Early Postnatal Follow-up Conducted by Midwives from the Hérault Maternal and Child Health (PMI) Program: Data from a Departmental Study on Postpartum Depression Screening in 2024

Introduction – The early postnatal interview (EPNP) became mandatory in France in 2022 to identify the early signs of postpartum depression (PPD) or risk factors for it, and to assess the potential needs of the woman or her partner. The objective of our study was to explore data from the EPNP conducted by midwives from the Maternal and Child Health (PMI) program in the Hérault department in 2024 to determine whether the practice effectively addressed the key challenges of prevention, identification, and assessment of support needs as outlined in the Public Health Code.Methods – Any adult patient who had given birth to a live infant weighing at least 500 grams or at least 22 weeks’ gestation, seen in a clinic or during a home visit by abetween the 4th and 8th weeks postpartum as part of the EPNP, during the period from April 1, 2024, to September 30, 2024, within the Hérault department, was eligible. The 24 PMI midwives trained in the EPNP used a standardized interview guide. Screening for postpartum depression (PPD) was conducted using the Edinburgh Postnatal Depression Scale (EPDS).Results – In 2024, over a 6-month period, 277 EPNPs were conducted by PMI midwives in the Hérault department: 14 patients refused to participate in the study; 263 EPNPs were included. Most of the postpartum interviews were conducted in the patients’ homes. The pregnancy was perceived as difficult in 40% of cases (95% confidence interval, 95% CI: [34.5–46.9]), and childbirth in 31% of cases [25.3–37.0], with nearly 15% [10.8–20.0] of patients experiencing childbirth as traumatic. Nearly a quarter of the mothers found returning home difficult. Although the majority reported feeling supported upon returning home (80%), safe (89%), and surrounded by loved ones (57%), fatigue was frequently reported (73%), as were isolation (39%) and anxiety (33%). More than 94% of the postpartum care visits resulted in PPD screening using the EPDS. Nearly 3 in 10 women (29.8% [24.3–36.0]) showed moderate to severe signs of postpartum depression (EPDS ≥ 10), and 1 in 6 women (16.1% [11.9–21.4]) were severely symptomatic (EPDS ≥ 13).Discussion – Our study reveals that the EPNP is well accepted by patients and that it allows for the collection of important data on women’s health status in the weeks following childbirth, thereby meeting the main objectives set forth in the law. The estimated prevalence of PPD based on the EPDS administered during the EPNP between the 4th and 8th weeks postpartum confirms the results observed in the 2021 National Perinatal Survey. Taken together, our results demonstrate the clear value of incorporating the EPNP into the perinatal care pathway, provided it is conducted by trained professionals equipped with appropriate and validated tools, and supported by a network to refer patients.

Author(s): Fèvre Gilson Sylvain, Lauze Laetitia, Rougier Liza, Garo Alice

Publishing year: 2025

Pages: 255-267

Weekly Epidemiological Bulletin, 2025, n° 14, p. 255-267

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