Antenatal and postnatal depression - Are Polish midwives really ready for them?

OBJECTIVE: Before January 2019, no established solutions regarding the screening, assessment, and treatment of patients suffering from perinatal depression existed in Poland. From 2019, a new standard of perinatal care has imposed the obligation to monitor the mental state of women during pregnancy and in the postpartum period on the healthcare providers (mainly on midwives). Thus, our study aimed to evaluate midwives' knowledge about prenatal and postnatal mental health disorders in the first six months of implementing the new standard of perinatal care in Poland. DESIGN: Polish midwives completed a survey consisting of the Test of Antenatal and Postpartum Depression Knowledge by Jones, Creedy, and Gamble (2001) and questions related to a hypothetical case study of a depressed woman named "Mary", developed by Buist and colleagues (2006). The midwives also rated their perceived knowledge and skills in assessing women' mental health condition. SETTING: The study was conducted in four Polish cities: Gdansk, Olsztyn, Szczecin, Wroclaw, and the surrounding rural areas. PARTICIPANTS: 111 Polish midwives with varied professional experience and socio-demographic characteristics participated in the study. MEASUREMENTS AND FINDINGS: Among all of their professional responsibilities, the midwives self-rated their knowledge and skills in assessing the mental state of patients as the lowest ones. A subsequent objective assessment revealed their insufficient knowledge about antenatal and postnatal depression and the ways of treatment of these disorders. KEY CONCLUSIONS: Midwives are not properly prepared for the new tasks resulting from the Polish standard of perinatal care: specifically, for the assessment of a woman's mental state. IMPLICATIONS FOR PRACTICE: Further trainings are required to ensure midwives' competency and knowledge about the assessment and dealing with mental disorders of patients who experience prenatal and postpartum depression.

Estratégias de enfermagem na prevenção da depressão pós-parto / Nursing strategies for the prevention of post-birth depression / Estrategias de enfermería en la prevención de la depresión post-parto

Objetivo: identificar na literatura as estratégias utilizadas pelos(as) enfermeiros(as) na prevenção da depressão pós-parto. Método: revisão integrativa da literatura realizada nas bases de dados da Biblioteca Virtual da Saúde da Literatura Científica e Técnica da América Latina e Caribe, Base de Dados de Enfermagem Medical Literature Analysisand Retrieval System Online, por meio dos descritores depressão pós-parto and "enfermagem" e "Depression Postpartum" and "nursing". Resultados: a amostra foi constituída de nove estudos. Para a análise foi realizada a categorização dos trabalhos por similaridade de conteúdo, sendo construídas duas categorias para a análise: o acolhimento como estratégia de prevenção da depressão pósparto e o grupo de gestante como espaço de troca de experiência. Conclusão: prevenir a DPP é uma ação de fácil abordagem, com baixo custo e de viável execução na prática do enfermeiro

Objective: To identify in the literature the strategies used by the nurses in the prevention of postpartum depression. Method: Integrative literature review carried out in the databases of the Virtual Health Library of the Scientific and Technical Literature of Latin America and the Caribbean, Medical Literature Analysis and Retrieval SystemOnline Nursing Database, through the descriptors postpartum depression and "nursing" and "Depression Postpartum" and "nursing." Results: The sample consisted of nine studies. For the analysis, the categorization of the work by content similarity was performed, and two categories were constructed for the analysis: the host as a strategy to prevent postpartum depression and the pregnant group as a space for the exchange of experience. Conclusion: Preventing PPD is an easy-to-approach action, with low cost and feasible execution in the practice of nurses

Objetivo: identificar en la literatura las estrategias utilizadas por los enfermeros (as) en la prevención de la depresión posparto. Método: revisión integrativa de la literatura realizada en las bases de datos de la Biblioteca Virtual de la Salud de la Literatura Científica y Técnica de América Latina y el Caribe, Base de Datos de Enfermería, Análisis de la Revisión de la Resurrección del sistema, por medio de los descriptores depresión postparto y "enfermería" y "Depresión Postpartum" y "enfermería". Resultados: La muestra se constituyó de nueve estudios. Para el análisis se realizó la categorización de los trabajos por similitud de contenido, siendo construidas dos categorías para el análisis: la acogida como estrategia de prevención de la depresión posparto y el grupo de gestante como espacio de intercambio de experiencia. Conclusión: prevenir la DPP es una acción de fácil abordaje, con bajo costo y de viable ejecución en la práctica del enfermero

Integrating Optimal Screening, Intervention, and Referral for Postpartum Depression in Adolescents.

