- Identify the appropriate screening tool for Natalie to complete during her first visit and discuss why the selected tool is appropriate for the client.
For Natalie, the Edinburgh Postnatal Depression Scale (EPDS) is the most appropriate screening tool to use during her first visit. The EPDS is a widely used 10-item questionnaire designed to identify women who have postpartum depression. Patients can complete it easily, and practitioners can score it quickly. This efficiency facilitates timely identification of depressive symptoms during Natalie’s first visit. This EPDS tool specifically focuses on the emotional and psychological symptoms of anxiety and depression in the postpartum period, making it highly relevant for Natalie’s situation. (Justesen, & Jourdaine, 2023).
- Natalie is diagnosed with peripartum depression. Identify the appropriate treatment for Natalie and discuss why the selected treatment is appropriate for the client.
Given Natalie’s diagnosis of peripartum depression, a combination of psychotherapy and possibly pharmacotherapy would be appropriate. There are 2 types of psychotherapy that would be beneficial for Natalie; Cognitive Behavioral Therapy (CBT), which is effective for treating depression and can help Natalie address and reframe her negative thoughts and feelings of guilt and disconnection from her baby. Additionally, Interpersonal Therapy (IPT) can help Natalie improve her interpersonal relationships and address her new role, and grief associated with her past stillbirth.
For pharmacotherapy, Selective Serotonin Reuptake Inhibitors (SSRIs) like sertraline or escitalopram are often considered safe and effective for postpartum women. They can help alleviate moderate to severe depressive symptoms, they have a good safety profile, and are compatible with breastfeeding. (Hardy, & Reichenbacker, 2019).
PMHNP’s can take several supportive actions to validate and empathize with Natalie. The first strategy would be to acknowledge her feelings and validate her experiences to let her know it’s okay to feel overwhelmed or anxious during this time. Emphasize the commonality and treatability of peripartum depression. Explain to her that many women go through similar challenges after childbirth, and that seeking help is a sign of strength, not weakness. Another strategy I would employ is to encourage her to involve her support systems such as her partner, family, and friends, which would provide an outlet and safe space for sharing her feelings. Social support is crucial during this period.