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Policy

Early Head Start staff will provide pregnant women and other family members, as appropriate, with prenatal education on postpartum recovery, including maternal depression.

Procedure

Depression Screening

  1. All pregnant women and for those who give birth to a child while enrolled in EHS (0-24 months post partum) will be screened using the Edinbaugh Postnatal Depression Scale during a home visit. Women will be screened one time per month for nine months and as needed thereafter. Screening results as well as referrals [WellMama or Mental Health Provider] will be documented in WebCAF. Follow the Depression Screening and referral flow chart.

The EPDS was developed for screening postpartum women in outpatient and home visiting settings. It has been utilized among numerous populations including U.S. women and Spanish speaking women in other countries. The EPDS consists of 10 questions. The test can usually be completed in less than 5 minutes. Responses are scored 0, 1, 2, or 3 according to increased severity of the symptom. Items marked with an asterisk (*) are reverse scored (i.e., 3, 2, 1, and 0). The total score is determined by adding together the scores for each of the 10 items. Validation studies have utilized various threshold scores in determining which women were positive and in need of referral. Cut-off scores ranged from 9 to 13 points. Therefore, to err on safety’s side, a woman scoring 9 or more points or indicating any suicidal ideation – that is she scores 1 or higher on question #10 – should be referred immediately for follow-up. Even if a woman scores less than 9, if the clinician feels the client is suffering from depression, an appropriate referral should be made.

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The Promoting Maternal Mental Health During Pregnancy Program is designed to assist the pregnant woman in moving beyond the physical dimensions of pregnancy by addressing the emotional and psychological challenges new mothers face, including post-partum depression, unresolved grief or loss and other mental health disruptions. This program includes the normal, typical course of pregnancy, high-risk pregnancies, domestic violence, pregnant women with unresolved grief or loss, and those women experiencing depression or other mental health disruptions. Promoting Maternal Mental Health During Pregnancy covers issues critical to the development of the early mother-child relationship including:

  1. Bonding of parent to child
  2. Attachment of child to parent
  3. The importance of early brain development
  4. The role that emotionally available and attentive care giving play in the child’s emotional and cognitive development

Home Visitors/Teachers can use this curriculum to supplement the Healthy Babies – Prenatal Curriculum.

Meets Performance Standard(s): 1304.40(c)(1)(iii) and 1304.40(c)(2)

Policy Council approved April 2010. October 2010. August 2012
Updated September, 2010
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