Pathways

What Can Providers Do?

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Screening

  • All women should be screened once each trimester and at the postpartum visit.
  • Fax a copy of the screen to Nurture 2 Nurture if score is above 9.
  • Women may call for an appointment at any time during their pregnancy as well as several months after delivery.
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Under Assessment

  • Ask if the patient has been treated for any mental health issue in the past; depression, anxiety, bipolar disorder.
  • Ask if the patient has any family members suffering with mental health complications.
  • Ask if patient has severe PMS or PMDD
  • Ask if patient is currently on anti-depressants , anxiolytics, or mood stabilizers. If yes, who prescribes this medication?_____________________
  • Consider a phone consultation with prescribing MD.

If patient answers yes to any of these questions she is at a higher risk for maternal depression.

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Treatment

  •  If a patient has been successfully treated with a certain medication in the past, it is wise to restart them on the same medication, at a starting dose.
  • You can follow ACOG recommendations for medication and dosage.
  • Recommend Omega 3s (from fish oil) 1000mg and Vitamin D-3 1000mg. Both have a positive effect on depression.
  • Encourage hospitals to protect mom’s sleep. Write an order to delay vital signs , lab draws closer to breakfast and MD visits. Sleep deprivation starts many women down the road to maternal depression.
  • Provide patient with written info about maternal depression at her first visit. Discuss it again each trimester when she is screened. Include her partner, or family in the discussion.

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