Your body and mind go through huge changes during and after pregnancy.
Many women expect to have the ‘baby blues’ after birth, but when those feelings remain, beyond the early days, it might be a sign of postnatal depression (PND).
You might be worried or even scared about having PND and not knowing what to do.
The most commonly used screening tool is the Edinburgh Postnatal Depression Scale (EPDS).
It’s accessible to all women. You can find it online or talk to your health care provider.
This article looks at what the Edinburgh Postnatal Depression Scale is, and how to take the test.
Who created EPDS?
The Edinburgh Postnatal Depression Scale was developed in Scotland in 1987, as a means to detect postnatal depression in women.
The authors of the EPDS had first-hand experience of the devastating impact of postnatal depression on women and families.
They designed the screening tool to be useful for health professionals and accessible to the women taking it.
What is the purpose of the Edinburgh Postnatal Depression Scale?
The EPDS is a tool used to screen women for symptoms of emotional distress, during pregnancy and in the postnatal period.
The scale isn’t a diagnostic tool, but it helps health care professionals decide whether postnatal depression is a factor, and if referral to a mental health specialist is needed.
What exactly is the EPDS tool?
The Edinburgh Postnatal Depression Scale is a questionnaire of 10 questions with multiple-choice answers.
It focuses mainly on the past week of the woman’s life. Questions are asked about emotions and feelings in daily life, and the answers cover a range – from total agreement (‘Yes, it happens very frequently’) to complete disagreement (‘Not at all; this question doesn’t apply to me’).
It’s not diagnostic, but helps build a picture of what is happening.
The purpose of the EPDS is to discover whether a woman meets the criteria for developing postnatal depression, or is at risk of developing depression if no action is taken.
When should EPDS be done?
Ideally, women should complete the Edinburgh Postnatal Depression Scale (EPDS) questionnaire at least once during pregnancy and again in the 6-12 weeks after birth.
Some health professionals believe the EPDS should be done at least twice, both in pregnancy and postnatally, to ensure those who most need support will get it.
The fact the EPDS is not diagnostic, and relates to only the previous seven days should be clearly explained to the person having the screen.
Interpreting EPDS scores
Your doctor must use clinical judgment to interpret your score, as sometimes it doesn’t accurately represent a person’s mental and emotional health.
Clinical judgment refers to the way your doctor or midwife understands the problems or concerns happening for you.
They might be aware, for example, that you have little family support, or your baby was in special care for some time after birth.
These concerns can play a part in how your mental health is now. You might have a low score on the screening tool, even though your doctor believes you’re experiencing symptoms of depression.
A very high score suggests a crisis or other mental health problems.
The score can be influenced, however, by your understanding of the purpose of the screen. Many women worry about the consequences or stigma if postpartum depression is diagnosed.
Language barriers and socio-economic factors also affect the score.
How accurate is the Edinburgh Postnatal Depression Scale?
Postnatal depression can’t be simply measured by its symptoms like a physical illness. There’s more than just one symptom of depression and some people can experience it differently from others.
Mental health screening, however, is a useful tool to build a picture of what women are experiencing. It’s possible to identify those who have symptoms that indicate they’re suffering from postpartum depression.
How to read EPDS scores
The Edinburgh Postnatal Depression Scale (EPDS) asks 10 questions which are scored depending on the answer given.
If you take the EPDS during pregnancy, a total score of 13 or more suggests possible depression, and you will have a repeat EDPS in 2-4 weeks.
If the second score is also 13 or more, then you will be referred to a health professional for depression during pregnancy.
If you have a score of 13 or more in the postnatal period, you should seek support and guidance from your doctor or midwife.
They can take into account the wider picture of your life and refer you for ongoing support if they suspect you have postnatal depression.
It’s important to remember that having a high score doesn’t mean that you’re not a good parent. Seeking support and help for postnatal depression is the ultimate act of self-care and care for your family.
Where can I take the Edinburgh Postnatal Depression Scale (EPDS) test?
More often, women who suspect they might have PND will seek out information online before speaking to their health care provider.
Here is an EPDS screening questionnaire that also gives you an insight into what your symptoms mean.
Once you get your score, make sure you take further action and discuss it with a health professional.
What should I do if I get a high score?
If you get a high score on the Edinburgh Postnatal Depression Scale (EPDS) the most important next step is to talk to a health professional.
They will talk with you about what is going in your life, most likely redo the EPDS and use their clinical judgment (remember we talked about that earlier) to make a diagnosis.
They will refer you to the appropriate services or get the right treatment plan in place.
Use and misuse of the Edinburgh postnatal depression screening tool
There are different versions of the Edinburgh Postnatal Depression Scale tool.
All of them act as a method of determining whether the symptoms a woman develops postnatally are enough reason to suspect she is developing postnatal depression.
Unless someone uses it on behalf of another person, it’s hard to see how it can be misused. A worried partner or family taking the test for a woman they think is suffering from PND won’t get an accurate result.
Can fathers also take the EPDS test?
Of course, this test can be taken by anyone who suspects they might be suffering from depression.
The birth of a new baby can be overwhelming to anyone related to that child, including the father.
The Edinburgh Postnatal Depression Scale (EPDS) has been developed to help any person at risk of developing postnatal depression.
Men should be encouraged to use all postnatal services available to them. Postpartum depression, even major depression, can affect anyone, regardless of their sex.
