Degree Name

DrPH (Doctor of Public Health)


Public Health

Date of Award


Committee Chair or Co-Chairs

Amal Khoury

Committee Members

Michael Smith, Deborah Slawson



Postpartum depression (PPD) is a major public health challenge and associated with poor maternal and infant health outcomes. Quality prenatal care decreases adverse outcomes in pregnancy and may reduce PPD risk factors. This study critically reviews the evidence about the role of prenatal care practices in reducing PPD prevalence across population groups and examines the association between prenatal care timing and counseling content with PPD prevalence.


A scoping review was completed across eight databases to synthesize evidence about prenatal care and PPD across different contextual settings. National data from the Pregnancy Risk Assessment Monitoring System (PRAMS) was used to examine the research questions. The key outcome was PPD symptoms as self-reported by postpartum women. Key independent variables were timing and content of prenatal care. Bivariate analyses used chi-square and t-tests, as appropriate, and a logistic regression analysis examined associations at the multivariable level while accounting sociodemographic characteristics, history of depression, and interaction effects. An issue brief was developed, triangulating findings from the scoping review and quantitative analysis.


Forty-five studies were analyzed as a part of the scoping review and identified a strong association between robust prenatal care that included education about depression and increased awareness of PPD prevention among pregnant women. In the PRAMS analysis, women with a history of depression (aOR: 2.87; 95% CI: 2.74, 2.99) and those who initiated prenatal care in the third trimester or had no prenatal care (aOR: 1.54; 95% CI: 1.21, 1.85) had higher odds of PPD. Women who were not asked about depression during prenatal care had higher odds of PPD (aOR: 1.26; 95% CI: 1.21, 1.32). Women who were Asian, Black, and asked less than five questions on health-related topics during prenatal care were more likely to report PPD symptoms.


Blending education and counseling into routine prenatal care for pregnant women will increase awareness of depression, thereby preventing PPD. Prenatal care should, therefore, be accompanied by evidence-based systems for counseling, education, diagnosing, treatment, and referral of perinatal depression. To optimize the health of women, prenatal care should provide services and support tailored to each woman's needs.

Document Type

Dissertation - embargo


Copyright by the authors.

Available for download on Sunday, June 15, 2025