According to the World Health Organization, 10% to 13% of postpartum women develop a mental disorder, mainly depression. This number is higher in developing countries. This percentage increases in adolescents and symptoms in adolescents tend to be overlooked. These disorders can be treated successfully if detected early, which will in turn prevent more severe symptoms from developing. This article provides evidence-based clinical best practices for the assessment and early recognition of postpartum depression, specifically in adolescents. In addition, suggestions for integration into practice and recommendations for interprofessional collaboration are discussed.

Alojamento conjunto em um hospital universitário: depressão pós-parto na perspectiva do enfermeiro / Accommodation set in a university hospital: postpartum depression in nurses’ perspective / Alojamiento conjunto en un hospital universitario: depresión pós-parto en la perspectiva del enfermero

Objective: knowing the nurses' understanding from the accommodation-set about postpartum depression; and identify the perception of these nurses related to importance of guidelines for postpartum depression to puerperal women. Method: this is a descriptive, exploratory research, of qualitative approach, with five (5) nurses from the accommodation-set of a Hospital in Niterói/RJ, in the year 2011. The data were collected by semi-structured interviews and treated in accordance with the precepts of the content analysis, complying with the thematic analysis technique, after approval of the research project by the Research Ethics Committee of the Faculty of Medicine/HUAP/UFF, CAAE n. 0215.0.258.000-11, through favorable protocol no. 206/11. Results: the nurses find it difficult to provide a specific assistance and qualified to postpartum women because of lack of knowledge about this disorder. Conclusion: those nurses must have knowledge about postpartum depression to facilitate the approach and the care to postpartum women and family.

Objetivo: conhecer o entendimento dos enfermeiros do alojamento conjunto sobre depressão pós-parto; e identificar a percepção desses enfermeiros relativa à importância das orientações sobre depressão pós-parto às puérperas. Método: trata-se de uma pesquisa descritiva, exploratória, de natureza qualitativa, com cinco (5) enfermeiros do alojamento conjunto de um Hospital da cidade de Niterói/RJ, no ano de 2011. Os dados foram coletados por entrevistas semiestruturadas e tratados de acordo com os preceitos da análise de conteúdo, obedecendo à técnica de análise temática, após aprovação do projeto de pesquisa pelo Comitê de Ética em Pesquisa da Faculdade de Medicina/HUAP/UFF, CAAE n. 0215.0.258.000-11, mediante parecer favorável n° 206/11. Resultados: os enfermeiros encontram dificuldades em prestar uma assistência especifica e qualificada à puérpera por falta de conhecimentos sobre esse transtorno. Conclusão: o enfermeiro precisa ter o conhecimento sobre a depressão pós-parto para facilitar a abordagem e os cuidados à puérpera e a família.

Objetivo: conocer el entendimiento de los enfermeros del alojamiento conjunto en respecto a la depresión pos-parto; e identificar la percepción de estos enfermeros sobre la importancia de las orientaciones sobre depresión pos-parto a las puérperas. Método: se trata de una investigación descriptiva y exploratoria, de carácter cualitativo, con 5 enfermeros del Alojamiento Conjunto de un Hospital de la ciudad de Niterói/RJ, en el ano de 2011. Los datos fueron obtenidos a través de encuestas semi-estructuradas y fueron tratados de acuerdo con los preceptos de análisis de contenido, obedeciendo a la técnica de análisis temático, después de la aprobación del proyecto de investigación por el Comité de Ética en Investigación de la Facultad de Medicina/HUAP/UFF, CAAE n. 0215.0.258.000-11, por medio del parecer favorable nº 206/11. Resultados: los enfermeros encuentran dificultades en prestar una asistencia específica y calificada a la puérpera por falta de conocimientos sobre estos trastornos. Conclusión: el enfermero necesita tener el conocimiento sobre la depresión pos-parto para facilitar el abordaje y los cuidados a la puérpera y a la familia.

Depression screening on a maternity unit: a mixed-methods evaluation of nurses' views and implementation strategies.

