Authors: (including presenting author): :
Ho HL(1), Yip MY(1), Chan HY(1), Lam SM(1), Tao MTM(1), Wan MW(1), Li OC(1), Lau R (1), Wong D(1)
Affiliation: :
(1) Department of Obstetrics & Gynaecology, Pamela Youde Nethersole Eastern Hospital
Keyword 3: :
Early screening
Introduction: :
Postnatal depression is a common but serious mental health condition affecting mothers, with approximately 17% of postnatal women in Hong Kong impacted (Wang, 2021). It profoundly affects mothers' well-being and baby care, and potentially leads to self-harm or suicide, which can result in tragedy for families. Current screening for postnatal depression is conducted around 6-8 weeks after delivery. To identify mothers with psychological needs shortly after discharge and prevent the development of postnatal depression, a pilot program for early screening and individualized support was launched at the Midwife Clinic, Department of O&G, PYNEH.
Objectives: :
1. To identify mothers at high risk of developing postnatal depression early. 2. To provide timely psychological support and interventions to high-risk mothers.
Methodology: :
This pilot program consists of telephone follow-ups with mothers approximately 1-2 weeks after discharge, and the administration of the online Edinburgh Postnatal Depression Scale (EPDS) questionnaire. Midwives explore the mothers’ emotional status, baby feeding and care, and social support over the phone; then screen their EPDS responses. Those who score 13 or above on the EPDS are identified as high risk. Next, midwives will further contact those at risk to explore the source of their emotional issues, provide psychological care, and give advice accordingly. Advanced postnatal follow-up is offered to high-risk mothers, to make referrals to Psychiatry or other services as needed. Subsequent telephone follow-ups at around 4 weeks and 6-8 weeks after delivery, along with online EPDS questionnaires, are conducted to continue monitoring their conditions.
Result & Outcome: :
After the pilot programme was started in May 2025, 56 low-risk mothers from the Midwife Clinic were approached. 50 of them (89%) were reached by telephone follow-up 1-2 weeks after discharge and 39 mothers (78%) completed the online EPDS questionnaires. 3 (6%) of them were identified as high risk, but they did not have thoughts of self-harm or harm to their babies. Their major stressors included baby care, lack of social support and physical illness. All three opted for continued telephone follow-ups and monitoring instead of early postnatal follow-up. With psychological care and support from midwives, all high-risk mothers showed a downward trend in subsequent EPDS scores, with a mean reduction of 6.3 (SD=1.3) at around 4 weeks and 3.3 (SD=2.6) at 6-8 weeks after delivery. This pilot program demonstrates earlier detection and intervention to mothers with emotional needs can facilitate timely psychological care and support to these ladies, hence reducing the risk of postnatal depression.
