Routine screening for postnatal depression in a public health family service unit: A retrospective study of self-excluding women

Abstract

At this time, there is limited scientific knowledge about women who exclude themselves from screening programs for postnatal depression. In this retrospective descriptive study, we have sought to investigate the socio-demographic and psycho-social factors of women who withdraw from PND screening of their own accord. Study participants were 525 women attending antenatal classes who later took part in institutional routine screening for PND at the Consultorio Familiare Service of the National Health Service, Italy. The PND screening program consisted of the completion of the postpartum depression predictors inventory-revised and psychological well-being (PWB) questionnaires within eight to nine months of pregnancy, and Edinburgh Postnatal Depression Scale, GHQ-12 and PWB within six to eight weeks after childbirth. The Responders group was made up of 346 subjects – 65.9% of the total sample – who completed the entire program of screening for PND. The Non-Responders group, on the other hand, consisted of 179 subjects – 34.1% of the total sample – who, after childbirth, withdrew from the screening program. Compared to the Responders group, the Non-Responders group showed a greater number of subjects with marital dissatisfaction, and with unemployment as a stressful event. Health professionals who detect marital dissatisfaction and/or unemployment as a stressful event in pregnant women should bear in mind that these individuals, besides being at high risk for depression after delivery, will also tend to exclude themselves from screening for PND.

Keywords:

• postpartum depression
• postnatal depression
• screening
• EPDS

Acknowledgments

This article is based on a poster presented at the 16th International Congress of the International Society of Psychosomatic Obstetrics and Gynecology, Venezia, Italy, 28–30 October 2010, under the title “Screening for PND in Italy: Self-exclusion by women who use the public health family service.” While the research and analysis are based on data of Azienda ULSS 17 Monselice, Veneto Region, National Health Service, Italy, the opinions expressed do not represent the views of Azienda ULSS 17 Monselice. The authors would like to thank Dr Martina Muraro for data analysis, Donna Wawrykow Spanu for the grammatical and stylistic correctness of the English language, and the Staff of Percorso Nascita, Consultorio Familiare Service of Monselice and Este, Azienda ULSS 17 Monselice.