Australian midwives' awareness and management of antenatal and postpartum depression

Background: The detection of maternal depression can be improved with routine screening. This practice is expected to be integrated into midwifery practice under the Australia National Perinatal Depression Initiative. Research objective: To describe midwives' self-reported practice in caring for women suffering from antenatal and postpartum depressive symptoms; and assess midwives' ability to detect depression and their knowledge of therapeutic interventions for depressive symptoms in childbearing women. Method: Using a descriptive cohort study design, a postal survey was sent to all members of the Australian College of Midwives (n = 3000). The survey consisted of items drawn from beyondblue's "National Baseline Survey - Screening Evaluation Questionnaire'' and questions relating to a hypothetical case study of a depressed woman "Mary'' developed by Buist et al.(25) Findings: A total of 815 completed surveys were received. 69.1% of midwives reported screening for antenatal and postpartum depression using instruments such as the Edinburgh Postnatal Depression Scale. Time constraints were perceived as the major barrier to effective emotional care. 63.3% of midwives correctly recognised depression in the case study and 82.4% reported that "Mary'' required assistance. Antidepressants were more likely to be recommended postnatally (93.2%) than antenatally (61.5%) by midwives. Conclusions: Further training is required to ensure midwives' competency in psychosocial assessment and management of women experiencing antenatal and postpartum depression. Systemic issues (e.g. time constraints) encountered by midwives need to be addressed to support the delivery of effective emotional care to childbearing women. (C) 2011 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.