Why Moms Lie on the EPDS (And Why It's Not Really Lying)
If you've been pregnant or had a baby in the last decade, you've probably seen the Edinburgh Postnatal Depression Scale. It's usually a single sheet of paper handed to you at a prenatal appointment or your six-week postpartum checkup. It has 10 questions with 4 answer choices each and usually takes about 3 minutes to complete.
It's also one of the most commonly faked questionnaires in medicine.
Not because moms are dishonest people! But because the whole setup makes honesty really hard.
What the EPDS Is Actually For
The Edinburgh Postnatal Depression Scale was developed in the 1980s to give doctors a fast, standardized way to flag women who might be struggling with postpartum depression. For that narrow purpose, it's genuinely useful. It's been studied extensively, it's free to use, and it's far better than nothing.
The problem is that "flag someone who might need help" and "understand how a mom is actually doing" are two very different goals. The EPDS does the first one reasonably well. It does the second one poorly, and most of the time, it isn't even administered in a way that gives it a chance.
The Reasons Moms Don't Answer Honestly
The fear of losing the baby is the most common one, and it rarely gets said out loud. If a mom checks the wrong box, she worries (sometimes rightly, often not) that a provider will see it as a reason to question her ability to parent. Nobody tells her this is going to happen. But the fear is there, especially for moms who are already in stressful situations at home or who have had any involvement with child protective services in the past.
Then there's the timing. The EPDS is usually given at the six-week postpartum visit, which is often the first time a new mom has left the house alone. She's in a doctor's office, possibly still bleeding, definitely not sleeping. She has maybe twelve minutes with her provider. Answering "I have been so unhappy that I have been crying" honestly to someone she barely knows, in a room that doesn't feel private, is a different ask than filling out a form quietly at home.
The questions themselves also create problems. The EPDS leans heavily on depressive symptoms like sadness, crying, and inability to enjoy things. But postpartum anxiety is actually more common than postpartum depression, and the two often look different.
A mom who is running on adrenaline, convinced something terrible is about to happen to her baby, who hasn't cried in three weeks because she's too wired to cry, may read through the EPDS and not recognize herself at all.
She scores fine. She goes home. Nobody notices.
Irritability and rage are largely missing, too. A mom who snaps at her partner twelve times a day, who feels a sudden, terrifying flash of anger when the baby won't latch, who cries from pure frustration rather than sadness, isn’t reflected on the EPDS.
Neither is perfectionism, nor hypervigilance, nor the kind of numbness that feels more like going through the motions than like sadness.
And finally, the snapshot problem. The EPDS captures one moment in time. Postpartum mental health doesn't work that way. The six-week mark is actually a relatively stable point for some women. The acute hormone crash has leveled out a bit, and the adrenaline of early survival mode is still running. A mom who scores fine at six weeks can be in real trouble at three months, when support disappears, and the newness wears off, and the sleep debt keeps accumulating.
Nobody checks again.
What Happens When a Mom Is Missed
When a screening tool misses someone because she answered the way she thought she was supposed to, or because her symptoms didn't fit the questions, or because she happened to have a good week, she doesn't get connected to care she might need.
Her provider closes the chart. She goes home to figure it out.
For some women, things get better on their own. For others, the window where early support would have made a real difference quietly closes.
This isn't a criticism of providers who use the EPDS.
Most of them are working in a system that gives them very little time and very few tools. The EPDS is what exists, so they use it. That makes sense. It's a criticism of a system that built a brief one-time screening tool and then treated the problem as solved.
What Would Actually Help
Consistent, low-stakes check-ins over time are more useful than a single high-stakes questionnaire at an appointment. Not every check-in has to be clinical. Asking "how are you actually doing this week" in a way that feels like someone genuinely wants to know, not a liability checkbox, opens a different kind of door than a paper form does.
The other thing that matters is removing the fear. Moms answer more honestly when they believe the person asking is on their side and trust that disclosing a hard feeling will bring support rather than consequences. That trust takes more than one form and one appointment to build.
That's honestly a big part of why VeedaMom exists. To sit in the space where clinical screening doesn't reach, with the daily, ongoing, low-stakes question of how a mom is really doing, asked consistently over time, in a format where she doesn't have to worry about what her answer will set in motion.
Most moms don't need someone to hand them a piece of paper and score it. They need someone to ask, and to keep asking, and to actually listen to what comes back.
FAQ
What is the EPDS, and when is it used?
The Edinburgh Postnatal Depression Scale is a ten-question screening tool used by healthcare providers to identify women who may be experiencing postpartum depression. It's typically administered at prenatal appointments and at the six-week postpartum checkup. Research shows it can be successfully used at many different types of checkup, starting within pregnancy and extending to well-child visits.
Is the EPDS accurate?
It's a useful screening tool for identifying likely cases of postpartum depression, but it has real limitations. It doesn't screen well for postpartum anxiety, rage, or numbness, and it captures a single point in time rather than tracking how a mom is doing over the weeks and months after birth.
Why do moms answer the EPDS dishonestly?
Most moms who underreport on the EPDS aren't deliberately lying. Fear of judgment, fear of child protective involvement, feeling rushed at the appointment, and simply not recognizing their own symptoms in the questions are all common reasons women don't answer fully honestly.
What does the EPDS miss?
The EPDS is primarily built to catch depressive symptoms. It's less effective at identifying postpartum anxiety, hypervigilance, irritability, rage, and the kind of emotional numbness or "going through the motions" that many moms experience.
What should I do if I think I'm struggling but scored fine on the EPDS?
Trust what you're feeling over what a score says. The EPDS is a starting point, not a verdict. If something feels off, it's worth naming it to your provider, someone you trust, or to a resource like the National Maternal Mental Health Hotline at 1-833-852-6262.