Introduction: Up to 20% of mothers experience issues such as perinatal depression and anxiety (Austin et al 2016). Australia has made an increasing investment in perinatal mental health screening, with clinical practice guidelines recommending screening both antenatally and postnatally. We aimed to: 1) report screening rates from 2000-2017, mapped against policy changes; and 2) investigate factors associated with not being screened according to clinical practice guidelines more recently (2013-2017).
Method: This study used data from a national sample of 7566 mothers from the Australian Longitudinal Study of Women’s Health, reporting on 9384 births. Mothers reported whether a health professional had asked about their mental health during pregnancy or after birth (including by questionnaire).
Results: From 2000-2017, the percentage of women not screened decreased from 40.6% to 1.7%, and the percentage screened both antenatally and postnatally increased from 21.3% to 79.3%. From 2013-2017, women who were older (aOR, 0.77; 95% CI, 0.60-0.99) and had reported emotional distress (aOR, 0.65; 95% CI, 0.52-0.81) were less likely to be screened both antenatally and postnatally.
Conclusions: Despite substantial improvements linked to policy initiatives, perinatal mental health screening is not aligned with clinical practice guidelines and is not yet universal. One in five women are not screened both antenatally and postnatally, including high-risk populations such as those who have reported emotional distress. Women are in regular contact with health professionals in the perinatal period. While screening has both risks and benefits, this opportunity to detect women at risk is too important to be missed.