Purpose and scope
The purpose of this best practice guideline (BPG) is to present evidence-based recommendations for nurses and the interprofessional team across all care settings to enhance the quality of their practices to support the reduced incidence of perinatal depression through the implementation of five components of care: routine screening, assessment, prevention, coordinated interventions, and evaluation.
The scope of this BPG recognizes perinatal depression as the most commonly occurring mood disorder during pregnancy and postpartum . Furthermore, while recognition is given to the impact that perinatal depression can have on partners, infants, other children, and families (as defined by the person), the scope of this BPG is limited to the person at risk for or experiencing perinatal depression.
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Registered Nurses’ Association of Ontario. Assessment and Interventions for Perinatal Depression. 2nd ed. Toronto (ON): Registered Nurses’ Association of Ontario; 2018.
Recommendations
Recommendation 1.1: Routinely screen for risk of perinatal depression, using a valid tool, as part of prenatal and postpartum care.
Recommendation 1.2: Conduct or facilitate access to a comprehensive perinatal depression assessment with persons who screen positive for perinatal depression.
Recommendation 2.1: Collaborate with the person to develop a comprehensive person-centred plan of care, including goals, for those with a positive screen or assessment for perinatal depression.
Recommendation 2.2: Implement prevention or early intervention strategies for perinatal depression symptoms to reduce the risk of illness progression.
Recommendation 2.3: Promote self-care strategies for persons at risk for or experiencing perinatal depression including:
- Time for self;
- Exercise;
- Relaxation; and
- Sleep.
Recommendation 2.4: Encourage persons with perinatal depression symptoms to seek support from their partner, family members, social networks and peers, where applicable.
Recommendation 2.5: Provide or facilitate access to psychoeducational interventions to persons at risk for or experiencing perinatal depression.
Recommendation 2.6: Provide or facilitate access to professionally-led psychosocial interventions, including non-directive counselling, for persons with perinatal depression.
Recommendation 2.7: Provide or facilitate access to psychotherapies, such as cognitive behavioural therapy or interpersonal therapy, for perinatal depression.
Recommendation 2.8: Support informed decision-making and advocate for access to pharmacological interventions for perinatal depression, as appropriate.
Recommendation 2.9: Facilitate informed decision-making regarding the use of complementary and alternative medicine therapies for perinatal depression.
Recommendation 2.10: Evaluate and revise a plan of care for perinatal depression, in collaboration with the person, until goals are met. Include the person’s partner, family, and support network, where applicable.
Recommendation 3.1: Develop educational programs on perinatal depression care incorporating both theory and clinical practice into undergraduate nursing and other allied health professional pre-licensure curricula.
Recommendation 3.2: Participate in ongoing professional development to enhance knowledge and skills in mental health services and supports for perinatal depression.
Recommendation 3.3: Perform regular self-reflection on attitudes and beliefs regarding perinatal depression.
Recommendation 4.1: Implement comprehensive and coordinated mental health services and supports for perinatal depression across communities to support care strategies provided by nurses and the interprofessional team.
