Published online January 2, 2007
PEDIATRICS Vol. 119 No. 1 January 2007, pp. 123-128 (doi:10.1542/10.1542/peds.2006-2122)
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SPECIAL ARTICLE

Legal and Ethical Considerations: Risks and Benefits of Postpartum Depression Screening at Well-Child Visits

Linda H. Chaudron, MD, MSa,b,c, Peter G. Szilagyi, MD, MPHb, Amy T. Campbell, JD, MBEd,e, Kyle O. Mounts, MDf,g and Thomas K. McInerny, MDb

a Departments of Psychiatry
b Pediatrics
c Obstetrics and Gynecology
d Division of Medical Humanities, University of Rochester School of Medicine and Dentistry, Rochester, New York
e Regional Early Childhood Direction Center, Rochester, New York
f Newborn Care Physicians of SE Wisconsin, Milwaukee, Wisconsin
g Department of Pediatrics, University of Wisconsin-Madison, Madison, Wisconsin

Pediatric professionals are being asked to provide an increasing array of services during well-child visits, including screening for psychosocial and family issues that may directly or indirectly affect their pediatric patients. One such service is routine screening for postpartum depression at pediatric visits. Postpartum depression is an example of a parental condition that can have serious negative effects for the child. Because it is a maternal condition, it raises a host of ethical and legal questions about the boundaries of pediatric care and the pediatric provider's responsibility and liability. In this article we discuss the ethical and legal considerations of, and outline the risks of screening or not screening for, postpartum depression at pediatric visits. We make recommendations for pediatric provider education and for the roles of national professional organizations in guiding the process of defining the boundaries of pediatric care.

Key Words: postpartum depression • screening tools • well-child care

Abbreviations: AAP—American Academy of Pediatrics • USPSTF—US Preventive Services Task Forces

Accepted Sep 25, 2006.


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