Postpartum women often suffer clinically significant depressive symptoms, a problem addressed by nurse-delivered screening programs. In the past, success of these identification programs was measured in terms of screening rates; however, merely evaluating the screening rate does little to inform how to implement depression screening in clinical practice. This article describes the experiences of nurses in implementing depression screening on a maternity unit. We evaluate the practice qualitatively, by asking nurses to describe their screening strategies and their views about implementation, as well as quantitatively by assessing their screening rates and the number of women identified. Utilizing a framework of program evaluation, 20 maternity unit nurses completed qualitative assessments investigating their day-to-day experiences with this practice. To include the perspectives of nurses that declined to participate in qualitative assessments, 14 additional maternity unit nurses completed a brief survey assessing their views. We also assessed screening rates, defined as the number of women screened divided by the number eligible for screening. Maternity unit nurses viewed depression screening positively and were able to screen patients in relatively few steps, which they implemented using strategies they had developed themselves. Despite nurses' ongoing concern about finding time to screen, they achieved high screening rates and, with one exception, indicated they would opt to continue voluntarily. Depression screening on the maternity unit is feasible and embraced by attending nurses. The clinical strategies used to implement screening are extensively described and provide a basis for implementation in other settings that serve perinatal women.

Screening for symptoms of postpartum traumatic stress in a sample of mothers with preterm infants.

There are no established screening criteria to help identify mothers of premature infants who are at risk for symptoms of emotional distress. The current study, using data obtained from recruitment and screening in preparation for a randomized controlled trial, aimed to identify potential risk factors associated with symptoms of depression, anxiety and posttraumatic stress in a sample of mothers with premature infants hospitalized in a neonatal intensive care unit. One hundred, thirty-five mothers of preterm infants born at 26-34 weeks of gestation completed three self-report measures: the Stanford Acute Stress Reaction Questionnaire, the Beck Depression Inventory (2nd ed.), and the Beck Anxiety Inventory to determine their eligibility for inclusion in a treatment intervention study based on clinical cut-off scores for each measure. Maternal sociodemographic measures, including race, ethnicity, age, maternal pregnancy history, and measures of infant medical severity were not helpful in differentiating mothers who screened positive on one or more of the measures from those who screened negative. Programs to screen parents of premature infants for the presence of symptoms of posttraumatic stress, anxiety, and depression will need to adopt universal screening rather than profiling of potential high risk parents based on their sociodemographic characteristics or measures of their infant's medical severity.

PTSD after childbirth: early detection and treatment.

Posttraumatic stress disorder (PTSD) following childbirth may be diagnosed as postpartum depression. With a thorough assessment, women with this condition can be diagnosed correctly and receive appropriate treatment, promoting a better outcome for both mother and baby.

Internet confessions of postpartum depression.

Women with postpartum depression may suffer in silence due to the stigma of depression and failed motherhood. It is important to consider how mothers are able to talk about postpartum depression and what strategies they use. Foucault's idea that confession is a widespread technique for producing truth in Western societies was tested through discourse analysis of posts on an Internet forum for women with postpartum depression. The Internet forum showed women's use of confessionary language and self-judgments as well as their sense of disconnected mothering, shame, and disembodiment. Discourses of depression included the good mother, biomedical illness, and social dysfunction. Findings have implications for creating safe spaces for helping mothers with postpartum depression.

Postpartum depression screening in yemeni and punjabi immigrant women.

This article describes strategies for using a postpartum depression screening tool with women from two immigrant minority populations (from Yemen and from the Punjab region of India). Techniques to maximize success while working with interpreters and with women's unique cultural considerations are presented. Two case studies provide examples of challenges presented and overcome by women from each of these populations.

Exploring perceptions and experiences of maternal depression in Latinas: a qualitative study.

Understanding how depression is conceptualized is key to designing effective screening and treatment procedures. Of particular concern is maternal depression in Latinas, given the high Latina birthrate. We conducted two focus groups of pregnant Latinas to elicit their perceptions of and experiences with maternal depression. Women reported familiarity with the concept of maternal depression and that their experiences with depression were linked to social support from family and friends. Women also indicated that they felt responsible for coping and recovering from depression independently. How experiences with depression interact with traditional Latino idioms of distress, needs further investigation.

Depression among mothers of high-risk infants discharged from a neonatal intensive care unit.

