Date of Publication


Project Team

Lili Martin, DNP, RN, PCCN and Carol Buck Rolland, Ed.D., APRN


Purpose: Perinatal mood and anxiety disorders (PMADs) are the most common obstetric complication. They create dysfunctional parent-infant relationships by dysregulating emotional responses, thus increasing the risk of child abuse/neglect, maternal suicide, and infanticide. Local problem: The American Academy of Pediatrics (AAP) recommends screening caregivers for postpartum depression at well-child checks (WCC) before six months postpartum. National research indicates 60% of women at risk for developing PMADs don’t receive subsequent mental health care. This project examined how expanding documentation of screening and referrals in the pediatric setting impacts identification and follow-up for PMADs. Methods: A retrospective chart review was done at a pediatric practice in Vermont to identify the current process for PMAD screening and referrals during recommended WCCs. A standardized protocol for documenting screening and follow-up care was implemented for providers and an additional screening was added to the six-month WCC. A second retrospective chart review then assessed for improvements in screening and follow-up care. Data were reported descriptively as percentages in charts and graphs. Results: Screening rates did not increase following the intervention due to a high overall baseline rate of 85%. Following expansion of the screening template there was an increase in the rate of documented follow-up plans from 50% of encounters to 86.7%. Conclusions: Standardized documentation, screening, and follow-up for PMADs provides a framework for providers to address this sensitive topic. Posting information and resources around the office also raises awareness and normalizes PMADs. These actions augment early identification of PMADs and mitigate the effects on families.

Document Type


Available for download on Thursday, May 01, 2025