New Developments in Screening and Insurance Coverage for Postpartum Depression

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Motherhood is an adventure that, for all its joys, can also be a struggle. For reasons out of your control, you might feel unlike yourself or unable to cope. And as many moms know, those troubles can arise long before the baby even arrives.

Fortunately, help and support may be just one doctor’s visit away.

The U.S. Preventive Services Task Force (USPSTF) has made strides to improve the safety and care of new and expectant moms with their latest recommendation. The panel of experts is advising that these women should be screened for depression and receive counseling, and insurance companies will likely be obligated to cover it.

The recommendation carries a “B” grade, which is a ranking of importance and priority.

“A’ and ‘B’ recommended screenings are typically covered under primary care insurance and our AdventHealth care teams take this proactive depression screening approach very seriously.

Over 97% of our patients are currently being screened and it's also important to screen reproductive-age women even before they’re pregnant so we can identify who might be at risk. We also screen during pregnancy because a significant number of women who have depression problems during pregnancy also have problems postpartum. We screen in the hospital prior to discharge and the recommendation is to also screen in the first year after birth.

The Spectrum of Perinatal Depression

Perinatal (the time period before and after birth) depression affects as many as 1 in 7 women and is one of the most common complications of pregnancy and postpartum recovery.

People refer to ‘baby blues’ which may include not feeling like yourself, feeling like you’re having trouble managing your emotions or feeling too overwhelmed to take care of yourself, but those things should resolve themselves within the first couple of weeks after delivery.

Contact your doctor if you notice any of the following:

  • feeling intensely anxious
  • experience an inability to complete tasks
  • have mental fog
  • feel disengaged from daily life
  • perform tasks robotically
  • lose interest in things you used to enjoy
  • increased anxiety around your baby or other children
  • have thoughts that feel scary and you can't rationalize away

If you feel even worse than that, like you’re hopeless or despairing or even may hurt yourself or your baby, that’s when you need to seek immediate help. Reach out to your provider, or for truly immediate help, call 911 or go to an emergency room.

Pregnancy, birth and new motherhood cause so many physical, mental and emotional changes and affect each mom in different ways. Dr. Boardman acknowledged that a woman’s obstetrician sees her less as her baby gets older, making it especially important that her entire network of care is trained to screen for symptoms.

The American Academy of Pediatrics has recommended that pediatricians — who are seeing new moms even more frequently than we, as OBs, are — screen the moms they see in addition to caring for the new babies.

Emergency department teams and primary care providers should also be aware of when a woman is in her first year postpartum and be on the lookout for signs and symptoms.

The Importance of Screening at Every Stage

We know that when a mother has untreated depression, it affects more than just her. Any depressed person has a tendency to not seek health care, so the babies of depressed moms are less likely to be seen at their regular wellness visits or get their vaccinations on time. And when the mom is disengaged because of her depression, that baby is missing some valuable nurturing, and those children can have behavioral problems and other issues down the road.

AdventHealth believes in screening early and regularly.

We want to help identify at-risk moms as soon as possible and get them resources and treatment. We even look for things in their own personal and health histories that could be triggers for depression, including a history of abuse.

Being attuned to who your patients are and screening them accordingly reduces the chance that they end up experiencing something more severe. We also really rely on the partners and families of new moms to recognize when something is wrong, so we seek to educate the whole family as much as we can.”

Treating Depression During and After Pregnancy

If your doctor feels you may be at risk for depression during pregnancy or after birth, you’ll find compassionate support and guidance.

We know that counseling works and reduces the likelihood that a patient will experience full-blown postpartum depression.”

Both individual and group settings have found to be effective. Medication such as antidepressants may also be prescribed in more persistent cases.

Improving Processes and Outcomes

The USPSTF also looked at what hospitals can do on a system level to better recognize and care for at-risk patients. Our teams are seeking even more ways to support new and expectant moms.

We’re working with the education team here to see what we can develop when it comes to things like new parent education and group counseling sessions. We want to not only prevent depression but also be able to efficiently identify who may need a higher level of care or additional resources, so our care navigation team will be critical in this effort.

Whatever phase of parenthood you’re in, remember that you always have someone to turn to. If you think you may be experiencing symptoms of depression at any stage, don’t hesitate to tell your primary care provider or OB-GYN.

To learn more about our personalized maternity care services, please visit our website.

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