PURPOSE: This study investigated potential associations between maternal depression and specific infant health conditions, smoking, and socioeconomic characteristics among mothers of high-risk infants during medical follow-up visits. STUDY DESIGN AND METHODS: Cross-sectional self-report, and interview data were collected from 114 mothers of high-risk infants previously discharged from a neonatal intensive care unit. Mothers were assessed at a postdischarge clinic visit. RESULTS: Prevalence rates for a Center for Epidemiological Studies-Depression Scale score ≥ 16) suggestive of a depressive disorder exceeded 20% at all time points for this sample of predominantly low-income, minority-race mothers. A greater number of mothers who had infants with a highly visible illness (e.g., surgical necrotizing enterocolitis) were depressed. Depression was also associated with the presence of a household smoker, younger age, and less education and income. CLINICAL IMPLICATIONS: Given the prevalence rates, routine screening for postpartum depression in mothers of high-risk infants is imperative, with particular attention to the infant's health, smoking, and socioeconomic variables.

Update on adolescent motherhood and postpartum depression.

Adolescent motherhood is a common and costly phenomenon, with almost a half million American girls becoming mothers every year in the United States. Postpartum depression is also common, with an estimated 53% to 61% of teen mothers affected. Psychiatric nurses can intervene by recognizing the high rate of postpartum depression among teen girls, screening, and referring to treatment when necessary.

Australian midwives' awareness and management of antenatal and postpartum depression.

BACKGROUND: The detection of maternal depression can be improved with routine screening. This practice is expected to be integrated into midwifery practice under the Australia National Perinatal Depression Initiative. RESEARCH OBJECTIVE: To describe midwives' self-reported practice in caring for women suffering from antenatal and postpartum depressive symptoms; and assess midwives' ability to detect depression and their knowledge of therapeutic interventions for depressive symptoms in childbearing women. METHOD: Using a descriptive cohort study design, a postal survey was sent to all members of the Australian College of Midwives (n=3000). The survey consisted of items drawn from beyondblue's "National Baseline Survey--Screening Evaluation Questionnaire" and questions relating to a hypothetical case study of a depressed woman "Mary" developed by Buist et al. FINDINGS: A total of 815 completed surveys were received. 69.1% of midwives reported screening for antenatal and postpartum depression using instruments such as the Edinburgh Postnatal Depression Scale. Time constraints were perceived as the major barrier to effective emotional care. 63.3% of midwives correctly recognised depression in the case study and 82.4% reported that "Mary" required assistance. Antidepressants were more likely to be recommended postnatally (93.2%) than antenatally (61.5%) by midwives. CONCLUSIONS: Further training is required to ensure midwives' competency in psychosocial assessment and management of women experiencing antenatal and postpartum depression. Systemic issues (e.g. time constraints) encountered by midwives need to be addressed to support the delivery of effective emotional care to childbearing women.

A mãe em sofrimento psíquico: objeto da ciência ou sujeito da clínica? / Mother in psychic suffering: object of science or subject of the clinic? / La madre en sufrimiento psíquico: ¿objeto de la ciencia o sujeto de la clínica?

A vivência da maternidade é abordada no modelo médico científico do ponto de vista orgânico. Porém, para algumas mulheres, isso se dá como uma experiência de intenso sofrimento psíquico. Desenvolvemos uma reflexão teórica visando refletir acerca das possibilidades de abordagem dessa questão na perspectiva de uma clínica do sujeito, conforme delimitado na abordagem psicanalítica, contrapondo-a à visão do modelo médico científico. A ciência moderna institui-se como práxis pela exclusão do sujeito, e é esta racionalidade que subsidia a abordagem dos sintomas psíquicos no modelo médico, percebidos como algo a ser eliminado. A psicanálise surge a partir da descoberta do inconsciente e do sintoma como portando uma verdade sobre o sujeito que sofre. Consideramos que os conceitos apontados pela perspectiva psicanalítica podem nos apoiar na construção de uma clínica menos objetificadora, que permita ao próprio sujeito se interrogar sobre o sentido daquilo que o faz sofrer.

The maternity experience is seen in the medical scientific model and approached under the organic point of view. However, for some women this is an experience of intense psychic suffering. We developed a theoretical reflection aiming to reflect on the possibilities of approaching this matter in the perspective of a clinic of subject as delimited in the psychoanalytic approach, opposing it to the medical scientific model view. The modern science institutes the exclusion of the subject as praxis, and it is this rationality that supports the approach of psychic symptoms in the medical model, seen as something to be eliminated. Psychoanalysis comes from the discovery of the unconscious and the symptom as a truth on the subject in suffering. We consider that the concepts pointed by the psychoanalytic perspective can support us on the construction of a less objectifying clinic that allows the subject to interrogate himself on the meaning of what makes him suffer.

