# Counselling to prevent perinatal depression Intervention · id `maternal:perinatal-depression-prevention-counselling` · Maternal & Newborn Atlas · release `c7fb95f1d15a7d13` (public) > General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here. The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations. Browse, life stage: Pregnancy; Postpartum Browse, care area: Mental health ## In plain language Talk-based support, such as cognitive behavioral therapy or interpersonal therapy, offered to pregnant and postpartum people who are at higher risk of developing depression, with the aim of preventing it. In 2019 the US Preventive Services Task Force recommended that clinicians provide or refer people at increased risk to this kind of counselling. ## Technical summary USPSTF 2019 (B recommendation): provide or refer pregnant and postpartum persons at increased risk to counselling interventions; convincing evidence that cognitive behavioral and interpersonal therapy are effective in preventing perinatal depression; harms bounded as no greater than small; moderate certainty of moderate net benefit; inadequate evidence for non-counselling interventions (see the claim on this page). One randomised trial of a group intervention based on interpersonal therapy in 205 pregnant women on public assistance found depression rates of 16% against 31% at 6 months (see the second claim). NIMH separately names cognitive behavioral and interpersonal therapy as evidence-based therapies for treating perinatal depression; this page is about prevention. The USPSTF guideline record is linked through the claim; it links to the shared USPSTF record in core. The recipient is the pregnant or postpartum person. ## Claims, with the population each applies to ## Context: Pregnant women aged 18 or older on public assistance and at risk of postpartum depression Recipient: Maternal; Population: 205 pregnant women aged 18 years or older, on public assistance and at risk for postpartum depression (mean age 23; 38% Hispanic and 23% Black), randomized to a group intervention based on interpersonal therapy (n=104) or a treatment-as-usual programme (n=101).; Care setting: Not stated in the abstract.; Geography: Not stated in the abstract.; Life stage: Pregnancy, with the depression rate assessed 6 months postpartum; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Depression rate at 6 months (abstract). ### In a randomized controlled trial of 205 pregnant women aged 18 or older who were on public assistance and at risk for postpartum depression, a group intervention based on the principles of interpersonal therapy (n=104) was compared with a treatment-as-usual programme (n=101). At 6 months the overall depression rate was 16% in the intervention group and 31% in the control group, a difference the authors report as statistically significant at p<0.05. - Category: Effect - Evidence stage: Interventional - Certainty: Certainty not assessed - Applies to: Recipient: Maternal; Population: 205 pregnant women aged 18 years or older, on public assistance and at risk for postpartum depression (mean age 23; 38% Hispanic and 23% Black), randomized to a group intervention based on interpersonal therapy (n=104) or a treatment-as-usual programme (n=101).; Care setting: Not stated in the abstract.; Geography: Not stated in the abstract.; Life stage: Pregnancy, with the depression rate assessed 6 months postpartum; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Depression rate at 6 months (abstract). - Limitations: Only the PubMed abstract was read. The authors note it is unknown whether the findings generalize to a more heterogeneous sample of women, such as women from a range of socio-economic and cultural backgrounds, or marital status, and that the amount of contact differed between the treatment-as-usual and intervention conditions. The abstract names no country or setting and gives no confidence interval. This is one trial of one programme and not a statement about counselling in general. - Last checked: 2026-10-14 - Sources: 1. Supports: Randomized controlled trial to prevent postpartum depression in mothers on public assistance (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, METHODS, sentence 1. Retrieved 2026-10-14T18:18:21Z. Source state: Current. Snapshot hash: 8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7. How it applies: Trial design and participants. 2. Supports: Randomized controlled trial to prevent postpartum depression in mothers on public assistance (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, METHODS, sentence 2, fragment 1 of 2. Retrieved 2026-10-14T18:18:21Z. Source state: Current. Snapshot hash: 8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7. How it applies: Participant details and group sizes, part 1. 3. Supports: Randomized controlled trial to prevent postpartum depression in mothers on public assistance (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, METHODS, sentence 2, fragment 2 of 2. Retrieved 2026-10-14T18:18:21Z. Source state: Current. Snapshot hash: 8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7. How it applies: Group sizes, part 2. 