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Transparent weighted points for common postpartum distress risk factors: mood history (+3), anxiety, support, relationship strain, stressors, birth complications, NICU, severe sleep, feeding distress, finances, thyroid, and young first-time parenthood. Safety questions for self-harm or infant harm thoughts come first. This is not the Edinburgh scale (EPDS), not PHQ-9, not a diagnosis—use it to prepare for conversations with clinicians or Postpartum Support International.
Last updated: June 5, 2026
Thoughts of hurting yourself or your baby require immediate help—call or text 988 (U.S.), 911, or go to an emergency department. You deserve support; postpartum crises are treatable.
Safety questions — answer honestly
Stressors and history (past 12 months)
Moderate checklist burden (educational)
5 pts
Several stressors or risk factors are present. Many new parents in this range benefit from earlier—not later—conversation with a clinician or therapist, peer support, sleep and feeding help, and concrete social support.
Postpartum Support International offers support lines and directories in many countries (postpartum.net). This tool cannot replace therapy, medication evaluation, or emergency services.
Lower burden
0 pts
No factors selected
Moderate (default example)
5 pts
Prior depression + low support
Moderate (multi-factor)
8 pts
Anxiety + stress + sleep + complications
Higher burden
11 pts
Prior mood + anxiety + support + partner + NICU
Educational weights reflecting common perinatal mental health teaching—not validated against EPDS cutoffs.
| Factor | Points | Why included |
|---|---|---|
| Prior depression or bipolar disorder | +3 | Strongest population predictor of perinatal mood recurrence |
| Significant anxiety during pregnancy or now | +2 | Antenatal anxiety often precedes postpartum depression |
| Low practical or emotional support from others | +2 | Isolation and low support correlate with worse outcomes |
| Major strain with partner or co-parent | +2 | Relationship conflict is a common perinatal stressor |
| Major stressors (loss, move, job loss, violence exposure) | +2 | Cumulative stress raises vulnerability |
| Pregnancy or birth complications | +2 | Traumatic or complicated birth linked to mood symptoms |
| Infant NICU stay or rehospitalization | +2 | NICU parents have elevated depression/anxiety rates |
| Severe sleep difficulty beyond typical newborn waking | +2 | Sleep loss amplifies mood and anxiety symptoms |
| Breastfeeding problems causing strong distress | +1 | Feeding distress prompts earlier lactation + mental health support |
| Financial hardship or food insecurity | +1 | Socioeconomic stress is a modifiable risk context |
| Thyroid disease or postpartum thyroid symptoms | +1 | Postpartum thyroiditis can mimic depression |
| First-time parent under age 22 | +1 | Younger first-time parents may have fewer resources |
| Points | Band | Suggested action |
|---|---|---|
| 0–4 | Lower checklist burden | Does not rule out depression—seek care if symptoms worsen; keep routine postpartum visits |
| 5–10 | Moderate checklist burden | Earlier clinician or therapist contact, peer support, sleep/feeding help, concrete social support |
| 11+ | Higher checklist burden | Prioritize obstetric, primary care, or mental health evaluation soon (may include EPDS/PHQ-9 and safety planning) |
| Safety “yes” | Crisis | Emergency services immediately—988 (U.S.), 911, or local crisis line; no numeric score |
| Aspect | This checklist | EPDS |
|---|---|---|
| Purpose | Educational risk-factor burden checklist | Validated 10-item depression symptom screen |
| Scoring | Weighted yes/no factors (max ~20 pts) | 0–30 with established cutoffs (often ≥10–13) |
| Safety | Explicit self-harm / infant harm questions → crisis | Item 10 asks about self-harm—clinician follow-up required |
| Use | Self-reflection and conversation prep | Clinical and research screening with licensed wording |
| Condition | Timing | Key features | Action |
|---|---|---|---|
| Baby blues | Days 2–14 postpartum | Mood swings, tearfulness, irritability | Usually self-limited; rest and support; watch if persists |
| Postpartum depression | Can start anytime first year | Depressed mood, anhedonia, guilt, sleep/appetite change, impaired function | Therapy and/or medication; do not wait to “tough it out” |
| Postpartum anxiety | Often overlaps with depression | Panic, intrusive thoughts, hypervigilance, insomnia | CBT, medication, reassurance with safety assessment if intrusive thoughts |
| Postpartum psychosis | Usually first 2–4 weeks | Delusions, hallucinations, confusion, rapid deterioration | Emergency—psychiatric hospitalization; rare but life-threatening |
Prior depression or bipolar disorder (+3) plus low social support (+2), all safety questions “no”:
Interpretation: not a diagnosis, but a reasonable prompt to contact your obstetric or primary care clinician early for mood screening—even before symptoms peak. Many postpartum programs offer proactive outreach for this risk profile.
Any “yes” bypasses scoring and shows crisis resources. Intrusive harm thoughts without intent still deserve urgent clinician assessment—especially in the first weeks postpartum.
Isolation, partner conflict, grief, moves, job loss, and food insecurity are modifiable contexts—social work, doulas, peer groups, and family planning can reduce burden alongside therapy.
Complicated birth, infant hospitalization, pathological sleep loss, and thyroid dysfunction are educational flags to discuss with clinicians—not standalone explanations for every mood change.
| Sign | Urgency |
|---|---|
| Thoughts of self-harm or harming baby | Emergency now (988, 911, ED) |
| Cannot care for self or infant safely | Same-day emergency or crisis line |
| Symptoms >2 weeks with worsening function | Schedule clinician within days |
| Panic, intrusive thoughts, or inability to sleep at all | Urgent visit—even if checklist score is low |
| Partner notices personality change you do not see | Trust their concern; seek evaluation |
| Resource | Detail |
|---|---|
| 988 Suicide & Crisis Lifeline (U.S.) | Call or text 988—24/7 |
| 911 (U.S.) | Medical or psychiatric emergencies |
| Postpartum Support International | postpartum.net—support line directory, online groups, provider lists |
| Emergency department | Go in person if you feel unsafe or cannot wait |
| Option | Note |
|---|---|
| Psychotherapy (CBT, IPT) | First-line for many mild–moderate perinatal mood disorders |
| Medication (SSRIs, etc.) | Risk/benefit discussion with prescriber—several are used in pregnancy/lactation |
| Peer support / PSI groups | Reduces isolation; complements clinical care |
| Practical help | Sleep shifts, feeding support, childcare, financial counseling |
| Thyroid labs | If fatigue, palpitations, or thyroid history—rule out postpartum thyroiditis |
This postpartum depression risk calculator is a self-reflection checklist—not the Edinburgh Postnatal Depression Scale, not a licensed clinical screen, and not a substitute for emergency or outpatient mental health care. ACOG recommends perinatal depression screening at least once; use this page to understand risk context and when to escalate.
Suggested hashtags: #Postpartum #MaternalMentalHealth #PPD #Perinatal