La experiencia de la maternidad es mirada en el modelo médico científico y discutida bajo la perspectiva orgánica. Sin embargo, para algunas mujeres, esto se realiza como una experiencia de gran sufrimiento psíquico. Desarrollamos una reflexión teórica con el fin de reflexionar sobre las posibilidades de abordar esta cuestión desde la perspectiva de una clínica del sujeto, definida en el abordaje psicoanalítico, en contraste con la visión del modelo médico científico. La ciencia moderna se ha establecido como práctica para la exclusión del sujeto, y es esta racionalidad que subsidia el abordaje de los síntomas psicológicos en el modelo médico, que se percibe como algo que debe eliminarse. El psicoanálisis surge a través del descubrimiento del inconsciente y del síntoma como una verdad sobre el sujeto que sufre. Creemos que los conceptos subrayados por la perspectiva psicoanalítica nos pueden ayudar en la construcción de una clínica menos objetiva, que permita al propio sujeto la pregunta sobre el significado de lo que le hace sufrir.

Inequity in provision of and access to health visiting postnatal depression services.

AIM: This paper is a report of a study of equity in the provision of a public health nursing postnatal depression service. BACKGROUND: Postnatal depression is a global public health concern. Health visitors are nurses involved in the early detection and treatment of postnatal depression. However, research has revealed that all women are not assessed for postnatal depression particularly women in minority ethnic groups. METHODS: A case study was conducted involving 21 observations of health visitors visiting postnatal women, interviews with 20 health visitors, 6 managers, 12 English women, 9 Bangladeshi women and 3 other personnel. Data were collected between 2003 and 2005 and analysis was completed in 2008. FINDINGS: The organization had a policy to create equitable postnatal depression services, but practitioners were not clear whether it was to be implemented, and it did not address the needs of a diverse population. All health visitors received specialized training and were consequently expected to assess and treat all women. The training based on the policy had not equipped health visitors with knowledge and skills to assess and treat women in minority ethnic groups. CONCLUSION: While a policy was in place, equity in care was not achieved. An analysis of women's needs is recommended prior to policy development and policy implementation should be planned. To achieve equity, training should include knowledge and skills for cultural competency. Research is needed to illuminate the characteristics of equitable nursing services.

Identificação dos fatores de risco para depressão pós-parto: importância do diagnóstico precoce / Identifying the risk factors for postpartum depression: importance of early diagnosis / Identificación de los factores de riesgo para depresión post-parto: la importancia del diagnóstico precoz

A pesquisa objetivou identificar os fatores de risco que podem contribuir para a Depressão Pós-parto (DPP), bem como identificar os sintomas que podem caracterizá-la no período puerperal imediato. Trata-se de uma pesquisa descritiva, com abordagem quantitativa, realizada entre abril e maio de 2008, com puérperas (n=95) de uma maternidade de Referência da cidade de Fortaleza-CE/Brasil. Como instrumentos utilizaram-se: um formulário com informações socioeconômicas e demográficas e a Edinburgh Postnatal Depression Scale (EPDS), para avaliação da DPP. A prevalência de depressão pós-parto encontrada foi de 24,2% (EPDS=13). Os achados sugerem que baixas condições socioeconômicas podem contribuir para o desenvolvimento de DPP e, apesar de ser uma enfermidade subdiagnosticada, os números encontrados revelam alto percen¬tual de puérperas suscetíveis a desenvolver sintomas depressivos após o parto.

The research aimed to identify the risk factors that may contribute to post-partum depression (PPD) and identify the symptoms that can characterize it in the immediate puerperal period. This is a descriptive research with quantitative approach, conducted between April and May 2008, with puerperas (n = 95) of a Reference Maternity Hospital of the city of Fortaleza. It was used as instruments of research: a form with socioeconomic and demographic information and the Edinburgh Postnatal Depression Scale (EPDS) for PPD evaluation. The prevalence of postpartum depression found was 24.2% (EPDS = 13). The findings suggest that low socioeconomic conditions may contribute to the development of PPD and, despite being an under diagnosed disease, the figures show high percentage of women who are susceptible to developing depression symptoms after giving birth.

