Screening for postnatal depression - is it acceptable to women and healthcare professionals? A systematic review and meta-synthesis

Postnatal depression (PND) impacts on the mother and her partner, the family, mother-baby interaction and on the baby. This review synthesises the evidence from qualitative and quantitative research to determine whether screening for PND is acceptable to women and healthcare professionals. The research literature was systematically searched to retrieve articles available until February 2007. No language or geographical restrictions were applied. Studies were included if the acceptability of PND screening was assessed during the prenatal and postnatal period. Data were synthesised using the textual narrative approach. Fifteen of the 16 eligible studies focused on the acceptability of the Edinburgh Postnatal Depression Scale (EPDS). Screening for PND was generally found to be acceptable to women and healthcare professionals, although aspects of its administration were identified as being important. Specifically, a woman needs to feel comfortable about the screening process if she is to answer the questions honestly. This may be facilitated through forewarning and administration by a trusted person in her own home. Healthcare professionals need to be aware of differing cultural attitudes towards answering the questions, and the ambiguity of the question about self-harm. Further research into the acceptability of strategies other than EPDS is needed.