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Addressing Perinatal Depression

Wednesday, December 29, 2021

Depression during and after pregnancy occurs more often than people may realize. Perinatal depression, a depressive disorder occurring during pregnancy or in the first 12 months after delivery, affects as many as 1 in 7 women1. Health Net Federal Services, LLC (HNFS) wants to make sure you have information and resources to help with patient screening. We offer a new provider toolkit – Pregnancy and Postpartum Care – that includes printable handouts, patient resources and links to evidenced-based provider screening tools. We also offer a Pregnancy and Postpartum Care health topic for your TRICARE patients.   

Why screen for perinatal depression?
It’s important to identify pregnant and postpartum women with depression. Left untreated, perinatal and other mood disorders can have devastating effects, including poor infant care and developmental issues.

The U.S. Preventive Services Task Force states that risk factors for developing perinatal depression include:

  • personal or family history of depression 
  • history of physical or sexual abuse
  • unplanned or unwanted pregnancy
  • current stressful life events
  • pregestational or gestational diabetes
  • complications during pregnancy

In addition, social factors such as low socioeconomic status, lack of social or financial support, and adolescent parenthood have also been shown to increase the risk of developing perinatal depression. 

The American College of Obstetricians and Gynecologists recommends OB/GYNs and other obstetric care providers screen patients at least once during the perinatal period for depression and anxiety symptoms. Well-child visits provide yet another opportunity to screen for postpartum depression. While several screening instruments have been validated for use during pregnancy and the postpartum period, the American Family Physicians recommends the Edinburgh Postpartum Depression Scale or the Patient Health Questionnaire. 

Patients with elevated screening scores should be directed to mental health care providers, as appropriate, for maximum benefit. 

HNFS offers case management services for specific conditions, including maternity management and mental health care. To nominate a TRICARE patient, click on the “Nominate a Beneficiary for Case or Disease Management” link from the Secure Tools box.