La investigación tuvo como objetivo identificar los factores de riesgo que pueden contribuir para la Depresión Post-parto(DPP) y también identificar los síntomas que pueden caracterizarla en el período del puerperio inmediato. Se trata de una investigación descriptiva con enfoque cuantitativo, realizada entre abril y mayo del 2008, con puérperas (n = 95) de una maternidad considerada de referencia de la ciudad de Fortaleza. Como instrumentos se utilizaron: un formulario con informaciones socioeconómicas y demográficas y la Edinburgh Postnatal Depression Scale (EPDS), para evaluar la DPP. La prevalencia de depresión post-parto encontrada fue de 24,2% (EPDS = 13). Los hallazgos sugieren que las bajas condiciones socioeconómicas pueden contribuir para el desarrollo de la DPP y, a pesar de ser una enfermedad subdiagnosticada, las cifras encontradas muestran alto porcentaje de puérperas susceptibles a desarrollar síntomas de depresión después del parto.

Immigrant and refugee women's post-partum depression help-seeking experiences and access to care: a review and analysis of the literature.

ACCESSIBLE SUMMARY: • This literature review on post-partum depression (PPD) presents an analysis of the literature about PPD and the positive and negative factors, which may influence immigrant and refugee women's health seeking behaviour and decision making about post-partum care. • A critical review of English language peer-reviewed publications from 1988 to 2008 was done by the researchers as part of a qualitative research study conducted in a western province of Canada. The overall goal of the study is to raise awareness and understanding of what would be helpful in meeting the mental health needs of the immigrant and refugee women during the post-partum period. • Several online databases were searched: Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, MEDLINE (Ovid), EBM Reviews - Cochrane Database of Systematic Reviews. • Review of the literature suggests: 1 Needs, issues and specific risk factors for PPD among immigrant and refugee women have been limited. 2 Descriptive accounts regarding culture and PPD are found in the literature but impact of cultural factors upon PPD has not been well studied. 3 Few studies look at how social support, gender, and larger institutions or organizational structures may affect immigrant and refugee women's help-seeking and access to mental health care services. 4 More research is needed to hear the immigrant and refugee women's ideas about their social support needs, the difficulties they experience and their preferred ways of getting help with PPD. ABSTRACT: This review and analysis of the literature is about the phenomenon of post-partum depression (PPD) and the barriers and facilitators, which may influence immigrant and refugee women's health seeking behaviour and decision making about post-partum care. As part of a qualitative research study conducted in a western province of Canada a critical review of English language peer-reviewed publications from 1988 to 2008 was undertaken by the researchers. The overall goal of the study is to raise awareness and understanding of what would be helpful in meeting the mental health needs of the immigrant and refugee women during the post-partum period. Several online databases were searched: Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, MEDLINE (Ovid), EBM Reviews - Cochrane Database of Systematic Reviews. Findings suggest: (1) needs, issues and specific risk factors for PPD among immigrant and refugee women have been limited; (2) descriptive accounts regarding culture and PPD are found in the literature but impact of cultural factors upon PPD has not been well investigated; (3) few studies examine how social support, gender, institutional and organizational structures present barriers to the women's health seeking behaviour; and (4) additional research is required to evaluate immigrant and refugee women's perspectives about their social support needs, the barriers they experience and their preferred support interventions.

Screening and counseling for postpartum depression by nurses: the women's views.

PURPOSE: In this part 2 article of research examining a model of care in which nurses screen and counsel postpartum women for postpartum depression, acceptability of such a model to postpartum patients was evaluated with a diverse sample of American women. STUDY DESIGN AND METHODS: Descriptive survey of two groups: 691 predominately white postpartum women with relatively high annual incomes (Sample 1) and 132 low-income women, some of whom were ethnic minorities (Sample 2). The surveys were distributed and needed to be mailed back to the investigators. The response rate was 72% in Sample 1 and 30% in Sample 2. RESULTS: The overwhelming majority in both groups (>90%) felt that it was acceptable for nurses to perform screening for postpartum depression and for nurses to do the necessary counseling. More than half in each sample were "definitely willing" to see a nurse for counseling. Although women in both samples had positive views, when compared with each other, women with higher incomes (Sample 1) had more positive views of nurse-delivered mental healthcare. More than half in each sample were "definitely willing" to see a nurse for counseling. For Sample 1, 15% reported having taken medications for postpartum depression; in Sample 2 this number was 22.3%. CLINICAL IMPLICATIONS: Nurses have frequent contact with postpartum women; as such, they are well positioned to provide depression screening and counseling. Nurse-delivered mental healthcare has the potential to obviate many barriers that prevent the detection and treatment of depression, and ultimately improve outcomes for infant and children.