The edinburgh postnatal depression score is a 10 question checklist that screens for mood problems during pregnancy and after birth.
Feeling low, anxious, or unlike yourself in late pregnancy or after delivery is far more common than most people realise. The edinburgh postnatal depression score gives a quick snapshot of how the past week has felt and helps your midwife, doctor, or nurse decide whether you may need extra care.
This guide walks through how the scale works, how to read your score, and what steps to take next. It does not replace medical care, but it can make the conversation with a health professional clearer and a little less scary.
What Is The Edinburgh Postnatal Depression Score?
The edinburgh postnatal depression score comes from a questionnaire formally known as the Edinburgh Postnatal Depression Scale, first published in the late 1980s. It was created to help spot postnatal depression early, and it is now used across many countries in maternity, health visiting, and primary care services.
The scale has ten questions about mood, enjoyment, sleep, worry, and thoughts over the last seven days. Each answer is scored from 0 to 3. When the numbers are added, the total sits between 0 and 30, with higher scores linked to stronger symptoms of low mood and anxiety.
Health services often pair the scale with routine visits in pregnancy and after birth. The American College of Obstetricians and Gynecologists recommends regular screening for perinatal depression and anxiety, and the EPDS is one of the most commonly used tools in that guidance.
Because the questionnaire is short, many clinics use it in busy waiting rooms or through online forms before an appointment. Most people can complete it in less than five minutes.
| Score Range | Possible Meaning | Typical Next Step |
|---|---|---|
| 0–3 | Few or no mood symptoms in the past week | Routine check at the next visit |
| 4–6 | Mild ups and downs, still coping day to day | Mention feelings at the next appointment |
| 7–9 | Clear distress that may affect sleep or enjoyment | Talk with a midwife, nurse, or doctor soon |
| 10–12 | Symptoms that often line up with mild depression | Repeat the scale and review with a health professional |
| 13–14 | Higher chance of postnatal depression | Full assessment and a clear care plan |
| 15–19 | Strong symptoms that may limit daily life | Prompt review, likely need for treatment |
| 20–30 | Severe symptoms, often urgent risk | Same day mental health review and safety check |
Different health systems set different cutoffs, often between 10 and 13, based on local research and resources. Large reviews of many studies suggest that a threshold around 11 or 13 balances picking up most people who need help while avoiding too many false alarms.
If you are unsure how your clinic scores the scale, ask the person who gave you the questionnaire to explain how they use it and what happens next.
Edinburgh Postnatal Depression Scale Score Range And Cutoffs
Understanding where your score sits on the 0 to 30 scale makes the numbers feel less abstract. One research group linked EPDS bands to four levels of depression severity: 0 to 6 as none or minimal, 7 to 13 as mild, 14 to 19 as moderate, and 19 to 30 as severe. Other groups use 0 to 9, 10 to 12, and 13 or more as broad categories of low, possible, and probable depression.
The spread in cutoffs appears because studies from different countries, languages, and clinic types do not all land on the same best number. Some studies find that a cutoff of 10 gives a good balance, others favour 11, and many services still use 13 or more as the point where a full assessment is strongly advised.
The main point is that the edinburgh postnatal depression score is a starting guide, not a final label. A lower score does not guarantee that everything is fine, and a higher score does not mean you have failed in any way. It simply flags that you may benefit from a longer talk and, at times, from treatment.
Health professionals also pay close attention to item 10, which asks about thoughts of self harm. Any answer other than the lowest option calls for an urgent, caring response, even if the total score is not high.
How To Complete The Edinburgh Postnatal Depression Score
Many parents rush through forms because there is a crying baby nearby, a toddler needs a snack, or the waiting room feels busy. Slowing down for a few minutes when you fill in the scale can make the result far more accurate.
Each question asks how you have felt in the past seven days, not how you think you should feel. Try to think about an average day rather than a single peak or low point. If English is not your first language, ask whether a trusted translated version is available, as several have been tested in different countries.
Be as honest as you can, even with questions that feel uncomfortable, such as reduced enjoyment, crying, or thoughts of self harm. Many parents worry that writing these things down will lead to blame or judgement. In reality, staff use the answers to offer more care, not less.
You can also keep a copy of your answers. Seeing how your edinburgh postnatal depression score moves over time can help you and your clinician see whether things are getting better, worse, or staying much the same.
How The Edinburgh Postnatal Depression Score Fits Into Routine Care
The scale fits best as one part of normal antenatal and postnatal appointments. Many maternity services now screen during pregnancy and again at several points after birth, following guidance such as the ACOG perinatal mental health screening guidance. That approach helps reduce the number of parents who slip through the net.
