Screening and psychosocial assessment

Postnatal depression is frequently missed by primary care providers (Buist et al ., 2006), but there has recently been increased awareness of this condition. Antenatal depression is equally important and equally prevalent (Edwards et al. , 2008), but has less visibility. In a US study screening for antenatal psychiatric illness, only 26 per cent of patients who screened positive and only 12 per cent with suicidal ideation were detected by clinicians, and only 26 per cent who screened positive for depression had received treatment (Smith et al ., 2004). A review of perinatal maternal mortality reported a significant number of suicides in pregnancy (Austin et al ., 2007), but psychosocial assessment can enhance recognition of potential depression in this vulnerable antenatal period (Austin and Lumley, 2003).