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Depressed, Pregnant Women Receive Inconsistent Treatment, Have Longer Hospital Stays

Pregnant women who screen positive for depression are unlikely to receive consistent treatment, researchers say. That may translate to women spending more time in the hospital before babies are even born.

The Obstetric Clinics and Resources Study, published in General Hospital Psychiatry, tracked 20 healthcare providers in six Michigan clinics and revealed a lack of uniformity in addressing perinatal depression.

"There are a lot of barriers to translating information into everyday practice situations," says Christie Palladino, MD, an obstetrician/gynecologist with Georgia Health Sciences University's Education Discovery Institute and principal investigator on the study. "We wanted to understand what it's like for prenatal care providers to deal with depression care."

Providers felt burdened having to make instant decisions about complex issues, the multidisciplinary research team found. And those decisions varied dramatically, even within the same clinic.

"There was no system-level support for providers," Palladino says. "They felt as if they were making decisions out on an island." That sense of isolation, coupled with a lack of direction about how to treat pregnant women with depression, may explain why fewer than one-half of women who need treatment receive it.

Adding to the disconnect was providers' discomfort in talking about the disease with both patients and mental health care providers. "In training, we tend to talk about how frequent a disease is, what the known causes are and the treatments that are available, but we don't address developing referral relationships," Palladino says. "We need to focus on not only knowledge of the disease, but also on the intrinsic motivations."

To address the problem, Georgia Health Sciences University's Education Discovery Institute is conducting a pilot project to teach such skills. Residents and faculty in OB-GYN, psychiatry and pediatrics are collaborating to develop and test tailored educational interventions in perinatal depression care, in hopes of quickly implementing the content into clinical practice.

— Source: Georgia Health Sciences University