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Screening and Treatment Practices of OB/GYN Providers for Postpartum Depression and Anxiety [4L]

Hadley, Emily E., MD; Le, ViDonna, MPH; Swen, Tony; Munn, Mary, MD; Costantine, Maged, MD; Temple, Jeff, PhD

doi: 10.1097/01.AOG.0000533543.82153.c2
Saturday, April 28, 2018

INTRODUCTION: Prevalence of postpartum depression and anxiety is 20% and 4%–10%, respectively. We sought to identify differences in screening practices among providers and barriers to screening in an obstetric clinic system.

METHODS: Cross-sectional survey study was performed on obstetrical care providers including certified nurse midwives, nurse practitioners, and OB/GYN residents practicing in a regional clinic system. Surveys were anonymous and voluntary. The survey inquired about provider's frequency of screening, comfort screening, and treatment for postpartum depression and anxiety along with questions about barriers to screening. Residents and mid-level providers (MLP) results were compared using Pearson χ2 test.

RESULTS: 53/85 (62%) health care providers responded including 33 MLPs and 20 residents. The majority of respondents were female (96%). MLPs were significantly older (P=.001) and more likely Caucasian (P=.04). MLPs and residents reported screening for depression 85% and 70% of the time (P=.39) and for anxiety 59% and 20% of the time (P=.006). Significantly more MLPs reported their clinic utilizes a postpartum depression screen as compared to residents (66% versus 10%, P=.001). Sixty-two percent of providers feel their training prepared them to manage postpartum depression, but only 59% and 31% of providers reported feeling confident treating depression and anxiety, respectively. Lack of translation services is a screening barrier significantly more for resident providers (P=.004).

CONCLUSION: MLPs screen for postpartum anxiety and utilize clinic screening resources more than residents. Results indicate that more postpartum depression and anxiety training should be provided to residents and MLP providers. Translation services are a barrier to screening for some providers.

University of Texas Medical Branch, Galveston, TX

Financial Disclosure: The authors did not report any potential conflicts of interest.

© 2018 by American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.