Understanding the Edinburgh Postnatal Depression Scale: Beyond the Score

You’ve just completed an Edinburgh Postnatal Depression Scale (EPDS) screening. The client’s score is higher than expected, and the air in the room changes. Her eyes drop. Maybe she says, “I’m fine,” but you can feel she’s not.

What happens next defines whether this tool becomes a lifeline or a missed opportunity.

The EPDS is one of the most widely used postpartum depression screeners in the world—validated in over 20 languages, recommended by the World Health Organization, and trusted by countless clinicians and doulas. Yet, too often, it’s treated like a form to complete rather than a conversation to begin.

Every circle on that page represents an emotion someone has been carrying—sometimes silently for weeks. The magic of the EPDS isn’t in the number. It’s in what you do with the story that number tells.

See the Person, Not the Paper

A score of 10 or higher suggests symptoms of postpartum depression or anxiety, but scores as low as 5 can still reflect deep exhaustion, guilt, or emotional overload. In other words, a “low score” doesn’t always mean “no concern.”

The CDC reports that one in eight women experiences symptoms of postpartum depression. Among Black and Hispanic mothers, those rates may be as high as one in five—yet many never receive treatment because symptoms are minimized or missed altogether.

When you approach screening as a partnership instead of a protocol, you create safety. Try asking:

• “What part of this felt hardest to answer?”

• “How did you feel as you were filling it out?”

• “Is there anything you wish more people understood about what you’re feeling right now?”

Those questions turn a clinical moment into a connection point. You’re not collecting data; you’re opening dialogue.

What Gets Missed When It’s Done Wrong

When screenings are rushed or done mechanically, parents often shut down. Common missteps include:

• Focusing on the score instead of the story. A high score triggers panic instead of empathy, and the parent walks away feeling labeled, not helped.

• Failing to explain the “why.” When families don’t understand what the EPDS is for, they downplay symptoms to “pass” the test.

• Handing off cold referrals. A list of phone numbers isn’t connection. Without follow-up, most families never make that call.
  
  
  

The result? Missed warning signs, delayed care, and in some tragic cases—avoidable crises. The CDC’s 2023 Maternal Mortality Review found that mental health conditions are the leading underlying cause of pregnancy-related deaths in the U.S., accounting for nearly 23% of all cases. That means your approach to one simple screening could literally save a life.

“The magic of the EPDS isn’t in the number. It’s in what you do with the story that number tells.”

Turning a Score Into a Plan

After a positive screen, take a breath before responding. Look up, not down at the paper. Then say something like:

“Thank you for being honest with me. This score doesn’t define you—it helps us know where to give you more support.”

When clients feel seen instead of assessed, they are far more likely to accept help.
Follow with a warm handoff, not a cold one. Try:

“Would you like me to sit with you while we make the call together?”
or
“I know a counselor who works specifically with new moms—can I connect you directly?”

That small gesture keeps a parent from slipping through the cracks. Compassion is the bridge between screening and recovery.

Your Confidence Starts With Training

Before you screen another parent, ask yourself:

• Do I know what each score range means and when to refer?

• Am I confident in explaining results without causing fear?

• Do I have local and national referral resources ready?
  
  
  

If you hesitated on any of those, that’s exactly what our new training covers.

🎓 Course Highlight: Understanding the EPDS: Beyond the Score
Inside this course, you’ll learn:

• How to interpret each section of the EPDS with cultural sensitivity

• Trauma-informed phrasing that keeps families calm and engaged

• Documentation and referral best practices that protect both the client and the professional

• Real-world scenarios and scripts you can use right away

You’ll walk away ready to screen with confidence—and respond with skill.

What phrase helps you open sensitive conversations after screening?
Share your experience or tag @a.v_innovations on Instagram. Your words might help another provider save a life.