New evidence-based clinical practice guidelines to address peripartum depression

Pregnancy and the first year postpartum - referred to as the peripartum period - are a period of tremendous physiological, psychological, and social changes in a woman's life. An estimated 1 in 5 women develop mental health problems during the peripartum period, with depression and anxiety being the most prevalent mental health problems. Only half of these women will ever receive a diagnosis and even less will be fortunate to receive treatment.

Over the last four years the Riseup-PPD COST Action have been working to advanced research, practice, and foster collaborative work within Europe and beyond to improve understanding and treatment of peripartum depression (PPD). Their latest and final Action output is the production of evidence-based clinical practice guidelines to address peripartum depression.

Guidelines for the prevention, screening and treatment peripartum depression

Peripartum depression not only adversely affect the mother and her overall health, but also the infant's health and development and the wider family relationships. Furthermore, it puts a strong socioeconomic burden on society as a whole. In order to prevent peripartum depression and offer timely screening followed by appropriate treatment, it is crucial to have evidence-based clinical practice guidelines to instruct on all these steps.

These Guidelines provide a roadmap for healthcare professionals, women, men, families, health managers, and policymakers fostering a lasting impact on clinical practice and mental health policies in Europe. By equipping future clinical practice with a strong foundation, the Guidelines ensure that the Action's influence continues long after its formal conclusion, benefiting countless individuals and the forthcoming generations."

Prof. Ana Ganho ávila, Chair of Riseup-PPD

Watch the video Depression during and after pregnacy affects one in five women

In fact, many European countries do not have any clinical practice guidelines for PPD in place, and in countries where they exist, discrepancies in recommendations and the low methodological quality of the guidelines can lead to disparities and inequalities in clinical management. Riseup-PPD developed their guidelines using the WHO handbook for guideline development to ensure that the recommendations can effectively function as an evidence-based handbook for all involved.

Developing these Guidelines was based on a systematic evaluation of the existing and high quality scientific evidence. This means that now, all health care professionals who take clinical care of peripartum women are equipped with up to date information about the best PPD cover prevention, screening, and treatment alternatives and can discuss with their patients which are the more suitable options for their specific situation, considering their values and preferences."

Mariana Moura Ramos, member of Riseup-PPD and Guideline Development Group Leader

In all there are 44 recommendations divided over 3 sections (prevention, screening, treatment). The interventions are broken down to encompass a wide range of strategies including biological interventions such as pharmacotherapy and non-invasive brain stimulation, psychological and psychosocial interventions, and other non-conventional and complementary interventions. This approach helps provide different pathways for managing PPD and provides evidence on the benefits, harms, and efficacy of interventions like Electroconvulsive therapy (ECT), yoga, Chinese herbs, Transcranial direct current stimulation (tDCS), and antidepressants.

4 million babies are born every year in Europe. That's 4 million opportunities to make a change. We can go together towards this change and put our expertise available to you all."

Sandra Nakić Radoš, Vice-Chair of Riseup-PPD and Guidelines Development Group Co-Leader

Impact and policy

On 7 November 2023 the Guidelines were launched at a dedicated event at the European Parliament with Make Mothers Matter hosted by MEP Maria Noichl with the input of MEP Radka Maxová. The event included a call to action for all policymakers and the wider European community by Riseup-PPD to make maternal mental health a priority, make mental health care accessible to all women, and to develop new policies for peripartum depression that incorporate the Riseup-PPD Guidelines.

"We need a 'Care Deal' for Europe at the same level of the 'Green Deal'. This goes beyond caring for older persons and we should have more vision around the birth time. These Guidelines must be a clear position in the 'Care Deal' and we should always have this in our focus." Maria Noichl, Member of the European Parliament

"I think now is the right time to promote this topic to the mandate of the new European Parliament. Maternal mental health should be, it must be, the number one priority." Radka Maxova, Member of the European Parliament