Private health in postnatal depression data fail as public system leads the way

Expensive private maternity care is letting some women fall through the cracks, while the public system leads the way.

National Association of Specialist Obstetricians and Gynaecologists president Gino Pecoraro

Expensive private maternity care is failing to adequately record vital postnatal depression data that helps stop Queensland women from falling through the cracks into suicide, while the public system leads the way, a new report reveals.

National guidelines recommend that all women are screened for risk factors during the perinatal period using the Edinburgh Postnatal Depression Scale, but a new report released by the Australian Institute of Health and Welfare shows that in 2022 only 38 per cent of mothers whose care was co-ordinated by a private obstetrician had an EPDS score recorded during their antenatal period.

Public hospitals and midwifery group practice scored 89 per cent of women.

This is the first time there has been an analysis of models of care provided to women in Queensland and detailed antenatal mental health and family violence risk factor screening data from NSW public health services.

A Maternity Consumer Network spokeswoman said: “Screening like this is essential.

“We know the No.1 cause of perinatal mortality is suicide.

“It is encouraging to see so many maternity professionals taking this seriously.

“There are valid and serious concerns over the lack of data capture from private obstetricians.

“They have a responsibility to women to be offering this screening tool and referring them to appropriate support.

“All other models seem to be doing it quite well – even fragmented public care, where women will see umpteen midwives and sometimes different obstetricians.”

The report shows that in 2022 7.9 per cent of mothers with a recorded EPDS score were assessed as scoring 13 or above, indicating a high risk of depression and/or anxiety – 8.4 per cent were in public hospitals and 4.7 per cent private.

National Association of Specialist Obstetricians and Gynaecologists president Gino Pecoraro said private obstetricians saw their patients at each antenatal visit, during the delivery and post-natally every day they were in hospital, as well as for their post-natal check-up.

“Assessment of mental health is an intrinsic part of each of these encounters,” Prof Pecoraro said.

“Absence of the form being filled out doesn’t mean it wasn’t assessed.

“Increasing use of a tool like EDPS is certainly something (the association) supports.

“Continuity of care with a known provider and mental health assessment is so much more than a box-ticking exercise where a form is filled out.”