4. Supports: Randomized controlled trial to prevent postpartum depression in mothers on public assistance (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 1, fragment 1 of 2. Retrieved 2026-10-14T18:18:21Z. Source state: Current. Snapshot hash: 8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7. How it applies: Depression rates at 6 months. 5. Supports: Randomized controlled trial to prevent postpartum depression in mothers on public assistance (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, RESULTS, sentence 1, fragment 2 of 2. Retrieved 2026-10-14T18:18:21Z. Source state: Current. Snapshot hash: 8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7. How it applies: Statistical significance. 6. Background: Randomized controlled trial to prevent postpartum depression in mothers on public assistance (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, LIMITATIONS, sentence 1, fragment 1 of 2. Retrieved 2026-10-14T18:18:21Z. Source state: Current. Snapshot hash: 8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7. How it applies: Authors' generalisability limit. 7. Background: Randomized controlled trial to prevent postpartum depression in mothers on public assistance (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, LIMITATIONS, sentence 1, fragment 2 of 2. Retrieved 2026-10-14T18:18:21Z. Source state: Current. Snapshot hash: 8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7. How it applies: Authors' generalisability limit, continued. 8. Background: Randomized controlled trial to prevent postpartum depression in mothers on public assistance (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, LIMITATIONS, sentence 2. Retrieved 2026-10-14T18:18:21Z. Source state: Current. Snapshot hash: 8d1fcb3b487bc8408159aee2a004088cd08448cfbd7a7178cda02beb7ce4d2f7. How it applies: Authors' note on contact. ## Context: Pregnant and postpartum persons at increased risk of perinatal depression (USPSTF, 2019) Recipient: Maternal; Population: Pregnant and postpartum persons who are at increased risk of perinatal depression. The USPSTF says women with a history of depression, current depressive symptoms, or certain socioeconomic risk factors (for example low income, or young or single parenthood) could be considered at increased risk.; Care setting: Clinical care in which clinicians can provide or refer to counselling. The abstract names no setting.; Geography: United States (USPSTF recommendation statement); Life stage: Pregnancy and postpartum; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (recommendation context) ### In 2019 the US Preventive Services Task Force recommended that clinicians provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counselling interventions (B recommendation). It found convincing evidence that counselling such as cognitive behavioral therapy and interpersonal therapy is effective in preventing perinatal depression, bounded the potential harms of counselling as no greater than small, and concluded with moderate certainty that referral of people at increased risk has a moderate net benefit. It found inadequate evidence on the benefits and harms of other, non-counselling interventions. - Category: Recommendation - Evidence stage: Guidance - Certainty: Certainty not assessed - Applies to: Recipient: Maternal; Population: Pregnant and postpartum persons who are at increased risk of perinatal depression. The USPSTF says women with a history of depression, current depressive symptoms, or certain socioeconomic risk factors (for example low income, or young or single parenthood) could be considered at increased risk.; Care setting: Clinical care in which clinicians can provide or refer to counselling. The abstract names no setting.; Geography: United States (USPSTF recommendation statement); Life stage: Pregnancy and postpartum; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (recommendation context) - Limitations: Only the PubMed abstract of the JAMA statement was read, not the full statement or its evidence review. The USPSTF letter grade and its certainty wording are the Task Force's own and are not a GRADE rating, so the certainty field is left not assessed. The recommendation is about preventing depression in people at increased risk; it is not a recommendation about treatment, and it is not advice for any individual. The abstract names no programme or number of sessions. - Last checked: 2026-10-14 - Sources: 1. Supports: Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSIONS AND RECOMMENDATION, sentence 1. Retrieved 2026-10-14T18:18:31Z. Source state: Current. Snapshot hash: c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3. How it applies: The recommendation. 2. Supports: Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, CONCLUSIONS AND RECOMMENDATION, sentence 2. Retrieved 2026-10-14T18:18:31Z. Source state: Current. Snapshot hash: c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3. How it applies: The grade. 3. Supports: Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, FINDINGS, sentence 1. Retrieved 2026-10-14T18:18:31Z. Source state: Current. Snapshot hash: c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3. How it applies: Evidence on counselling. 