Postpartum depression screening happens once at the 6-week OB visit then disappears from the medical system entirely

The standard U.S. postpartum care model includes a single Edinburgh Postnatal Depression Scale (EPDS) screening at the 6-week postpartum OB visit, but postpartum depression and anxiety can onset anytime in the first 12 months, and after that single screening, there is no systematic follow-up pathway in either OB or pediatric care. So what? Mothers who screen negative at 6 weeks but develop symptoms at 3, 6, or 9 months postpartum fall through a gap between OB care (which has effectively ended) and primary care (which may not screen for postpartum-specific conditions). So what? Pediatricians see the mother at every well-child visit but only 50% of states have policies supporting maternal screening in pediatric settings, and most pediatricians lack billing codes to treat the mother. So what? Untreated postpartum depression directly impairs infant bonding, breastfeeding continuation, and responsive caregiving during the most neurologically critical developmental window. So what? Children of mothers with untreated postpartum depression show measurable cognitive and emotional developmental delays by age 3. So what? A single missed screening window creates a cascade of preventable harm across two generations, yet the healthcare system structurally assigns the mother's mental health to a provider she stops seeing at 6 weeks and excludes the provider she sees monthly. The structural root cause is that postpartum care is siloed between OB (mother's provider, engagement ends at 6 weeks), pediatrics (child's provider, sees mother regularly but cannot bill for her care), and mental health (requires separate referral, long wait times, and often does not accept insurance), with no coordinating entity or shared medical record.