence interval, 4.4-5.2) and exclusive bottle feeding (risk ratio, 2.0; 95% confidence interval, 1.6-2.4).