A common pattern is to give the questionnaire at a late pregnancy visit, then again at the six week and three month postnatal checks. Some services repeat it later in the first year, as depression can start months after birth.
The score then feeds into a wider conversation. Your clinician may ask more detail about sleep, appetite, worry, feelings about the baby, and any past history of depression or other mental health problems. They will also want to know about practical stresses such as housing, money, and relationship strain, which can all weigh heavily on mood after birth.
From there, you and your clinician can agree on next steps, which might range from simple watchful waiting and follow up, through to talking therapy, medication, or a mix of options.
Second Trimester, Third Trimester, And Postnatal Use Of The Scale
Although the word postnatal sits in the name, the scale also works during pregnancy. Studies in many countries show that the same questions pick up depression and anxiety before birth as well as after, though some clinics adjust cutoffs slightly.
In the second trimester, the questionnaire can flag mood changes that arrive early, long before the baby is born. In the third trimester, repeated use can show whether feelings are settling or rising, which helps staff plan closer follow up around delivery.
After birth, the first few weeks bring broken sleep, body changes, and a huge shift in daily routine. The scale helps separate short term “baby blues”, which usually peak around day four or five and ease within two weeks, from longer lasting depression that needs treatment.
For parents with a history of depression or bipolar disorder, regular scoring can act like a warning light on a dashboard. Sudden jumps in the score, or any new thoughts of self harm, should trigger a same day review.
Strengths And Limits Of The Edinburgh Postnatal Depression Score
The scale has several clear strengths. It is short, free to use, and easy to understand. It has been tested in many languages and settings, from busy city hospitals to rural clinics.
Studies show that the questions pick up a large share of parents with depression when used with cutoffs around 11 or 13. At the same time, no simple score can capture every person who is suffering, and some people with low scores still feel low enough to need help.
Another limit is that the questionnaire relies on self report. Some parents downplay their feelings because they fear judgement or worry that raising concerns might lead to child protection involvement. Others may overstate distress on a very bad day and then feel different a week later.
For these reasons, guidelines stress that the edinburgh postnatal depression score should not replace a full clinical assessment. The best care blends the score, your own story, clinical judgement, and, when needed, input from partners or close relatives who know you well.
Using The Edinburgh Postnatal Depression Score Alongside Other Resources
The score is only one piece of the puzzle. Many parents also find it helpful to read trusted information about postnatal depression and anxiety. National organisations and perinatal mental health charities publish clear guides on symptoms, treatment choices, and where to get help.
Online tools, such as the Edinburgh Postnatal Depression Scale calculator, can help you see how different sets of answers would score. Used alongside clinical advice, these tools can make the numbers feel less mysterious and turn them into something practical you can act on.
| Score And Situation | What A Clinician May Do | What You Can Do Next |
|---|---|---|
| Score 5 at six week check, no self harm thoughts | Offer reassurance, give information, and repeat scale later | Watch mood, use rest and practical help from others |
| Score 11 in late pregnancy, trouble sleeping | Ask about history, offer follow up and talking therapy | Keep a mood diary and attend planned appointments |
| Score 14 two months after birth, tearful most days | Arrange full assessment and go through treatment options | Share feelings with trusted people and accept help |
| Score 18 at any time, no self harm thoughts | Arrange urgent mental health review and close follow up | Stay in close touch with the clinic and follow the plan |
| Any score with self harm thoughts on item 10 | Carry out immediate safety check and crisis plan | Seek emergency help through local services or hotlines |
Practical Tips If Your Score Is High
A high score can feel frightening, especially if you pride yourself on coping well. Try to see it as information rather than a verdict. The number is telling you that the last week has been tough and that you deserve more care, not less.
First, share the result with a health professional you trust, such as a midwife, obstetrician, family doctor, or health visitor. Bring a copy of your answers or keep a photo of the page on your phone so you can talk through each item.
Next, ask about options that fit your life. These might include talking therapy, peer groups run by trained staff, medication, or a mix of these. Good care plans also look at sleep, nutrition, exercise, and ways to reduce daily pressure where possible.
If you ever have thoughts of harming yourself or your baby, treat this as an emergency. Contact local emergency services, a crisis line, or the nearest emergency department straight away. You are not being dramatic; these thoughts are a sign that you need fast, caring help.
By understanding your edinburgh postnatal depression score and using it as a starting point for open conversation, you give yourself and your baby a better chance of a steadier, kinder postnatal period. You are not alone in finding this time hard, and asking for extra care is a sign of strength, not weakness.