Detection and care practices for postpartum depressive symptoms in public‐sector obstetric units in Mexico: Qualitative results from a resource‐constrained setting

Abstract

Critical needs in obstetric units include formal mental health care detection and care protocols during the perinatal period, strategies to address mental health needs despite short hospital stays, and training for providers on how to implement detection and care protocols and strategies.

Sensitivity and specificity of the three Whooley and Arroll questions for detecting perinatal depression in Mexican women

“…[18][19][20] This may be due to the lack of adequate tools at the primary care level for accurately identifying women at risk of depression, 21 since the extremely high demand for health services prevents professionals from conducting lengthy diagnostic interviews. 22 Although there are several instruments for detecting perinatal depression in primary care settings, including the Edinburgh Postnatal Depression Scale (EPDS), 23 validated in Mexico by Juárez et al 24 and by Alvarado-Esquivel et al, 25 and the Center for Epidemiological Studies Depression-Scale (CES-D), 26 validated in Mexico by Lara and Navarrete, 27 these screening scales are not routinely used at healthcare centers. Among the reasons for not using them are the fact that, although there is an official standard for the detection of perinatal depression, it is not put into practice, since doctors prefer to ask a general question about their patients' emotional state if they find any abnormal physical symptoms.…”

Depressive symptoms during pregnancy and postpartum: a prospective cohort study

“…PPD is a debilitating disorder that can affect not only maternal function and overall health but also the health of the infant and the entire family . The negative effects of PPD include poor self‐care, malnutrition, noncompliance with prenatal care, higher rates of tobacco and alcohol use, pregnancy‐related complications such as early gestational age at birth and low birth weight, impaired mother‐infant attachment, lower rates of breastfeeding, marital discord, and poor parenting .…”

“…However, PPD is still considered as one of the health problem which remains underdiagnosed and untreated in many countries, possibly because the postpartum period in which PPD symptoms arise marks a time away from healthcare personnel at the new mother's home. Many women may be unaware of symptoms of PPD or feel guilty of having depressive feelings at a time when they believe that they should be happy, and consequently, they may tend to conceal those symptoms . Screening for perinatal depression is now considered to be standard in many settings, and in Turkey, the Postnatal Care Management Manual states that new mothers need to be questioned about their psychological state .…”

“…8 PPD is a debilitating disorder that can affect not only maternal function and overall health but also the health of the infant and the entire family. [9][10][11] The negative effects of PPD include poor self-care, malnutrition, noncompliance with prenatal care, higher rates of tobacco and alcohol use, 11,12 pregnancy-related complications such as early gestational age at birth and low birth weight, 13,14 impaired mother-infant attachment, 14,15 lower rates of breastfeeding, marital discord, and poor parenting. 11,12 However, PPD is still considered as one of the health problem which remains underdiagnosed and untreated in many countries, 7,16 possibly because the postpartum period in which PPD symptoms arise marks a time away from healthcare personnel at the new mother's home.…”

“…Many women may be unaware of symptoms of PPD or feel guilty of having depressive feelings at a time when they believe that they should be happy, and consequently, they may tend to conceal those symptoms. 10,17 Screening for perinatal depression is now considered to be standard in many settings, 1,10,11,18 19 According to the manual, follow-ups of the new mothers should be at the 1st week (5th-7th days) and between 5 and 6 weeks (30 th -42 nd days) of the postpartum period.…”