EPDS Calculator - Edinburgh Postnatal Depression Scale
The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item validated questionnaire used to screen for depression during pregnancy and after birth. Answer each question based on how you have felt over the past 7 days. Your total score (0-30) and risk category appear instantly, along with a step-by-step breakdown of each item and guidance on when to seek further support.
What is the Edinburgh Postnatal Depression Scale?
The Edinburgh Postnatal Depression Scale (EPDS) is a 10-item self-report questionnaire developed by J.L. Cox, J.M. Holden, and R. Sagovsky and first published in the British Journal of Psychiatry in 1987. It was created specifically to screen for depression in new mothers, but subsequent research has validated its use throughout pregnancy (antenatal screening) and in fathers and partners as well. Each question asks about feelings and experiences over the past 7 days, and the total score ranges from 0 to 30. The EPDS does not make a diagnosis - it identifies individuals who may benefit from further clinical evaluation.
How the EPDS is scored
The 10 questions are not all scored in the same direction. Questions 1, 2, and 4 use straightforward scoring: the most positive response scores 0 and the most negative scores 3. Questions 3, 5, 6, 7, 8, 9, and 10 are reverse-scored: the worst-sounding response scores 3 regardless of where it appears in the list. This design prevents respondents from mechanically selecting the top or bottom option for every item. The item scores are simply added together to give a total from 0 to 30. A score of 13 or above is the original threshold at which a probable depressive illness is indicated and a full clinical assessment is required. A score of 10-12 falls in a borderline zone where further assessment is recommended. Any score above 0 on question 10 (thoughts of self-harm) requires immediate clinical follow-up regardless of the total.
Anxiety subscale and when to use it
Questions 3, 4, and 5 together form an anxiety subscale that has been validated in research settings. A combined score of 6 or above on these three items is associated with clinically significant anxiety symptoms that warrant separate clinical attention. Perinatal anxiety is common - it can occur alongside depression or on its own - and it is easy to miss when looking only at the total score. Discussing a high anxiety subscale result with your clinician is worthwhile even if the overall EPDS total is below the depression threshold.
Who should complete the EPDS and when
National guidelines in the UK, Australia, Canada, and many other countries recommend offering the EPDS at booking or in early pregnancy, again at around 28-32 weeks, and then at 6-8 weeks and around 3-4 months postpartum. The scale has also been validated for use with fathers and partners, who face their own elevated risk of perinatal depression. It takes approximately 5 minutes to complete. Because it screens the past 7 days, results can change quickly: if symptoms are worsening or a score is borderline, retesting after 2-4 weeks alongside a full clinical review is appropriate. A single score should never be the sole basis for diagnostic or treatment decisions.
EPDS score interpretation
| Total Score | Category | Recommended Action |
|---|---|---|
| 0-9 | Low likelihood of depression | Monitor and reassess if symptoms persist |
| 10-12 | Possible depression (borderline) | Clinical assessment recommended promptly |
| 13-30 | Probable depression | Urgent clinical evaluation and treatment planning |
| Any Q10 > 0 | Self-harm ideation flagged | Immediate clinical follow-up required |
| Q3+Q4+Q5 >= 6 | Significant anxiety | Discuss anxiety symptoms with clinician |
Thresholds from Cox, Holden & Sagovsky (1987) and subsequent validation studies. Clinical judgment is always required alongside the score.
Frequently asked questions
What score on the EPDS means I have postnatal depression?
No score on its own diagnoses postnatal depression. The EPDS is a screening tool, not a diagnostic test. A score of 13 or above indicates a probable depressive illness requiring a full clinical assessment by a qualified healthcare professional. A score of 10-12 falls in a borderline range where further evaluation is also recommended. Your GP, midwife, or health visitor will use clinical judgment alongside your EPDS result to determine whether a diagnosis applies.
Is the EPDS used only after birth?
No. Although the "postnatal" name reflects its original development, the EPDS has been extensively validated for use during pregnancy (antenatal screening) and is recommended at multiple time points including early pregnancy, the third trimester, and several weeks after birth. Many clinicians also use it with fathers and partners.
Why does question 10 have a special warning?
Question 10 asks about thoughts of self-harm. Even a score of 1 on this single item (indicating the thought has occurred "hardly ever") requires immediate clinical follow-up regardless of the total EPDS score. This is because any self-harm ideation during the perinatal period is a serious safety concern. If you answered anything other than "Never" on question 10, please contact your healthcare provider, a crisis helpline, or emergency services today.
Can a low EPDS score mean I am definitely not depressed?
No. The EPDS has good sensitivity but it is not perfect. A score below 10 makes depression less likely but does not rule it out. Clinicians are advised to trust their clinical judgment: if they suspect depression despite a low score, further evaluation is still warranted. If you feel you are not coping, speak with your healthcare provider regardless of your score.
What treatment options are available for perinatal depression?
Perinatal depression is treatable. Options include psychotherapy (such as cognitive behavioral therapy and interpersonal therapy), peer support programs, and medication such as certain antidepressants that are considered safe in pregnancy and breastfeeding. Your clinician will discuss which approach or combination is appropriate for your situation. Early treatment leads to better outcomes for both parent and baby.
How is the EPDS different from the PHQ-9?
Both are validated depression screening questionnaires, but the EPDS was specifically designed for the perinatal period. It avoids somatic items (like fatigue and sleep changes) that are nearly universal in new parents and that would inflate PHQ-9 scores falsely. The EPDS is therefore considered more specific and appropriate for screening during pregnancy and after birth.
Sources
- Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression: development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry. 1987;150(6):782-786.
- National Institute for Health and Care Excellence (NICE). Antenatal and postnatal mental health: clinical management and service guidance. Clinical guideline CG192. 2014 (updated 2020).