4. Supports: Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, FINDINGS, sentence 2, fragment 1 of 2. Retrieved 2026-10-14T18:18:31Z. Source state: Current. Snapshot hash: c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3. How it applies: Who could be considered at increased risk, part 1. 5. Supports: Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, FINDINGS, sentence 2, fragment 2 of 2. Retrieved 2026-10-14T18:18:31Z. Source state: Current. Snapshot hash: c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3. How it applies: Who could be considered at increased risk, part 2. 6. Supports: Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, FINDINGS, sentence 3, fragment 1 of 2. Retrieved 2026-10-14T18:18:31Z. Source state: Current. Snapshot hash: c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3. How it applies: Harms bounded as no greater than small, part 1. 7. Supports: Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, FINDINGS, sentence 3, fragment 2 of 2. Retrieved 2026-10-14T18:18:31Z. Source state: Current. Snapshot hash: c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3. How it applies: Harms bounded as no greater than small, part 2. 8. Supports: Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, FINDINGS, sentence 5, fragment 1 of 2. Retrieved 2026-10-14T18:18:31Z. Source state: Current. Snapshot hash: c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3. How it applies: Certainty and net benefit, part 1. 9. Supports: Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, FINDINGS, sentence 5, fragment 2 of 2. Retrieved 2026-10-14T18:18:31Z. Source state: Current. Snapshot hash: c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3. How it applies: Certainty and net benefit, part 2. 10. Supports: Interventions to Prevent Perinatal Depression: US Preventive Services Task Force Recommendation Statement (Publication, edition PubMed record (abstract and bibliographic data) from NCBI E-utilities. The full text and the version of record were not fetched.) Locator: Abstract, FINDINGS, sentence 4. Retrieved 2026-10-14T18:18:31Z. Source state: Current. Snapshot hash: c7a737a54883711a0300ea526238b7e344c82df6f883be6ed2b8a7f7f8356fa3. How it applies: Other interventions: inadequate evidence. ## Guidance, authorization and access ### Recommendation `maternal:rec-uspstf-2019-counselling-referral` - Intervention: Counselling to prevent perinatal depression (`maternal:perinatal-depression-prevention-counselling`) - Direction: Recommended - Issued by: U.S. Preventive Services Task Force (`core:uspstf`) - Guideline record: USPSTF 2019: interventions to prevent perinatal depression (`maternal:guideline-uspstf-2019-perinatal-depression`) - Guideline: Perinatal Depression: Preventive Interventions (USPSTF final recommendation statement page), edition Final recommendation statement page as fetched on 2026-10-14 (mx-uspstf-perinatal-depression-preventive-interventions.html). The date under the title is February 12, 2019.; snapshot `maternal:uspstf-perinatal-depression-2019-2026-10-14` - Jurisdictions: United States; note: United States (the issuer is a United States task force). - Strength: B recommendation (USPSTF letter grades: A, B, C and D recommendations, and the I statement for when the evidence is insufficient to recommend for or against. The grade reflects the Task Force's certainty about net benefit. These are not GRADE strength labels.) - Effective: 2019-02-12 (The date under the title of the USPSTF final recommendation statement page, February 12, 2019. The statement was also published in JAMA, which has its own issue date.) - Supersession: Not checked - Applies to: Recipient: Maternal; Population: Pregnant and postpartum persons who are at increased risk of perinatal depression. The USPSTF says women with a history of depression, current depressive symptoms, or certain socioeconomic risk factors (for example low income, or young or single parenthood) could be considered at increased risk.; Care setting: Clinical care in which clinicians can provide or refer to counselling. The abstract names no setting.; Geography: United States (USPSTF recommendation statement); Life stage: Pregnancy and postpartum; Gestational age: Not reported; Postnatal age: Not reported; Follow-up: Not applicable (recommendation context) - Basis: claim `maternal:claim-uspstf-2019-counselling-referral` ## Connected pages - USPSTF 2019: provide or refer people at increased risk to counselling (B): Perinatal depression (mother) (`maternal:perinatal-depression`) [a claim, not a settled fact; see claim `maternal:claim-uspstf-2019-counselling-referral` and its context] - Trial of a group interpersonal-therapy based intervention: depression 16% against 31% at 6 months: Perinatal depression (mother) (`maternal:perinatal-depression`) [a claim, not a settled fact; see claim `maternal:claim-ipt-group-intervention-ppd-prevention-public-assistance` and its context] - The US Preventive Services Task Force: U.S. Preventive Services Task Force (`core:uspstf`) - Filed under this front: Mental health and support (`maternal:front-mental-health-and-support`) ## Provenance Content hash: 2dd88782d10451597d1b9be40f49f57d52a48eb53d2a1ba0d2b5bc8f2f898dff Last substantive edit: 2026-10-14 Evidence last checked: 2026-10-14