There has been a great deal of confusion and misinformation around the concept of mandated screening for perinatal mood disorders. Who is mandated to offer screening? And are mothers required to receive it?
The answer is, there is no law in any state or federal bill that mandates mothers to receive screening for postpartum depression. While New Jersey has a law mandating health care facilities to offer screening to new mothers prior to discharge, mothers are not required to receive it. There is no such law in any state in the union. As with any other medical test, the patient must consent to participate.
But think about it for a moment. There is no controversy around other screenings for illnesses which are common in pregnancy and in the postpartum such as suspected gestational diabetes or hypertension. So why has screening for perinatal mood disorders become such a debated issue?
We are right up against our old nemesis "The Motherhood Myth", for one. Secondly, health care providers with an obstetrical or pediatric specialty do not necessarily want to be in the business of mental health. And third, we still need appropriate referral resources so that a continuum of care is offered to each mother who may accept the screening and find that further evaluation is needed.
While the majority of mothers will maintain health and enjoyment throughout their pregnancy and beyond, those who suffer from perinatal mood disorders will experience a despair which is amplified by unawareness. If no one told them that such illnesses exist - which is still all too common - these women will be left in an isolating hell of self-doubt and recrimination that will seriously undermine their maternal experience... and could compromise their infants very first human relationship.
No mother wants to be depressed or anxious. But women during the reproductive years are often highly motivated to consider optimal self-care and address longstanding health issues as they prepare to parent their babies.
Primary prevention is the very best method we have to identify, moderate, reduce or eliminate the incidence or likelihood of a perinatal mood disorder.
Tests like the Edinburgh and Beck postnatal depression screening scales are not diagnostic; rather they are suggestive that further evaluation is needed. Neither the screening scale or subsequent professional evaluation are mandatory anywhere. But why we would discourage women from availing themselves of these potentially life-saving instruments lacks any reasonable basis.