Experiences with the routine use of the Edinburgh Postnatal Depression Scale from health visitors' and midwives' perspectives - An exploratory qualitative study

Background: The Edinburgh Postnatal Depression Scale has been practiced as a routine screening for postnatal depression at a municipal health care centre for more than ten years. Objectives: The aim of this study was to examine how health visitors and midwives perceive and practice this routine screening. Study design: We chose an exploratory qualitative approach, with analysis of data from focus group interviews. Methods: Ten health visitors and two midwives participated in two focus group interviews by sharing their thoughts and reflections. The analysis was performed in collaboration with all authors according to thematic network analysis. Findings: The Edinburgh Postnatal Depression Scale is well accepted as a screening tool. In addition to giving health visitors and midwives information about mothers who need special attention concerning mental health challenges, the Edinburgh Postnatal Depression Scale is a tool for talking about problems related to early motherhood. A trusting relationship is a prerequisite for these conversations. The health visitors seldom use the word 'depression' in contact with the individual mother. They sometimes lose opportunities to identify mothers in need of help because of a tight time schedule and social and cultural factors. Collaboration on a daily basis with colleagues and family therapists, and monthly guidance from mental health professionals are necessary to secure professional quality and confidence. Conclusion: The Edinburgh Postnatal Depression Scale is a useful screening tool, but there are social and cultural challenges, and the available time during screening consultations is often too short. Collaboration with and guidance from other professionals are necessary.