This section describes screening for depression and anxiety, assessment of psychosocial risk factors and screening for family violence.
Summary of advice for women about social and emotional assessments during pregnancy
Detecting symptoms of depression enables appropriate follow-up
Anxiety, either alone or with depression, is common in pregnancy
Assessment of psychosocial factors aims to identify women who are more vulnerable to mental health conditions during pregnancy
All women are asked about domestic violence during pregnancy to enable access to additional support and care
Key considerations for service provision
Systems for follow-up and support
Before screening and assessment is carried out, systems need to be in place to ensure that appropriate health professionals are available to provide follow-up care if required and to assist if there are concerns for the safety of the woman, the fetus or infant or other children in the woman’s care. Health professionals will greatly benefit from identifying other professionals from whom they can seek advice, clinical supervision or support regarding mental health care in the perinatal period.
Who attends assessment
Women need to feel safe during screening and assessment, so consideration should be given to other people who may be present. While the presence of significant others is often helpful, sensitivity is required about whether it is appropriate to continue with psychosocial assessment while they are in the room. Screening for family violence should only be conducted when alone with the woman.
An explanation of the purpose of screening and assessment should be given before they take place. It is important to stress that this is part of usual care and results will generally remain confidential. If a woman does not consent to assessment and/or screening, this should be explored and documented and assessment and screening offered at subsequent consultations.
It should also be explained that confidentiality may not be kept if there is a perceived risk of harm to the woman or her baby as there is a duty of care for this to be communicated to key others. However, in this situation, only information relevant to the risk will be shared.