The Edinburgh Postnatal Depression Scale (EPDS) is the clinical reference standard obstetric and midwifery teams use to screen for postpartum depression — understanding what it actually measures makes any self-reflection tool, including ours, easier to interpret honestly.
Where the EPDS Came From
The EPDS was developed and validated by Cox, Holden, and Sagovsky in 1987, published in the British Journal of Psychiatry. It is a 10-item questionnaire designed specifically for the postpartum period, covering domains such as anhedonia, guilt, anxiety, and — notably — thoughts of self-harm, since general depression scales were not built with the specific postpartum context in mind.
Why a Dedicated Self-Harm Item Exists
One of the EPDS's ten items screens directly for thoughts of self-harm. This is not incidental. A 2013 study that screened 10,000 postpartum women found that among the 14.0% with a positive depression screen, 19.3% also reported thoughts of self-harm — which is why a dedicated, sensitively worded item is a standard convention in postpartum screening rather than an optional extra.
Professional bodies take this seriously at a policy level: the American College of Obstetricians and Gynecologists recommends every patient be screened at least once during the perinatal period with a standardized, validated tool.
What a Screening Tool Can and Cannot Tell You
A screening score, whether from the EPDS in a clinical setting or from a self-reflection tool online, is not a diagnosis. It flags a pattern worth a closer look. Only a licensed clinician, usually through a structured conversation, can diagnose postpartum depression and rule out related conditions.
Our Approach
Our Postpartum Mood Check-In uses original questions grounded in the same clinical domains the EPDS was built around — anhedonia, guilt, anxiety, sleep disturbance, and self-harm ideation among them — without reproducing the EPDS's own wording. It is designed as a starting point for self-reflection, not a substitute for the validated clinical instrument or a professional evaluation.