BEYOND THE BLUES:
The Effectiveness of Postpartum Depression Tools and Maternal Education

Beyond the Blues:
The Effectiveness of Postpartum Depression Tools and Maternal Education
The birth of a baby can trigger a vast array of powerful emotions: from joy to fear and excitement to anxiety. But it can also result in something that most new mothers don’t expect – post partum depression (PPD). According to the American Psychological Association, (2014), PPD is a moderate to severe depression that may occur soon after delivery or up to a year later. An estimated 9-16% of new mothers will develop PPD and the prevalence rate increase to 41% in mothers who have experienced PPD in a previous pregnancy. Unfortunately, not all the cases are recognized and many new mothers go through this alone without a proper diagnosis or treatment. This can lead to health risks for both the postpartum mother and the child and can even cause permanent negative effects on child development. Maternal depression can lead to serious health risks for both the mother and infant, increasing the risk for costly complications during birth and causing long-lasting or even permanent effects on child development and well-being as well as significant lifetime consequences on women (NIHCM, 2010) Given the prevalence and significant consequences it is imperative that healthcare providers educate new mothers about PPD and use the appropriate screening tools to screen for PPD.

Clinical Experience and PICOT Question
During my medical surgical rotation last semester I came across two patients who I developed a relationship with. I had told them both that I was interested in working with children and both revealed to me that they had suffered from PPD after the birth of their first child. Neither of the moms had been screened for PPD and were only briefly told of the symptoms of PPD and to contact their healthcare provider if they were experiencing any of those symptoms. Hearing these women’s’ stories made me question whether maternal education was effective in preventing PPD or if the use of PPD screening tools was more effective. Hence, my picot question became: In postpartum women, are the use of depression screening tools more effective than maternal education in preventing and treating postpartum depression? I did not include a timeframe because I am comparing two interventions with each other, not necessarily over a fixed amount of time. The population of this study is postpartum women. The intervention is the use of depression screening tools. The comparison intervention is maternal education. The outcome is preventing and treating postpartum depression.

Literature Search
I began my literature search by using the following nursing and health databases on the USF Gleeson Library: CINAHL and PubMed. I also utilized Google Scholar. I used the key words “postpartum depression”, “postnatal depression”, “screening tools”, “maternal education”, “teaching” and “prevention”. Many articles that I found were focused on the various screening tools being used in the US as well as internationally. However, most studies I found discussed only the different screening tools used to screen for PPD, only a limited amount focused on education. It was very difficult to find any articles that discussed both the use of screening tools and maternal education. Trying different filters did not yield better results. I came across one or two articles focusing on both interventions but the studies were very old and did not relate to my PICOT question enough. After careful review I decided to choose the following three articles to try and answer my PICOT question.

Rapid Analysis
Article 1.
The first article, “Screening tools for postpartum depression: validity and cultural dimensions” is not really a systematic review but a literature review. I still decided to use the systematic review appraisal form when critiquing the study. It compared the four main postpartum screening