Does Your Birth Center Screen for Perinatal Mood Disorders According to National Guidelines and Best Practice?
Perinatal mental health disorders have been identified in every culture, age, socioeconomic level, and
ethnicity. They can appear during pregnancy or within days or up to a year after the baby is born and seldom resolve without treatment. Although postpartum depression is the most well-known, others include perinatal anxiety, perinatal obsessive compulsive disorder, perinatal panic disorder, postpartum post-traumatic stress disorder (PTSD), perinatal bipolar, and postpartum psychosis.
Perinatal mood disorders are the most common complication associated with pregnancy and
childbearing. Postpartum PTSD occurs in about 9% of childbearing people, and is more common
after what is perceived by the individual as a traumatic birth experience. Postpartum depression occurs in 15-21% of childbearing people, with teens and individuals with low income having rates of up to 60%. Other perinatal mood disorders occur at lower rates, from 9-11%. Compared to white women, Black women are twice as likely to experience MMH conditions but half as likely to receive treatment. These mood disorders, without the needed intervention, may have long-term, adverse effects for the childbearing person, their partner, and the infant.
In June 2023, the United States Preventive Services Task Force (USPSTF) issued new guidance for screening for anxiety, depression, and suicide risk in adults, including pregnant and postpartum people. Both USPSTF and ACOG recommend screening for perinatal mood disorder risk factors at least once during pregnancy and again postpartum.
CABC Indicators require screening at the initial prenatal visit for a history of or risk factors for perinatal mood disorder and depression and anxiety symptoms using a standardized, validated tool. It also recommends that clinicians complete a full assessment of mood and emotional well-being (including screening for postpartum depression and anxiety with a validated instrument) during final postpartum visit for each patient. Best practices includes more frequent screening, for example initial prenatal visit, 3rd trimester, early, and late postpartum.
Excellent resources for both professionals and consumers are Postpartum Support International and Maternal Mental Health Leadership Alliance. ACOG offers a Lifeline for Moms Perinatal Mental Health Tool Kit developed by the UMass Chan Medical School, with information and guidelines for for professionals and resources for consumers. This NIH website, Mom’s Mental Health Matters, provides a good overview for pregnant and postpartum people.
Exciting News from Massachusetts!
On August 26, the Massachusetts legislature passed a Maternal Health Omnibus bill into law. This important bill will “promote access to midwifery care and out-of-hospital birth options” by:
- Providing licensure of Certified Professional Midwives under a CPM-majority Board of Midwifery, with mandated reimbursement by MassHealth;
- Reimbursement for CNM’s through MassHealth at 100% of the physician rate for the same services;
- Updated birth center regulations removing barriers to encourage opening and sustaining birth centers;
- Proving access and reimbursement for perinatal mental health screening and services, comprehensive doula services, postpartum home visiting, lactation consultant services, and donor human breastmilk.
An important driver for the passage of this innovative legislation was the advocacy of Neighborhood Birth Center. Founded in 2015 with a planned opening in 2026, “Neighborhood Birth Center will be the first-of-its-kind community birth center in Boston, providing community midwifery to strategically address the maternal health crisis.” In a state that currently has only one birth center, this law will greatly increase access to midwifery care and community birth. Learn more about this trailblazing legislation and about Neighborhood Birth Center HERE.
Is tracking everything required in your birth center a big job that sometimes seems impossible?
One birth center shared with us the software that they use for tracking – a platform called Expiration Reminder.
Pricing: Small business pricing with up to 250 tracked items – $49/month
The platform is customizable with reports for documentation of tracking activities and reminders sent to email, text, or other apps.
An Easy Way to Track Your CQI & Personnel File Requirements
You can use it to track and document tracking of almost every CABC requirement. Expiration dates of medications and sterile
supplies; Facility checks and medical equipment maintenance and calibration; Licensure and certifications for clinical staff; Required training, such as CPR, NRP OSHA, HIPAA and CLIA training; Emergency drills and other staff training, such as Intermittent Auscultation competency assessment and review; Contract renewals, such as insurance, waste disposal, cleaning, facility maintenance such as HVAC system, fire extinguishers and alarms, childbirth educators and other contracted services.
Access can be given to staff so that they receive reminders and can easily update their own documents for personnel files, including uploading copies of documents such as NRP or CPR cards and certifications. You can sign up for a free 14-day trial to find out if the platform is a good fit for your birth center.
Achievement Spotlight August – September 2024
Congratulations on Your Re-Accreditation!
- Bellingham Birth Center – Bellingham, WA
- The Coit House – Buffalo, NY
- The Birth Center at PCC – Berwyn, IL
- Fort Worth Birthing & Wellness Center – Fort Worth, TX
Congratulations on Being In-Process!
- Birthroot Midwives and Birth Center – Bellingham, WA
- The Nest Birth & Wellness – Pullman, WA
