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Practice Recommendations

Prevention:

1.0 Nurses provide individualized, flexible postpartum care based on the identification of depressive symptoms and maternal preference.

2.0 Nurses initiate preventive strategies in the early postpartum period.

Confirming Depressive Symptoms

3.0 The Edinburgh Postnatal Depression Scale (EPDS) is the recommended self-report tool to confirm depressive symptoms in postpartum mothers.

4.0 The EPDS can be administered anytime throughout the postpartum period (birth to 12 months) to confirm depressive symptoms.

5.0 Nurses encourage postpartum mothers to complete the EPDS by themselves in privacy.

6.0 An EPDS cut-off score greater than 12 may be used to determine depressive symptoms among English-speaking women in the postpartum period. This cut-off criterion should be interpreted cautiously with mothers who:

1. are non-English speaking;
2. use English as a second language, and/or
3. are from diverse cultures.

7.0 The EPDS must be interpreted in combination with clinical judgment to confirm postpartum mothers with depressive symptoms.

8.0 Nurses should provide immediate assessment for self harm ideation/behaviour when a mother scores positive (e.g., from 1 to 3) on the EPDS self-harm item number 10

Treatment

9.0 Nurses provide supportive weekly interactions and ongoing assessment focusing on mental health needs of postpartum mothers experiencing depressive symptoms.

10.0 Nurses facilitate opportunities for the provision of peer support for postpartum mothers with depressive symptoms.

General

11.0 Nurses facilitate the involvement of partners and family members in the provision of care for postpartum mothers experiencing depressive symptoms, as appropriate.

12.0 Nurses promote self-care activities among new mothers to assist in alleviating depressive symptoms during the postpartum period.

13.0 Nurses consult appropriate resources for current and accurate information before educating mothers with depressive symptoms about psychotropic medications

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