POSTPARTUM SCREEN EPDS

Please correct the errors described below.

Name:

Phone:

Address:

Your Date of Birth:

Baby's Date of Birth:

As you are pregnant or have recently had a baby, we would like to know how you are feeling. Please check the answer that comes closest to how you have felt IN THE PAST 7 DAYS, not just how you feel today.

1. I have been able to laugh and see the funny side of things

As much as I always could Not quite so much now Definitely not so much now Not at all

6. Things have been getting on top of me:

Yes, most of the time I havent been able to cope at all Yes, sometimes I havent been coping as well as usual No, most of the time I have copied quite well No, I have been coping as well as ever

2. I have looked forward with enjoyment to things:

As much as I ever did Rather less than I used to Definitely less than I used to Hardly at all

7. I have been so unhappy that I have had difficulty sleeping:

Yes, most of the time Yes, sometimes Not very often No, not at all

3. I have blamed myself unnecessarily when things went wrong:

Yes, most of the time Yes, some of the time Not very often No, never

8. I have felt sad or miserable:

Yes, most of the time Yes, quite often Not very often No, not at all

4. I have been anxious or worried for no good reason:

No, not at all Hardly ever Yes, sometimes Yes, very often

9. I have been so unhappy that I have been crying:

Yes, most of the time Yes, quite often Only occasionally No, never

5. I have felt scared or panicky for no very good reason:

Yes, quite a lot Yes, sometimes No, not much No, not at all

10. The thought of harming myself has occurred to me:

Yes, quite often Sometimes Hardly ever Never

For Office Use Only

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Date:

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