What is the USPSTF stance on perinatal depression?

• A. Screen all pregnant and postpartum women and treat everyone with antidepressants.
• B. Clinicians provide or refer pregnant and postpartum women who are at increased risk to counseling interventions.
• C. Do not address perinatal depression in primary care.
• D. Refer only if severe symptoms requiring hospitalization.

Answer: (B)

Screening pregnant and postpartum patients for major depressive disorder in primary care, with follow-up care that provides or refers them to counseling interventions, is the recommended approach. This means all who are pregnant or have recently given birth should be screened, and those at increased risk or who screen positive should receive evidence-based counseling—psychotherapy or similar interventions—rather than automatically starting everyone on antidepressants. Counseling is effective and safer in many perinatal situations, and treatment should be tailored to the individual rather than applying a one-size-fits-all medication plan. This approach reflects why the other options don’t fit: treating all patients with antidepressants ignores individual needs and potential risks; ignoring perinatal depression in primary care misses an important opportunity for early help; and waiting to refer only for severe cases would overlook many who could benefit from supportive counseling.