Investing in Maternal and Infant Mental Health: Screening for postpartum depression by Preventive Child Health Care

One in 10 women will experience a depression after childbirth, also known as postpartum depression (PPD). This PhD study investigated whether the use of the Edinburgh Postnatal Depression Scale (EPDS, a screening questionnaire aimed at identifying PPD) by preventive child health care helps to improve health outcomes for mother and child. We also examined the impact of PPD on health care utilization of mother and child, and maternal labor force participation. In addition, we investigated whether the EPDS can also be used to identify anxiety symptoms after childbirth, and the similarities and differences between the risk factors for depression and anxiety after childbirth.
Screening by preventive child health care 1, 3 and 6 months after delivery results in better outcomes for mothers. Mothers have less depressive symptoms, more confidence in their own parenting skills, less anxiety symptoms and a better general mental well-being. We found no measurable effect of screening for PPD on the social-emotional development of the children at the age of 1 year. This requires further research.
A limited number of mothers with PPD appear to receive care for their PPD symptoms. In addition, mothers with PPD make more use of general care, both for themselves and for their child. Also, mothers with PPD are significantly more absent from work. Screening for PPD therefore helps mothers and reduces the social costs of PPD, in terms of work and care use. This calls for a national implementation of this screening, and optimization of the care path after screening. Furthermore, we need to consider how anxiety can best be detected. With limited investments, we can contribute greatly to reducing PPD and thus increase the well-being of mothers and their children.