Postpartum Depression: The Timing and Tailoring of Inpatient Maternal Mental Health Counseling on a Postnatal Unit as Filmed Prior to Hospital Discharge [ID 1216]

INTRODUCTION: Postpartum depression (PPD) interferes with activities of daily life due to intense symptoms of anxiety, hopelessness, and sadness. Postpartum depression affects approximately 15% of birthing parents and is one of the leading contributors to maternal mortality. Quality of hospital discharge education influences the birthing parent’s preparedness for identifying symptoms and accessing services. However, past studies have yet to identify specific strengths and areas for improvement in inpatient postpartum communication. This analysis evaluates mental health-related counseling as filmed within postnatal unit rooms prior to childbirth hospital discharge. METHODS: After University of North Carolina IRB approval, 15 video and audio recordings of English-speaking (n=9) and Spanish-speaking (n=6) postpartum families and their health care team members were collected on the postnatal unit of a southeastern U.S. medical center. The recordings in the 12 hours before hospital discharge were evaluated. This analysis addresses patient–clinician communication related to maternal mental health. RESULTS: There were instances in which clinicians normalized PPD and clarified expected symptoms. However, there were missed opportunities in addressing some patients’ past mental health challenges with PPD, anxiety, or depression. Thresholds for mental health follow-up and warning signs were oftentimes unclear. Counseling did not always occur in patients’ preferred language. Further, the information was not always tailored. CONCLUSIONS/IMPLICATIONS: The results provide insight into opportunities to increase quality inpatient postpartum care through more meaningful health care service delivery. These findings will guide future interventions in the inpatient care setting to improve maternal mental health outcomes and better support women and all birthing people during the vulnerable postpartum period.